Socioeconomic-The more premature an infant is at birth, the greater the cost to care for the infant both on the family and on the healthcare system, as these infants require longer hospital stays and more extensive testing, medications and procedures. (Bowers, 2013, p. 29) Quite often the parents or other caregivers are forced to resort to becoming full-time caregivers and leave gainful employment. This places additional stress and financial burden on the families of these ELBW babies. Maternal stress is likely to increase as the mother may feel a sense of failure having given birth to an ELBW infant, leading to higher risk of postpartum depression and additional stress on the whole family.
Ongoing care- Need for ongoing early intervention services throughout childhood also contributes to the cost of raising a child born ELBW. Prematurity and low birth weight also increases the risk of readmission early in life, raising the overall cost to the family and increasing risks of hospital-acquired infections. Payment for routine and specialized care may be a challenge if the parent who carries insurance coverage for the child is unable to work and therefore loses employer-based health coverage.
Comorbidities-ELBW babies are at increased risk of fetal and neonatal death as well as long-term complications in adulthood like obesity, hypertension, diabetes and impaired fertility. (Bowers, 2013, p. 30) Short -term risks in ELBW infants include difficulties regulating temperature and blood sugar, risk for infection, renal failure and bleeding disorders. Many infants later demonstrate delays in motor development, speech delays and hearing impairment.
Ethnic and cultural disparities related to low birth weight babies- According to Bowers (2013), Non-Hispanic Black women are more likely to have a premature/LBW baby than a Non-Hispanic White woman, and while risk factors may include social stress, ethnicity alone, infection, inflammation, and genetic factors, the one factor most indicative of preterm delivery of a LBW infant is a previous preterm delivery.
One segment of our text pointed out that some cultures or ethnicities have varying views on infant death or death at any age, so the approach to care may differ greatly in those cultures and not have a direct association with the economic status of the family or culture or resources available to care for the ELBW infant. (Bowers, 2013, p. 29)
Support service from my community & Link and its effectiveness-
“WIC promotes the birth of healthy infants by preventing low birth weight, the leading cause of infant death and disability. The program provides prescribed supplemental foods, nutrition education and counseling, and referral to health care and other needed services for persons at nutritional risk. Eligibility includes: pregnant and nursing women and infants and children up to age 5.” (“Maternal and child health services | Schenectady County,” 2019)
Effectiveness– I chose to highlight the WIC program because it aims at prevention. A big part of addressing ELBW means looking at prenatal factors that may contribute to the risk of a low birth weight infant. Pregnant women are provided with appropriate nutrition through payment vouchers, while meeting with peer counselors and staff to learn about proper nutrition, prenatal care, breastfeeding preparation and many other services. Once a mother delivers her baby, the support continues through supplemental nutrition for the mother and child, help purchasing formula or breastfeeding support including breast pumps and peer counseling. The WIC program may be effective at reducing the risk of ELBW babies if the cause of low birth weight was related to the availability of proper nutrition for the mother while pregnant, or due to the lack of proper regular prenatal care. Once an ELBW infant is born, WIC may be effective at assisting the family already facing financial challenges with obtaining proper nutrition for the infant (then child up to age 5) as needed to ensure adequate growth and development.
Bowers, B. (2013). Prenatal, intrapartal, and postpartal risk factors. In C. Kenner & J. Lott (Eds.), Comprehensive neonatal nursing care (5th ed., pp. 28-30). Retrieved from https://ebookcentral-proquest-com.lopes.idm.oclc.org
Maternal and child health services | Schenectady County. (2019). Retrieved from https://www.schenectadycounty.com/node/413