EXTRA CARE OF SMALL BABIES OR TWINS IN THE FIRST DAYS OF LIFE

Provide the following care for small babies:

  • Preterm up to 1 month early
  • Low Birth Weight <2,500 g

Refer very small babies for specialized attention:

  • Very preterm >1 month early
  • Very Low Birth Weight <1,500 g
TYPE OF CARE AND
MONITORING
NOTES
Ensure room is warm:
Teach mother how to
keep baby warm
Provide extra blanket for
mother and baby if needed
Teach mother how to
ensure hygiene for baby
Do not bathe the baby
Clean prn with swabs or cloth
Give special support for
breastfeeding and assess
daily
If not breastfeeding well, teach
mother alternative feeding
methods
Assess small baby daily:

  • Measure temperature
  • Feeding progress,
    weight
  • Breathing
  • Jaundice (see sections
    17.1.2 and 17.2.2)
  • If breathing or breastfeeding
    problem or hypothermia,
    examine and manage
    accordingly
  • If maternal concern,
    examine and manage the
    baby accordingly;
  • If breastfeeding problem
    persists >3 days or weight
    loss >10% of birth weight and
    no other problems, refer for
    breastfeeding counselling
    and management
Keep mother and baby
(or twins) longer before
discharge. Plan the
discharge when:

  • Breastfeeding well
  • Weight gain on 3
    consecutive days
  • Body temperature
    normal for 3
    consecutive days
  • Mother confident in
    caring for baby
  • If mother & baby not able
    to stay, ensure daily (home)
    visits or send to hospital