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1. ________IUGR - initial evaluation
2. IUGR - postnatal considerations,   energy
3. IUGR - polycythaemia
4. IUGR
   What is asymmetrical IUGR?
5. IUGR - postnatal considerations, temperature
6. IUGR - problems at birth

• These babies may have experienced compromised placental blood flow and chronic hypoxia and have a lack of fat and glycogen stores which means they are more vulnerable to fetal distress during labour. Appropriately trained staff amy be required to attend the birth
• Temperature control - exaggerated increased surface area to volume ratio which means they can get cold very quickly. Low fat stores further impair ability to conserve heat. Ensure infant is adequately dried and dressed after birth. May require further support via overhead heater
• Babies with IUGR have very little fat and few glycogen stores, therefore more likely to become hypoglycaemic and require early feeding. Consider pre feed BSL monitoring APP
• Asymmetrical IUGR is used when the head circumference is preserved by the diversion of blood to the organs that need it the most. Most often associated with poor placental function. Likely to catch up as they grow
• Plot head circumference and weight on growth chart, assess for underlying fetal causes of IUGR as well as the clinical severity of their growth restriction i.e. fat stores
• IURG secondary to chronic (or even mild) hypoxia will result in an increase in red blood cell production and therefore more likely to have polycythaemia. If baby looks plethoric, their haematocrit should be measured