Risk Factors in All Young Infants (Birth up to 2 months)

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Look at the Child's Road to Health Booklet and/or Ask:

• Has the mother or a close contact had TB or been on TB treatment in the last 6 months? If yes:
• Did the mother start TB treatment more than 2 months before delivery?
• Assess the infant for symptoms and signs of congenital TB (see below).
• How much did the infant weigh at birth?
• Was the infant admitted to hospital after birth? If so, for how many days?
• Who is the child’s caregiver?
• How old is the mother/caregiver?
• Is the infant exclusively breastfed?

Check for Signs and Symptoms of Congenital TB

Congenital TB may be asymptomatic.

Symptoms suggestive of TB:

• Low birth weight
• Poor feeding
• Poor weight gain
• Fever
• Lethargy/ irritability
• Fast breathing/ shortness of breath
• Enlarged lymph nodes
• Enlarged liver and/ or spleen

Classify All Young Infants

Possible Congenital TB
Mother on TB treatment for less than 2 months before delivery AND Infant has one or more symptoms/ signs of congenital TB	Refer to hospital for investigations. If diagnosed with TB the baby will need a full course of TB treatment  Give BCG on completion of INH or TB treatment Ask about the caregiver’s health, and treat as necessary  Provide follow-up
TB Exposed
Mother on TB treatment for more than 2 months before delivery AND Infant has no symptoms/signs of congenital TB	Give INH for 6 months if mother has received TB treatment for more than 2 months before delivery Give BCG on completion of INH or TB treatment Consider HIV infection in the infant  Ask about the caregiver’s health, and treat as necessary  Provide follow-up
At Risk Infant
Infant weighed less than 2 kg at birth OR Admitted to hospital for more than three days after delivery OR Known neurological or congenital problem	Monitor growth and health more frequently Assess feeding and encourage breastfeeding Conduct home visits to assess feeding and growth Encourage mother to attend follow-up appointments and refer to other services if indicated (further medical assessment, social worker, support group ) Make sure that the birth has been registered and that the child is receiving a child support grant if eligible
Possible Social Problem
Mother has died or is ill OR Infant not breastfed OR Teenage caregiver OR Social deprivation	Assess breastfeeding and support mother to breastfeed successfully  If not breastfeeding, counsel and explain safe replacement feeding  Monitor growth and health more frequently Conduct home visits to assess feeding and growth Make sure that the birth has been registered and that the child is receiving a child support grant if eligible Refer to other available services if indicated (social worker, community based organisations) No risk factors Counsel the caregiver on home care for the young
No Risk Factors
No risk factors	Counsel the caregiver on home care for the young infant

 

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

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Last checked for updates: June 2023