Wednesday, January 24, 2018

Medical, nutritional, and dental considerations in children with low birth weight.

Department of Pediatric Dentistry
Lutheran Medical Center

Resident’s Name: Albert Yamoah, DDS                                                                               Date: 01/24/2018
Article Title: Medical, nutritional, and dental considerations in children with low birth weight.
Author(s): O'Connell S1, O'Connell A, O'Mullane E, Hoey H.
Journal: Pediatric Dentistry
Date: 2009
Major Topic: Summarize medical terminology and issues related to fetal growth, morbidity associated with being born low birth weight, premature, or small for gestational age, and the importance of appropriate nutrition in such infants
Type of Article:
Literature review and expert opinion
Key Points/Summary:
·       Estimates show that between 8% and 26% of infants are born with low birth weight (LBW)
·       These children are at risk for medical problems and often have poor oral health
·       Evidence now indicates that the postnatal period is a critical time when nutrition may predispose the child to lifelong metabolic disturbance and obesity

·       Term” is a 5-week period from 37 to 42 weeks gestation 
·       Broad range of normal birth weight depending on the precise gestational age.
·       There is also an influence of gender on LBW
o    It has been shown that at term birth, boys are heavier than girls.
o    Studies of dizygotic twins have demonstrated that female twins have longer gestation than that of male twins.

·       Many LBW infants may be sub-optimally managed
o    Lack of consensus on optimum infant nutrition for LBW/premature/small-for-gestational-age (SGA) infants
o    This may result in rapid postnatal weight gain and ongoing health problems
·       Early, integrated medical and dental care should be encouraged for all children with LBW

·       SGA and LBW children have been identified as an at-risk group for a number of problems
·       Problems may be influenced/exacerbated by nutritional practices
·       The pediatric dentist can play an important role in helping parents balance appropriate caloric intake with good oral health
·       Cleaning teeth after each intake of supplemented formula or snacks and avoiding prolonged feeding will help with oral clearance
·       Encouraging water consumption after snacking in older children should help reduce tooth surface contact time
·       Daily use of fluoride can aid with remineralization of hypoplastic tooth defects and prevent demineralization of enamel
·       LBW children are at risk of not catching up in growth, leading to short height
·       Inappropriately rapid catch-up growth and excessive weight gain, however, may be associated with long-term major morbidity, such as obesity and metabolic syndrome
·       SGA children should have length, weight, and head circumference measured every 3 months in the first year and every 6 months thereafter
·       Pediatric dentists should be aware of this special group of children and provide appropriate care
Assessment of Article:  
Level of Evidence/Comments:  Level III

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