Integrated Maternal and Newborn Care Basic Skills Course ...

Reference Manual
• Identification of danger signs:
o poor sucking or not sucking at all
o inactivity or lethargy
o fever (body too hot) or hypothermia (body too cold)
o difficulty in breathing/rapid breathing
o convulsions
o repeated or persistent vomiting and/or abdominal distention
o redness and/or swelling surrounding the base of the umbilicus, with our without pus
discharge, and/or foul smell
The first five danger signs are the most important. Although these are standard danger
signs, it is essential to inform mothers that they should look at their babies carefully at least
once a day in adequate light. Even if they do not detect a specific danger sign, mothers
should still seek care from an appropriate health worker if they feel their baby is “not looking
or doing well”. In this way, sick newborns can be identified and treated early which is
particularly important in the newborn period when the condition can deteriorate rapidly.
• Preparation for emergency issues in the mother or baby. Discuss with the woman and
her partner and family about emergency issues:
o where to go if there are danger signs
o how to reach the hospital
o how to meet the costs involved
o options for family and community support
• Advise the woman to ask for help from the community, if needed.
• Advise the woman to bring her home-based maternal record to the health center, even
for an emergency visit.
Care for HIV-Positive Mothers and Their Exposed Infants
For the baby, ask the following questions:
• Was ARV medication for prophylaxis administered to the baby (according to the
recommendation of the Ministry of Health)? If possible verify from any available records.
• Is the baby currently on any ARV prophylaxis?
• Is the baby receiving cotrimoxazole prophylaxis? (If not, counsel for commencing
cotrimoxazole prophylaxis according to national guidelines.)
• Has the baby been tested for HIV?
o If yes, note and record the test result.
o If not, refer the baby for HIV testing as early as six weeks after birth.
• Check infant feeding options:
o Provide support for the infant feeding choice.
o If breastfeeding:
Reinforce messages on care of the breast and prevention of problems.
Address any questions, concerns, and problems related to breastfeeding.
Warn about the risks of “mixed” feeding, giving both breast milk and formula.
Integrated maternal and newborn care
Basic skills course
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