Low Birth Weight

Low birth weight (LBW) is defined as a birth weight of an infant of less than 2,500 grams (5 pounds 8 ounces).


LBW is either the result of preterm birth (commonly defined as younger than 37 weeks of gestation) or the infant being small for gestational age (a slow prenatal growth rate), or a combination of both.


LBW is closely associated with inhibited growth, poor cognitive development, and chronic diseases or disabilities later in life. LBW is an important predictor of newborn health and survival and is associated with a higher risk of infant and childhood mortality.

Feeding Low Birth Weight Babies

Feeding LBW babies can be challenging. They can easily fall into a cycle of not getting enough to eat, becoming weaker, and as a result becoming even harder to feed. LBW babies are at risk of malnutrition. In addition, LBW babies typically require more calorically dense feedings compared with full terms infants.

Potential Problems:

  • Poor energy for feeding. May fall asleep in the middle of a feeding.
  • Baby is easily upset during feeding.
  • Frequent coughing, gagging, and spitting up during or after feeding.
  • Baby does not take in enough formula at each feeding.

Potential Solutions:

  • Some infants’ oxygen levels become low during feedings, reducing their stamina and causing them to fall asleep. These infants might benefit from supplemental oxygen during feedings. If supplemental oxygen is not available, pace the baby by allowing feeding breaks to maintain adequate oxygen status. Talk to a physician about oxygen needs if this is a concern.
  • The baby might be overwhelmed by too much surrounding activity while feeding, causing her to fall asleep in order to avoid the noise, light, activity, etc. Possible solutions include decreasing exposure to light, noise, and movement while feeding. Feed the baby in a dark, quiet place if at all possible.
  • Provide smaller, more frequent feedings to increase calories consumed. For example, babies can be fed every 2 hours instead of every 3 hours, or can be given a feeding in the middle of the night, even if they usually sleep through the night.
  • Some LBW babies benefit from specialized formula that is concentrated; contact a pediatrician or pediatric dietitian if you feel this may help your child.
  • Some LBW infants associate feeding with traumatic feeding experiences early in their lives. Some infants can move beyond this stage with consistent efforts from caregivers to make feeding a pleasant time. Force feeding will only make the problem worse.
  • The flow of milk from the bottle may be too fast or too slow. A change of bottle nipple type may help with this problem.
  • Work with a pediatric speech therapist that specializes in infant feeding to addresses any concerns.

Learn more about optimal feeding for LBW infants in this publication from the World Health Organization.

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