Author: Medonna S. & Prof. Dr. Gaurav Tyagi
Abstract: Low birth weight (LBW) (weight <2500g, irrespective of gestational age) is one of the most important maternal and newborn health issues and is linked to neonatal mortality, infection, hypothermia, feeding difficulties, poor post natal growth and adverse developmental outcomes. With improvements in neonatal care, more of these fragile babies are now surviving, and this has resulted in a huge burden on mothers and families for the continuation of care upon leaving the hospital. That transition relies not only on the knowledge of mothers, but on whether their knowledge is brought home in the form of safe, consistent care. This chapter looks at the gaps in knowledge–practice in the care of LBW and preterm infants and the strategies for improving home-based care, focusing on thermal protection, breastfeeding, Kangaroo Mother Care (KMC), hygiene and infection prevention, danger-sign recognition, growth monitoring, health-care-seeking behaviour, discharge preparation and continuity of professional care. One thing the evidence agrees on is that information alone is seldom enough to lead to lasting behaviour change. The use of structured education combined with demonstration and supervised practice, family involvement, discharge planning, home visits and professional or digital follow-up is much more effective. The chapter discusses the adaptation of mothers to the demands of caring for an LBW infant in the context of Roy's Adaptation Model and a planned home-based maternal intervention in Kollam District, Kerala. Nurses are strategically placed as the cornerstone of care between the hospital and the community, as they provide competency-based education, support breastfeeding, promote KMC, deliver psychosocial care, assess home practices and provide timely referral. The chapter concludes that culturally appropriate, family-centred, nurse-led approaches to home care are clearly effective in enhancing the safety of the hospital-to-home transition and building maternal caring capacity. Future studies should focus on directly observed practice, longer-term outcomes, and family involvement, in addition to short-term knowledge acquisition and feasibility for implementation, and infant health outcomes.
