Date of Visit:________
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?
Initial visit?
Follow-up vist?


CHECK FOR POSSIBLE BACTERIAL INFECTION
§ Has the infant had convulsions?

§ Count the breaths in one minute. ___ breaths per minute
o Repeat if elevated. ___ Fast breathing?
§ Look for severe chest indrawing
§ Look for nasal flaring
§ Look and feel for bulging fontanelle
§ Look for pus draining from the ear
§ Look at umbilicus. Is it red or draining pus?
o Does the redness extend to the skin?
§ Fever (temperature 37.5°C or feels hot) or low body temperature (below 35.5°C or feels cold)
§ Look for skin pustules. Are there many or severe pustules?
§ See if young infant is lethargic or unconscious
§ Look at the young infant’s movements. Less than normal?


DOES THE YOUNG INFANT HAVE DIARRHOEA?
§ For how long? ___ Days
§ Is there blood in the stools?

§ Look at the young infant’s general condition. Is the infant:
o Lethargic or unconscious?
o Restless and irritable?
§ Look for sunken eyes
§ Pinch the skin of the abdomen. Does it go back:
o Very slowly (longer than 2 seconds)?
o Slowly?


THEN CHECK FOR FEEDING PROBLEM OR LOW WEIGHT
§ Is there any difficulty feeding? Yes__ No__
§ Is the infant breastfed? Yes __ No__
§ If Yes, how many times in 24 hours? __ Times
§ Does the infant usually receive any other foods or drinks? Yes__ No__
§ If Yes, how often?
§ What do you use to feed the child?

§ Determine weight for age. Low__ Not Low__


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

§ Has the infant breastfed in the previous hour?

§ If infant has not fed in the previous hour, ask the mother to put her infant to the breast. Observe breastfeed for 4 minutes.
§ Is the infant able to attach? To check attachment, look for:
o Chin touching breast
o Mouth wide open
o Lower lip turned outward
o More areola above than below the mouth
no attachment at all not well attached good attachment
§ Is the infant suckling effectively (that is, slow deep sucks, sometimes pausing)?
not suckling at all not suckling effectively suckling effectively
§ Look for ulcers or white patches in the mouth (thrush)


CHECK THE YOUNG INFANT’S IMMUNIZATION STATUS

ASSESS FOR OTHER PROBLEMS: