High risk babies in Paediatric populations

High risk babies

1. High risk babies By Tanui

2. High risk neonate is defined as a new born, regardless of gestational age or birth weight, who has a greater-than- average chances of morbidity or mortality, usually because of conditions or circumstances superimposed on High risk periods begins at the time of viability( the gestational age at which survival outside the Introduction

3. Uterus is believed to be possible, or as early as 23 weeks of gestation) up to 28 days after birth and includes threats to life and health that occur during the pre natal, perinatal and post natal periods. High risk infants are more classified according to birth weight, gestational age and predominant pathophysiologic problems.

4. If children are to grow into healthy, confident and well-adjusted adults, with the skills necessary to navigate life’s complexities, they must have parents or carers who are able to meet their physical, emotional and cognitive needs from birth. For those infants whose parents are unable to meet their protective and care needs, child protection services must intervene, as early as possible, to moderate the impact of harmful living conditions and poor parenting practices (Campbell & Jackson 2002). Such infants are referred to as High Risk Infants (HRIs), that is, infants who, due to the presence of a number of risk factors, are at significantly greater risk of harm.

5. According to size e.g. low birth weight, less than 2500g or very low birth weight less than 1500g. According to gestational age e.g. preterm born before the completion of 37 weeks. According to mortality e.g. death that occurs 28 days to one year after birth. Classification of high risk infants

6. There is no single profile for a HRI or a high-risk family. Harm to an infant will most often be the result of the interplay between multiple risk factors related to the parent, the child and the social context in which the parent-child relationship exists. Risk factors in high-risk infant cases

7. Age of the parent: It has been proposed that young parents (those under 20 years of age) are more likely to abuse or neglect their infants. This higher risk may be the result of young or teenage parents: having unrealistic expectations of their parenting role and their child’s needs and behaviors being isolated and lacking family and community supports Parental risk factors

8. lacking confidence and self-esteem having lower incomes and a less healthy lifestyle, including substance abuse forming unwise relationships that result in violence suffering from depression.

9. Previous child protection history: Parents who have a previous history of abusing or neglecting a child or removal of a child are more likely to abuse subsequent children (Jackson et al 1999).

10. Substance abuse: Children are at a much higher risk of harm during infancy when one or more of their parents misuses alcohol or drugs. Research from the United Sates has proposed that children will be between 4 and 16 times more likely to experience harm when their parents misuse substances . In addition to the negative impact of alcohol and drugs on the parents’ capacity to provide constant care and supervision, substance misuse is also often exacerbated by a number of concurrent risk factors including:

11. poverty young age poor pre-natal care and nutrition domestic violence homelessness unemployment poor physical health mental illness stress low self-esteem poor parenting skills incarceration or criminal activity low educational status

12. Domestic violence: Research has clearly demonstrated that an infant will be at higher risk when his or her mother is a victim of domestic violence. The increased risk, it has been suggested, is due to the likelihood that the mother may suffer significant injury and emotional and psychological trauma and her resulting inability to meet the infant’s care needs or to comfort them during the violent incidents.

13. Childhood experience of abuse: Parents who had a history of childhood abuse were more likely to be substantiated as person responsible for abuse. This greater risk may have been the result of poor parenting models and reduced parenting capabilities.

14. Mental illness: Research found that caregivers who had a history of depression, post-natal depression, anxiety, delusional thoughts or attempted suicides were more likely to be substantiated for abuse. Disability: Parents with an intellectual disability may be at greater risk of harming their infants.

15. Stress or insult : interfere with the development of embryo i.e. nutritional deficiency. Infection during pregnancy: some virus may be transmitted through placenta thus affecting the development of the fetus i.e. rubella and syphilis. Drugs during pregnancy i.e . anti malaria and cocaine Intrauterine factors

16. Auto accidents or falls that may cause dislodgment of placenta resulting to insufficiency of food and oxygen to the fetal. Bleeding during pregnancy due to instability of the placenta that may cause prematurity and cp. Lack of oxygen during and soon after birth caused by entangled umbilical cord .

17. Nutrition Emotional deprivation Infections for instance measles. Assignment . What is kernicterus ? Explain how it can cause cerebral palsy. Post natal factors