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NICU guideline identifier

Weighing babies in NICU

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Weight on Admission to NICU

All infants are to be weighed during their admission to NICU, with the exception of infants who are less than 24 hours of age and have had their weight obtained in NWH theatre or NWH delivery suite.

All infants who are more than 24 hours old or who have been born and/or transferred from outlying delivery units must have a new weight taken on admission to NICU.

Level 3 Infants

  • Level 3 infants should be weighed from day 5 and then on an alternate day basis unless medically indicated. Infants requiring HFOV or chest drains should not be routinely weighed.
  • Infants who are receiving conventional IPPV or are unstable require two nurses to weigh when using either standard or giraffe scales. 
  • To obtain an accurate weight for an infant that requires IPPV, the baby should be weighed with a neopuff attached to their ET tube for both the transfer and weigh. This prevents ventilator tube from dragging (resulting in an inaccurate weight), whilst maintaining respiratory support. It is not appropriate to remove the baby completely from respiratory support while weighing.

Weighing infants in the Giraffe Omni Hood incubators

See Giraffe Omni Hood Scales information below

  • Infants nursed in the Giraffe Omni Hood Incubators can be weighed using the built in scale feature. 
  • Ensure the bed is level, press the scale icon on the display and follow prompts- refer to Giraffe Omni Hood Scales information below for further instructions.
  • For ventilated infants, disconnect ventilator tubing and place on the bed. Attach Neopuff to ET tube when lifting infant (aprox 8 seconds) - reattach ventilator tubing once infant is placed back onto the bed. This reduces drag on the tubing which can interfere with an accurate weight. 
  • For infants on CPAP, remove interface and place on bed. If the infant is stable and can tolerate brief periods without CPAP, proceed without a neopuff otherwise the infant will need to be supported via neopuff during the lift and replace commands. Once weight is obtained, the CPAP can be reinstated.

Level 2 Infants

  • Infants are weighed from day 3 unless requested earlier by medical staff.
  • To be weighed twice weekly on Sundays and Wednesdays unless a specific order for alternate day or daily weighs is initiated after discussion on ward round

Discharge weight

A discharge weight is required for all infants who have spent more than 24 hours in NICU (including infants that are discharged back to the postnatal ward).  The discharge weight is recorded by the registrar/NS-ANP in the discharge letter.

Additional considerations

  • Involve parents in weighing their infant. The weight can be performed when they are providing cares. 
  • Ensure that the infant is well contained and swaddled during the weighing process to avoid them becoming disorganised and limit heat loss.
  • Please ensure that all attachments left on the infant during weighing i.e. leads, gastric tubes or iv lines are subtracted from the total weight to maintain accuracy.
  • A nursing weight chart is not required unless there are concerns over weight gain/weight loss for any baby. 

Giraffe Omni Hood Scales - how to weigh a baby in the Giraffe Omni Hood incubator

  • Make sure the bed tilt platform is completely level
  • Prepare the bed for weighing- do not leave any items leaning against the side bed panels, secure all leads and tubing. Tuck blankets under the mattress but not under the weighing platform.
  • Place the patient in the centre of the bed
  • If side panels are down, press Air Boost to increase air flow in the compartment
  • Touch Scale on the Home screen
  • Follow instructions- you will be prompted by the display and a tone to Zero the scale by lifting the baby
  • Lift the baby and any tubing or leads attached to the baby. Make sure that arms, legs, blankets and clothing are clear of the mattress
  • Hold the baby until the tone and prompt indicate you should replace the baby
  • Place the baby back down on the mattress while holding up any leads or tubes attached to the patient. NB: The scale weighs any object on the platform, so if you replace the patient without holding up leads and tubes, the weight of the leads and tubes will be included with the baby's weight.
  • The scale calculates the baby's weight and displays it
  • Push the Reweigh button within 5 minutes if the previous weight is in doubt. NB: the most likely cause for using reweigh is failure to keep the leads and tubing clear of the mattress when placing the baby back on the mattress.
  • If desired, touch I Weigh to show the weight in a parent friendly display
  • Touch the X to exit the display and return to the scale screen
  • Touch the X to return to the home screen

Trending Weights

  • Weights can be shown over a period of time. A total of 14 weights can be stored.
  • To show weight trends, touch Scale on the home screen
  • Select Graph to plot a series of weights on a graph
  • The axis automatically adjusts to the nearest 10g threshold base
  • Touch the data point for a desired weight to see the exact data
  • Touch Previous or Next to move through the data points

Removing a weight from the graph

  • Touch the data point for a desired weight to see the exact data
  • Touch Remove

References

  1. Tyer, N., Srinivasan, R., Evans, K., Ward, L., Cheung, W-Y. & Matthew, J. Impact of an early weighing policy on neonatal hypernatraemic dehydaration and breastfeeding. Archives of Disease in Childhood 2008. 93, 297-299.
  2. Leven, L. & Macdonald, P. Reducing the incidence of neonatal hypernataemic dehydration. Archives of Disease in Childhood 2008. 93, 811.

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Document Control

  • Date last published: 09 October 2018
  • Document type: Clinical Guideline
  • Services responsible: Neonatology
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years