Topic 6.

High-Risk Needs of the Newborn

 6.4 High Risk Newborns and their
Families
• Small for gestational age (SGA)
• infants who below the 10% for weight for their age
• Large for gestational age (LGA)
• babies who above 90% in weight
• Premature neonate (preterm)
• Less than 2500g = low birthweight
• 1000-1500 = very low birthweight
• Post term neonate
• Risk for hypoglycemia
• Cracked skin
• Increased difficulty establishing respiration especially if meconium is
present
 High Risk Newborns and their
Families
• AGA – no problems but could still be preterm,
full-term, post-term.

• SGA – IUGR – could still be preterm, full-term,

post-term

• LGA – Could still be preterm, full-term or post-

term.
 High Risk Newborns and their
Families
Respiratory Distress Syndrome
• Expiratory grunting
• In drawing of sternum, zyphoid, intercostals
• Rapid respirations – Tachypnea RR>60
• Preterm- Deficient artificial surfactant
• Diabetic Moms – poor exchange of oxygen and Co2 at
alveoli

• Keep warm, O2, blood gases, IV, NICU

 High Risk Newborns and their
Families
Meconium Aspiration
• Aspirated meconium during labour, birth or at birth.
Meconium in alveoli, impairs gas exchange, O2 levels at
risk.
• Treatment - O2, antibiotics.
• Pneumothorax possible with high ventilation pressures
used
• High Pulmonary resistance – Ductus Arteriosus may
remain open causing cardia insufficiency and hypoxia
 High Risk Newborns and their
Families
Sudden Infant Death Syndrome
• Unknown cause
• Tends to occur more in babies of adolescents
• Peak occurrence 2-4 months of age
• Decrease in occurrence due to preventative measures:
• Sleep on back
• Safe sleeping environment (no loose blankets or toys)
• Smoke free environment
• Avoid overheating
*Breastfeeding and pacifier use may DECREASE the rate
of SIDS
 High Risk Newborns and their
Families
Drug-dependent or Alcohol Exposure infants
• Tend to be SGA
• May demonstrate withdrawal symptoms
• Symptoms usually seen within 24-48 hours of
birth
• Symptoms & treatment dependant on type of
drug mother has taken
 High Risk Newborns

• Communication with parents

• Resources(Community, Doctor, clinics, support groups)
• Support
• Education
• High risk support/organizations/ follow up clinics.
Glenrose Hospital for rehab