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1. Determine if the young infant needs urgent referral
• Before urgently referring a young infant to hospital, give all
appropriate pre-referral treatments.
• Give first dose of ampicillin or gentamicin intramuscularly.
• Treat to prevent low blood sugar.
• Advise the mother how to keep the infant warm on the way to the
hospital.
• If the young infant has diarrhoea, advise the mother to give frequent
sips of ORS on the way to the hospital and to continue breastfeeding.

2. Prophylaxis and other preventive measures for
HIV exposed or infected young infant
• ARV prophylaxis for preventing transmission of infection from mother
to child.
To prevent the opportunistic infections
• Cotrimoxazole prophylaxis from the age of 4-6 weeks to prevent
opportunistic infections to all HIV exposed or infected young infants
• Isoniazid preventive treatment is given to prevent and reduce active
tuberculosis (TB) in infants
• Immunizations

3. Remember these important rules when giving
intramuscular antibiotics
• Explain to the mother why the drug is given
• Use a sterile needle and sterile syringe. Measure the dose accurately.
• Give the drug as an intramuscular injection.
• Refer the child urgently
• Gentamicin: Check whether gentamicin should be used undiluted or
should be diluted with sterile water. When ready to use, the strength
should be 10 mg/ml.
Ampicillin: Read the vial of ampicillin to determine its strength. Add 1.3 ml
of sterile water to the vial of 250 mg powder. Shake the vial until the
mixture is clear

4. Care of the Low Birth Weight Newborn
• Give the baby short rests during a breastfeed; feeding is hard work for
LBW baby.
• If the baby coughs, gags, or spits up when starting to breastfeed, the
milk may be letting down too fast for the little baby. Teach the mother
to take the baby off the breast if this happens.
• Hold the baby against her chest until the baby can breathe well again
then put her back to the breast after the let-down of milk has passed.
• If the LBW baby does not have enough energy to suck for long or a
strong enough sucking reflex; teach the mother to express breastmilk
and feed her by a cup

5. TREAT LOCAL INFECTIONS AT HOME
To Treat Skin Pustules or Umbilical
Infection
• Wash hands
• Gently wash off pus and crusts
with soap and water.
• Dry the area
• Paint the skin or umbilicus/cord
with full strength gentian violet
(0.5%)
• Wash hands
To Treat Thrush ulcers or white patches
in mouth
• Wash hands
• Paint the mouth with half-
strength gentian violet (0.25%)
using a soft cloth wrapped
around the finger or,
• Apply nystatin oral drops 1ml-
2ml 4 times a day.
• Wash hands

6. BIRTH ASPHYXIA
• Cover the baby with warm clothing
• Position the newborn supine with neck slightly extended
• Clear mouth and nose with bulb syringe
• Put a towel or cloth behind the shoulder to facilitate positioning
• Use baby bag and mask to ventilate at 40 breaths per minute
• Continue to ventilate until the baby breathes independently
• If the baby remains weak or is having irregular breathing after 20
minutes of resuscitation; Refer urgently to hospital while continuing
to resuscitate on the way

7. • Keep the baby warm by skin-to-skin contact
• Breastfeed as soon as possible
• Watch for signs of a breathing problem; rapid, or noisy breathing,
blue colour of the tongue.
• If breathing problem occurs, stimulate, give oxygen

8. JAUNDICE AND SEVERE JAUNDICE
Treat to prevent low blood sugar by:
• If the young infant is able to breastfeed, ask the mother to breastfeed the
young infant.
• If the young infant is not able to breastfeed but is able to swallow, give 20-
50 ml (10 ml/kg) expressed breast milk before departure.
• If not possible to give expressed breast milk, give 20-50 ml (10 ml/kg) sugar
water
• To make sugar water: Dissolve 4 level teaspoons of sugar (20 grams) in a
200-ml cup of clean water).
• If the young infant is not able to swallow: give 20-50 ml (10 ml/kg) of
expressed breast milk or sugar water by nasogastric tube.

9. Advise mother how to keep the infant warm
on the way to the hospital:
• Keep the young infant clothed or covered as much as possible all the
time.
• Dress the young infant with extra clothing including hat, gloves, socks
and wrap the infant in a soft dry cloth and cover with a blanket.
• Provide skin to skin contact.
• Advise the mother to give home care for the young infant;
breastfeeding the infant at least 8 times in 24 hours.
• Advise mother to return immediately if palms and soles appear
yellow.
• Follow-up in 1 day