Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
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Reference Manual<br />
Major infections in the newborn period are identified by the presence of one or more danger<br />
signs, as noted below in Table 16 (on practical guidelines for identifying <strong>and</strong> treating major<br />
infections at peripheral centers).<br />
Minor Infections<br />
The most common minor infections are:<br />
• thrush<br />
• conjunctivitis<br />
• skin infections<br />
• umbilical infection (localized)<br />
While the focus in this manual will be on the most common major <strong>and</strong> minor infections listed<br />
above, other newborn infections include syphilis, HIV/AIDS, Hepatitis B, <strong>and</strong> tetanus.<br />
IDENTIFYING AND TREATING MAJOR INFECTIONS<br />
Very early signs of major infection/neonatal sepsis are vague <strong>and</strong> sometimes difficult to<br />
recognize, but early detection is needed as it takes time to effect referral to suitable centers.<br />
These early features include vague signs such as the baby just “not looking well” or appearing<br />
as if “he/she is just not well,” at times described as a “facial grimace.” However, these early<br />
features are more difficult to detect <strong>and</strong> require careful daily observation. Mothers, family<br />
members, <strong>and</strong> health care providers should be encouraged to view the baby in adequate light at<br />
least once a day, especially in the first week or two.<br />
More conventional clinical features labeled as “danger signs” used to identify newborn sepsis<br />
include the following (the first five are the most important):<br />
• sucking less or poor/no sucking<br />
• lethargy or diminished activity/inactivity<br />
• fever (body too hot) or hypothermia (body feeling too cold)<br />
• rapid breathing/difficulty in breathing<br />
• convulsions<br />
• repeated or persistent vomiting <strong>and</strong>/or abdominal fullness<br />
• features of severe umbilical infection (peri-umbilical redness, swelling <strong>and</strong>/or foul<br />
smelling, with or without pus 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 signs, it<br />
is essential that health workers should look at babies carefully at least once a day in adequate<br />
light while they remain in the facility. Even if they do not detect a specific danger sign, health<br />
workers should take care if they feel the baby is “not looking or doing well”. In this way, sick<br />
newborns can be identified <strong>and</strong> treated early which is particularly important in the newborn<br />
period when the condition can deteriorate rapidly. Mothers should also be counseled on these<br />
points to promote early careseeking.<br />
Training personnel in good follow-up supervision is necessary to identify these danger signs.<br />
Since they are difficult to remember, especially when health workers do not see very many<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course<br />
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