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MANAGEMENT OF THE SICK YOUNG INFANT AGE 1 WEEK UP TO 2 MONTHS

Name:______________________Age:__________Weight_______________kg. Temperature :______________C


Ask: What are the infant’s problems? __________________________ Infant visit? __________Follow – up Visit?______
ASSESS (Circle all signs present)
CLASSIFY

CHECK FOR POSSIBLE BACTERIAL INFECTION


Has the infant had convulsions:

• Count the breaths in one minute _____ per minute. Repeat if elevated_______. Fast breathing?
• Look chest for severe chest drawing.
• Look for nasal flaring.
• Look and listen for grunting.
• Look and feel bulging fontanelle.
• Look and pus draining from the ear.
• Look at the umbiculus. Is it read or draining pus?
Does the redness extend to the skin?
• Fever temperature (temperature 37.5*C* or above or feels hot)or
low body temperature (below 35.5*C* or feels cool)
• Look for skin pustules. Are there many or severe pustule?
• See if the young infant is abnormally sleepy or difficult to awaken.
• Look at young infant’s movements. Less than normal?

DOES THE YOUNG INFANT HAVE: DIARRHEA? Yes ____No_____


* For how long? _____Days * Look at the young infant’s general conditions. Is the infant:
* Is there blood in the stools? Abnormally sleepy or difficult to awaken
Restless or irritable?
* Look for sunken eyes.
* Pinch the skin of the abdomen. Does it go back:
Very slowly(longer than 2 seconds)
Slowly?

THEN CHECK FOR FEEDING PROBLEM OR LOW WEIGHT


* Is there any difficult feeding? Yes ____No_____. Determine weight for age. Low _______Not Low______
* Is the infant breastfeed? Yes _____No_______
If Yes. How many times in 24 days? ____times
* Does the infant usually receive any other foods or drinks? Yes _____No______
* What do you use to feed the child?

If the infant has any difficulty feeding, is feeding less than 8 times in 24 hours, is taking any foods or drinks, or is low weight
for age AND has no indications to refer urgently to hospital:

ASSESS BREASTFEEDING:
Has the infant breastfeed in the previous hour? * If infant not fed in the previous hour, ask the mother to put her
Infant to the breast. Observe the Breastfeed for 4 minutes.
* Is the infant able to attach? To check attachment, look for:
- Chin touching breast Yes _____No______
- Mouth wide open Yes _____No______
- Lower lip turned outward
- More areola above than below the mouth Yes _____No______
No attachment at all, not well attached, good attachment
* Is the infant sucking effectively(that is, slow deep sucks,
Sometimes pausing)?
Not sucking at all, not sucking effectively, sucking effectively
* Look for ulcers or white patches in the mouth(thrush)

Return
CHECK THE YOUNG INFANT’S IMMUNIZATION STATUS Circle immunizations needed today. for the
next
immunization:

_____ _____ _____ _____ ___________


BCG DPT1 OPV 1 Hep B1 (Date)
Improving Positioning and Attachment

 Teach Correct Positioning and Attachment for Breastfeeding


 Show the mother how to hold her infant
- with the infant’s head and body straight
- facing her breath breast, with infants nose opposite her nipple.
- with infant’s body close to her body
- supporting infant’s whole body, not just neck and shoulders.
 Show her how to help the infant to attach. She should:
- touch her infant’s lips with her nipple
- wait until her infant’s mouth is opening wide
- move her infant quickly onto her breast, aiming the infant’s lower lip below the nipple.
 Look for signs of good attachment and effective suckling. If the attachment or suckling is not good, try
again.

Advise mother to give home care for the young infant

 Advise Mother to Give Home Care for the Young Infant

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 Food

Fluid Breastfeed frequently, as often and for long as the infant wants, day or night
during sickness and Health

 WHEN TO RETURN

Follow – up visit When to Return Immediately:


If the infant has: Return for follow – up in: Advise the mother to return
immediately if the young infant
has any of these signs:
LOCAL
BACTERIAL Breastfeeding or drinking poorly
INFECTION ANY Becomes sicker
FEEDING 2 days Develops a fever
PROBLEM Fast Breathing
THRUSH Difficult Breathing
LOW WEIGHT 14 days Blood in stool
FOR HIS AGE

 MAKE SURE THE YOUNG INFANTS STAYS WARM AT ALL TIMES.


- In the cool weather, cover the infant’s head and feet and dress the infant with extra clothing.
CLASSIFY FEEDING
• Not able to feed or • Give first dose of intramuscular
• Not attachment at all or antibiotics.
• Not sucking at all. NOT ABLE TO FEED • Treat to prevent low blood
POSSIBLE SERIOUS sugar.
• Advise the mother how to kept
BACTERIAL the young infant warm on the
INFECTION way to the hospital
• Refer URGENTLY to hospital
• Not well attached to breast or • Advise the mother to
• Not sucking effectively or breastfeed as often and for as
• Less than 8 breast feeds in 24 FEEDING long as the infant wants, day
and night.
PROBLEM
hours or.
• Receive other foods or drink or - If not well attached or not
suckling effectively, teach


Low weight for age or
Thrush (ulcers or white
OR correct positioning and
patches in mouth) LOW WEIGHT -
attachment.
If breast feeding less than 8
times in 24 hours, advise to
increase frequency of feeding.
• If receiving other foods or
drinks, counsel mother about
breastfeeding more, reducing
other foods or drinks, and
using a cup.
- If not breastfeeding at all:
- Refer for breastfeeding
counseling and possible
relactation.
- Advise about correctly
preparing breastmilk
substitutes and using a cup.
• If thrush, teach the mother to
treat thrust at home.
• Advise mother to give home
care for the young infant.
• Follow – up any feeding
problem thrush in 2 days.
• Follow – up low weight for age
in 14 days.
• Not low weight for age and no • Advice mother to give home
other signs of inadequate care for the young infant.
feeding NO FEEDING • Praise the mother for feeding
the infant well.
PROBLEM
CLASSIFY ALL SICK YOUNG INFANTS FOR
BACTERIAL INFECTION

SIGNS CLASSIFY TREATMENT


AS
• Convulsion or • Give first dose of
• Fast breathing (60 intramuscular
breaths per minute or antibiotics.
more) or • Treat to prevent low
• Severe chest indrawing blood sugar.
or POSSIBLE • Advise mother how to
• Nasal flaring or SERIOUS keep the infant warm
• Grunting or on the way to the
• Bulging fontanelle or BACTERIAL hospital.
• Pus draining from ear INFECTION
or
• Umbilical redness
extending to the skin
or
• Fever (37.5*C* or
above or fees hot) or
low temperature(less
than 35.5* C* or feels
cold) or
• Abnormally sleepy or
difficulty to awaken or
• Less than normal
movement
• Red umbiculus or • Give an appropriate
draining pus or oral antibiotic.
• Skin pustules LOCAL • Treat local infection in
BACTERIAL the health care and
teach the mother to
INFECTION treat local infections
at home.
• Advise mother to give
home care for the
young infant
• Follow – up in 2 days
CLASSIFY DIARRHEA

Two of the following signs: • If infant does not have


• Abnormally sleepy difficulty POSSIBLE SERIOUS
to awaken BACTERIAL INFECTION nor
• Sunken eyes DYSENTRY:
• Skin goes back very slowly. SEVERE DEHYDRATION • Give fluid for severe
dehydration (Plan C).
• If infant also has possible
SERIOUS BACTERIAL
INFECTION or DYSENTRY:
• Refer URGENTLY TO
HOSPITAL with mother
giving frequent sip : of ORS
on the way.
Advise mother to continue
breast feeding.
Two of the Following signs: • Give fluid and food for some
• Restless, irritable dehydration (Plan B).
• Sunken eyes • If infant also has POSSIBLE
SOME SERIOUS BACTERIAL
• Skin pinch goes back slowly
DEHYDRATION INFECTION or DYSENTRY:
• Refer UNGENTLY to hospital
with mother giving ORS on
the way.
• Advise mother to continue
breast feeding.
• Not enough signs to classify NO • Give fluid to treat diarrhea
as some or severe at home (Plan A).
DEHYDRATION
dehydration

• Diarrhea lasting 14 days or • If the young infant is


more dehydrated, treat
SEVERE
dehydration before referral
PERSISTENT unless the infant has also
DIARRHEA POSSIBLE SERIOUS
BACTERIAL INFECTION.
• Refer to hospital
• Give Vit. A
• Blood in the stool • Refer UNGENTLY to hospital
with mother giving ORS on
DYSENTRY
the way.
• Advise mother to continue
breast feeding.
• Give antibiotic and follow up
for 2 day.

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