GuidelinesIMCI
Follow Up Care for the Sick Infant (Birth up to 2 months)
IMCI - Young Infant (Birth up to 2 months)
Local Bacterial Infection
After 1 or 2 days:
- Discharge of eyes: Has the discharge improved? Are the lids swollen?
- Red umbilicus: Is it red or draining pus? Does redness extend to the skin?
- Skin pustules: Are there many or severe pustules?
Treatment:
- If condition remains the same or is worse, refer
- If condition is improved, tell the caregiver to continue giving the antibiotic and continue treating for the local infection at home
Jaundice
After 1 day:
- Look for jaundice (yellow eyes or skin)
- Look at the young infant’s palms and soles. Are they yellow?
- Reassess feeding
- If palms and soles yellow, refer
- If palms and soles not yellow and infant feeding well, counsel mother to continue breastfeeding and to provide home care
- If you are concerned about the jaundice, ask the mother to return after one or two days or if the jaundice becomes worse
Feeding problem
After 2 days:
- Ask about any feeding problems found on the initial visit and reassess feeding
- Counsel the caregiver about any new or continuing feeding problems. If you counsel the caregiver to make significant changes in feeding, ask her to bring the young infant back again after 5 days
- If the young infant has POOR GROWTH (low weight for age or has poor weight gain), ask the caregiver to return again after 5 days to measure the young infant’s weight gain. Continue follow-up until the weight gain is satisfactory
- If the young infant has lost weight, refer
Exception:
If the young infant has lost weight or you do not think that feeding will improve, refer
Poor growth
After 2 days in infant less than 2 weeks or 7 days in infant more than 2 weeks:
- Reassess feeding
- Check for possible serious bacterial infection and treat if present
- Weigh the young infant. Determine weight gain
- If the infant is no longer low weight for age, praise the caregiver and encourage her to continue
- If the infant is still low weight for age, but is gaining weight, praise the caregiver. Ask her to have her infant weighed again within 14 days or when she returns for immunisation, whichever is the earlier
Exception:
If you do not think that feeding will improve, or if the young infant has lost weight, refer
Thrush
After 2 days in infant less than 2 weeks or 7 days in infant more than 2 weeks:
- Look for thrush in the mouth
- Reassess feeding
Treatment:
- If thrush is worse check that treatment is being given correctly, and that the mother has been treated for thrush, if she is breastfeeding. Also consider HIV infection
- If the infant has problems with attachment or feeding, refer
- If thrush is the same or better, and the baby is feeding well, continue with nystatin for a total of 7 days
Integrated Management of Childhood Illness 2022; Young Infant (Birth up to 2 months); Counsel the Caregiver; When to Return
Last checked for updates: June 2023