Babies may occur with preexisting pregnancy concerns if the mother has a hx of or is currently using alchol,
smoking, drugs and violence. The mother is at greater risk if she is over the age of 35 or younger than 15, low
income and inadequate prenatal care.
Culturally and ethnically the African American mothers are at the greatest risk of low birth weight babies.
Second ethnic group is the Asian community, Third is the American Indians, fourth is tied between the Hispanic
community and the Caucasion communities. Access to healthcare services for pregnant mothers can be
challenging if their is financial concerns, transportation issues and lack of community health clinics. Many of the
health community clinics are not always easy to get to or appointments fill up quickly.
The impact can effect the family financially and mentally both short term and long term. These impacts do not
go away all of a sudden they are there until something changes. If a child is born prematurely they will most
likely require follow up care, medications and treatments, these all require money which impacts the family.
Mentally the stress of having a child who may be sick from being low birth weight can be stressful impacting
the parents negatively as it could cause them to not take care of themselves properly such as getting enough
sleep and eating correctly. (n.d.)
Low birth babies are at greater risk of having further health concerns including one of the following, increased
risk of infections, respiratory/cardiac concerns, digestive concerns, brain and eye concerns. These can or may
impact their health short-term or long-term depending on the diagnosis and if surgery may be required. (n.d.).
Education in the community is very important for us as nurses to continue to perform. Reaching out to the
community and giving them information in regards to the risks of not receiving prenatal care and available
resources available in our local communities. One here in St Louis is called Nurses for Newborns. They
provide nurses that make home visits to the family/newborn which involve an individualized careplan, follow up
with the family and teach them everything involved with their newborns care needs. The company also have
MSW’s which assist the family with financial concerns, medicaid applications, general resources, transportation
concerns to appointments. This company has been very helpful for the community.
low birth weight is the delivery of babies weighing less than 5 pounds, 8 ounce, health issues usually arise
because many low birth babies faces restricted growth which expose the child to birth defects , breathing
problems, jaundice, heart defects, inability to fight, infections , babies failure to thrive. these present enormous
financial, psychological and emotional stress to the family who will be actively seeking medical support to
salvage various issues presented by the child. low birth weight not only create burden to the family but to the
society at large , this includes the economic and social burden of creating the necessary infrastructures within
the community to manage such conditions and to support children who faces health issues due to restricted
growth who requires constant medical attention and special support at all times ( Anura et al. 2018).
However unequal health disparities , low socioeconomic status , demographics , race and ethnicity plays a role
in contributing to low birth weight. taking an African American woman who lives in a poor neighborhood ,
exposed to environmental hazard from a nearby health disposal facility, who lacks financial means to to eat
right and access required medical needs is highly likely to experience birth complications and low birth weight.
Also lack of proper education about pregnancy , monitoring and follow up including during pregnancy to birth.
This include attending antenatal, prenatal and post natal follow ups. also prevalent negative behaviors
including lack of adequate diet , alcohol and substance abuse including indiscriminate use of drugs without
prescription contributes to harmful effect of low birth weight ( National academic press U.S 2007).
young age during pregnancy, pregnancy complications, sickness of the mother, disparities in ethnic and
cultural groups, and maternal stress and drug use (Chou et al., 2020). For instance, in the U.S, AfricanAmerican women have a high probability of extremely low birth weight babies because of cigarette smoking
and high levels of poverty. Caring for children with low birthweight brings more stress to the family members
because of the financial and emotional requirements, which may not be available. Giving birth to preterm
infants may lead to the rise of issues, such as socioeconomic implications, need for ongoing care, short-term
and long-term impacts, and other comorbidities. Preterm babies require specialized care from birth to a specific
year in their growth to monitor all body organs’ functionality and development; however, these hospital services
require vast amounts of money as hospital bills.
Prematurity poses massive health complications, such as brain problems, blood problems, metabolism, and
autism during the early stages of life and may continue into adulthood. In addition, such conditions may result
in long-term issues, such as mental retardation and cerebral palsy. Underdeveloped infants need quality care;
consequently, organizations such as healthy start help both the babies and mothers undergo this difficult
moment in a child’s development (Healthy Start, n.d). The organization addresses the community and
population’s needs towards mitigating the risk factors of preterm births, low birth weight, and infant mortality.
Performing an assessment on a baby includes not only the normal head to toe assessment but also includes
the motor and social skill developments. EBP plays an important role in our assessments of our pediatric
patients and allows us as nurses to make sure the patients are developing correctly. It also allows us to
possibly prevent further development delays and get the child the assistance they need to prevent further
Developmental milestones to look for include the following: Is she able to feed herself with a spoon or feed
herself finger foods? Does she pull up on furniture? Is she crawling without difficulty? Is she able to pick up
toys? Can she drink from a sippy cup? Is she able to transfer her toys from hand to hand? Does she smile in
response to her name or make vocal sounds when spoken too? (Falkner, 2018)
Recommendations: I would educate the mother on proper nutrition including balancing the food groups to
include grains, proteins, fruits and vegetables. Educate the mother on no dairy products until she is 12 months
old with the exception of breastmilk or formula. Educate the mother on sleeping habits of a 9 month old to
include the child sleeping up to 14 hours out of 24 hours. EBP includes these as guidelines to ensure the best
possibilty for the child to develop correctly.
The CDC sets evidence-based guidelines that helps practitioners determine if children are growing and
developing as they should be. These standards, along with those set by the WHO, can aid practitioners in
seeing how all babies 9-months of age compare to other babies around the world that same age who have
spent their first 9-months of life in an optimal environment for growth and development (CDC, n.d.). Although at
the lower end of the chart, it is important to note that all babies grow and develop at different paces, and the
nurse must recognize when this pace necessitates follow-up/intervention. The nurse should ask the parent
questions about the baby’s diet, which may give the nurse an idea if the baby is eating well but just small for
their age, or if there may be more of a problem that may require further inquiry such as food allergies or access
By 9-months, this baby should have specific fine and gross motor skills. According to WebMd (2021), at 9
months, most babies are expert crawlers. They can change positions quickly going from sitting, to crawling,
and pulling themselves up to stand. Some babies are beginning to try to walk by using their grip to walk from
object to object. Some babies are even able to independently walk at this age. In terms of fine motor skills,
babies at 9-months can pick up and hold onto objects and may even be able to stack items.
Babies are also beginning to communicate with others at this age. They may be able to say a few words like
mama or dada or may babble like they are trying to have a conversation with you. If you ask them a question
such as “Where is your doll?” they can point to their doll. They are beginning to recognize emotions and may
do things to elicit a smile. Your baby may start showing signs of separation anxiety, and show signs of
developing their short-term memory, too (WebMD, 2021). Again, if the baby seems to be lacking in her motor
and/or communication skills, follow-up and referral may be warranted.
The presented patient scenario is a case of underdevelopment because the infant is below the recommended
developmental markers. The development markers a nurse should assess for a 9-month-old female infant
include a weight of approximately 8.2 kilograms, approximately 70.1 cm in length, and a head circumference of
about 45 cm. However, in this case, the infant has a height in the 25 percentile, weight in the five percentile,
and head circumference in the 25 percentile of the CDC growth chart (Centers for Disease Control and
Prevention, n.d). Other developmental markers at nine months include crawling, babbling words, such as
‘mama,’ and walking for some babies.