Provide the following care up to the time of discharge:
TYPE OF CARE
AND MONITORING |
NOTES |
Keep baby with mother
- In same bed or within
easy reach
- Under mosquito net
|
If baby is in a cot, ensure baby
is dressed or well-wrapped:
covered with blanket, head is
covered and the feet and hands
have socks |
Ensure room is warm
(>25°C) and has no cold
breeze (draughts) |
Do NOT put baby in direct
sun or on any cold surface or
directly in the line of a cold
breeze |
Advise/teach mother
how to:
- Keep the baby warm
- Give cord care
- Ensure hygiene
|
- If mother is unable to
take care of baby, provide
required care or teach her
next of kin
- Wash hands before and after
handling baby
- Do not bath baby for up
24 hours
|
Support exclusive
breastfeeding
on demand, day and
night, whenever baby
wants |
If breastfeeding difficult:
- Help mother to position and
attach the baby
If breastfeeding not possible:
- Advise on safe replacement
feeding (AFASS)
|
Ask mother and
companion to:
- Watch the baby
- Report breastfeeding
or breathing problems,
cold feet, bleeding
from cord or other
bleeding
Check every baby at 4
and 8 hours then daily
for:
- Warm feet
- Normal pink colour
- Feeding
- Breathing problems
|
If feet cold-this is a sign of
hypothermia:
- Teach mother how to
rewarm the baby; apply one
to two layers of clothes more
than adults, and use of hats/
caps
- Reassess in 1 hour; if
no improvement, take
temperature and manage
accordingly
If breathing problem
- Assess and manage
accordingly
If cord tie loose/cord bleeding:
- Retie cord
- If bleeding persists, refer
urgently
|
Check any baby with
warning signs at 2, 4, 8,
and 12 hours:
- Listen for grunting
- Look for chest in
drawing
- Count breaths/minute
- Measure temperature
- Observe breastfeeding
|
Refer urgently if:
- Breathing problem worsens
or persists for >8 hours
- Temperature <36.5°C
persists or decreases
- Not able to feed at 8 hours
|
Give prescribed
treatments according to
dosage schedule |
If referring the baby, write
treatments given, when, and
why |
Assess breastfeeding
in every baby before
planning discharge |
Do not discharge if baby is not
feeding well |
| Do not discharge baby < 24 hours old |
Advise mother:
- When to seek care
- When to return if
danger signs appear
(refusal to feed,
excessive crying,
bleeding from the cord
stump, fever, bulging
fontanel, abdominal
distension, grunting
respiration)
|
Do NOT plan early discharge if:
- Baby small (LBW or
preterm)
- Not feeding well
|
Give BCG and polio 0
before discharge |
Counsel mother on next
routine check in 3-7 days and
next immunization in 6 weeks |