Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Reference Manual<br />
• Identification of danger signs:<br />
o poor sucking or not sucking at all<br />
o inactivity or lethargy<br />
o fever (body too hot) or hypothermia (body too cold)<br />
o difficulty in breathing/rapid breathing<br />
o convulsions<br />
o repeated or persistent vomiting <strong>and</strong>/or abdominal distention<br />
o redness <strong>and</strong>/or swelling surrounding the base of the umbilicus, with our without pus<br />
discharge, <strong>and</strong>/or foul smell<br />
The first five danger signs are the most important. Although these are st<strong>and</strong>ard danger<br />
signs, it is essential to inform mothers that they should look at their babies carefully at least<br />
once a day in adequate light. Even if they do not detect a specific danger sign, mothers<br />
should still seek care from an appropriate health worker if they feel their baby is “not looking<br />
or doing well”. In this way, sick newborns can be identified <strong>and</strong> treated early which is<br />
particularly important in the newborn period when the condition can deteriorate rapidly.<br />
• Preparation for emergency issues in the mother or baby. Discuss with the woman <strong>and</strong><br />
her partner <strong>and</strong> family about emergency issues:<br />
o where to go if there are danger signs<br />
o how to reach the hospital<br />
o how to meet the costs involved<br />
o options for family <strong>and</strong> community support<br />
• Advise the woman to ask for help from the community, if needed.<br />
• Advise the woman to bring her home-based maternal record to the health center, even<br />
for an emergency visit.<br />
<strong>Care</strong> for HIV-Positive Mothers <strong>and</strong> Their Exposed Infants<br />
For the baby, ask the following questions:<br />
• Was ARV medication for prophylaxis administered to the baby (according to the<br />
recommendation of the Ministry of Health)? If possible verify from any available records.<br />
• Is the baby currently on any ARV prophylaxis?<br />
• Is the baby receiving cotrimoxazole prophylaxis? (If not, counsel for commencing<br />
cotrimoxazole prophylaxis according to national guidelines.)<br />
• Has the baby been tested for HIV?<br />
o If yes, note <strong>and</strong> record the test result.<br />
o If not, refer the baby for HIV testing as early as six weeks after birth.<br />
• Check infant feeding options:<br />
o Provide support for the infant feeding choice.<br />
o If breastfeeding:<br />
Reinforce messages on care of the breast <strong>and</strong> prevention of problems.<br />
Address any questions, concerns, <strong>and</strong> problems related to breastfeeding.<br />
Warn about the risks of “mixed” feeding, giving both breast milk <strong>and</strong> formula.<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course<br />
121