Neobook — clinical reference

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

A young infant has diarrhoea if the stools have changed from the usual pattern, and are many and watery (more water than faecal matter)

For Dehydration:

Severe Dehydration
Two of the following signs: Lethargic or unconscious Sunken eyes Skin pinch goes back very slowly Young infant less than one month of age	Start intravenous infusion (Plan C) Give first dose of ceftriaxone IM Breastfeed or give frequent sips of ORS if possible Keep the infant warm on the way to hospital Refer URGENTLY
Some Dehydration
Two of the following signs: Restless, irritable Sunken eyes Skin pinch goes back slowly	If other severe classification, refer with breastfeeding or ORS sips on the way Give fluid for some dehydration Plan B Advise mother to continue breastfeeding Give zinc for 14 days Follow-up in 2 days Counsel the caregiver on home care for the young infant
No Visible Dehydration
Not enough signs to classify as some or severe dehydration.	Give fluids to treat for diarrhoea at Home (Plan A) If exclusively breastfed, do not give other fluids except SSS Give zinc for 14 days Counsel the caregiver on home care for the young infant Follow-up in 2 days

Severe Persistent Diarrhoea
Diarrhoea lasting 14 days or more	Refer after treating for dehydration if present Keep the infant warm on the way to hospital

Serious Abdominal problem
Blood in the stool	Refer URGENTLY Keep the infant warm on the way to hospital

Integrated Management of Childhood Illness 2022; Young Infant (Birth up to 2 months); Assess, Classify and Identify Treatment: Diarrhoea

Last checked for updates: June 2023

Diarrhoea (Birth up to 2 months)