Session-IVaIdentification of signs and actions
– Sepsis in new bornSigns of generalized sepsis in newborn and action to
be taken
Skin infection care
Hypothermia care
Fever and or chest indrawing
Hyperthermia and pneumonia
Hyperthermia care
Umbilical sepsis
Eye infection-Swollen or with pus
Cracks or redness on the skin fold
(Thigh/Axilla/Buttock)
SepsisGeneralized sepsis in newborn
All limbs limp
Feeding less or has
stopped feeding
Weak cry or the baby has
stopped crying
Action – Refer the baby to the nearest health facility to consult a medical doctor
Skin infection
Mild
Treat skin pustules and
blisters or local skin
infection by 0.25%
Gentian Violet (GV) in
children under 2 months
(eg newborns)
Treat skin pustules and
blisters or local skin
infection by 0.5% Gentian
Violet (GV) in children
over 2 months
Skin infectionModerate to severe
Skin infection-Severe
rash with Pus filled
Pustule and blisters.
There multiple pus points
on the body of the baby.
Action - Referral of the baby to
the nearest health facility to
consult a medical doctor for
treatmentSevere
Moderate
Hypothermia care
The baby is having
low body temperature
below 35.5oC (95.5oF.
The baby is suffering
from infection and is
having sepsis.
Action - Wrap the baby in the cloth with head covered and keep closer to the
mother. The baby needs to be referred to the nearest health facility keeping the
baby warm.
Fever and or chest indrawing
The baby has a
temperature above
37.2oC (98.96≈99oF).
The baby is suffering
from infection and is
having sepsis.
Action – Referral of the baby to the nearest health facility for consultation with a
medical doctor.
Pneumonia in newborn
The baby has a
temperature above
37.2oC (98.96≈99oF)
with breath rate of
above 60/minute and
there is indrawing of
chest. The baby is
suffering from
pneumonia.
Action – Referral of the baby to the nearest health facility for consultation with a
medical doctor.
Temperature above 37.2oC (98.96≈99oF)
Unwrap the baby and take
off its cap.
Ventilate the room too to cool
the baby.
Ask the mother to start
breastfeeding.
If there is a source of extra
heat (like a fire) in the room,
put it out.
Wait for 30 minutes and take
the temperature once again.
Counselling on Management of Hyperthermia
Persistent Hyperthermia
If the baby’s temperature returns to
normal, explain to the mother that in very
warm weather, the baby does not have to
kept covered with additional cloth or kept
wrapped.
Action - If the temperature is still above normal after the above measures have
been taken, refer the baby for treatment. Temperature persists above 37.2oC
(98.96≈100oF)
Umbilical sepsis
Treat Umbilical cord infection by 0.25%
Gentian Violet (GV) paint in children under
2 months (eg newborns)
Treat Umbilical cord infection by 0.5%
Gentian Violet (GV) paint in children over
2 months
Action - Referral of the baby to the nearest health facility for consultation with a
medical doctor
Eye infection-Swollen or with pus
Apply antibiotic
ointment in the baby’s
eyes or a capsule
which is available
Action - Consult a medical
doctor of the nearest facility
Cracks or redness on the skin fold
(Thigh/Axilla/Buttock)Treat Cracks or
redness on the skin
fold by 0.25% Gentian
Violet (GV) in children
under 2 months (eg
newborns)
Treat Cracks or
redness on the skin
fold by 0.5% Gentian
Violet (GV) in children
over 2 months
Referral of the baby to the nearest health
facility for consultation with a medical
doctor.
Session-IVb
Others complains in newborn and action
– Baby crying incessantly or passing urine less
than 6 times a day
– Jaundice-Skin and palm deep yellow
colouration
– Distended abdomen or mother says ‘Baby
vomits’
– Congenital Anomaly (Oesophageal
Artesia/Imperforate Anus)
Baby crying incessantly Is the baby crying
incessantly or passing
urine less than 6
times a day
Advise mother to feed
the baby after every 2
hours. Correct
attachment of the
baby with nipple and
areola.Do not give other liquids as honey water, glucose water, Gripe water, Naunehal…
Jaundice limited to eyes and
face
Jaundice extended to trunk
Jaundice extended to abdomen
Physiological Jaundice - Normal
Jaundice appearing
within 24 hours of
birth
Jaundice extended to
legs
There is deep yellow
colouration of palm
and sole of baby
Alert signs in a newborn with jaundice
Action – Referral of the baby to the nearest
health facility
BurpingPlace the abdomen of
the baby on the left
shoulder of the mother
Gently tap the back of
the baby 3-4 times
The baby has a burping
sound and burps
The baby is normal
Burping in sitting positionPlace baby in sitting position.
Lean them forward, supporting
their chin and chest with your
hand.
Pat their back in an upward
motion.
You may want to squeeze the
cheeks of their face to open the
mouth.
Continue until you hear the
burp of air.
Distended abdomen or mother says ‘Baby
vomits often’ –
Congenital Anomaly (Oesophageal
Artesia/Imperforate Anus)
Session-IVc
Identification of other signs and actions
– In Mother
Post partum haemorrhage
Post partum depression/mood changes
Post partum haemorrhage
Action - Refer the mother to the nearest health facility
for ruling out cervical/vaginal tear, retained placenta and
floppy (atonic) uterus.
Is the bleeding heavy. (Normally changes pad
after 4-6 hours)
Often this is quite obvious, but sometimes it
may be difficult to judge.
Using more than 5 pads a day or more than one
thick cloth in a day, she is having heavy
bleeding.
Some women may suffer from mood
changes after delivery.
They need family support.
The changes usually disappear after a
week or so.
The changes become severe.
Post partum depression/mood
changes
Action – Observe for one week and if it persists then referral is required
Session-IVd
Identification of signs and actions
– Sepsis in mother
Signs of puperal sepsis
Cracked Nipples/painful and/ breast engorgement
and infection
Gentian Violet and its use in baby and
mother
Puerperal sepsis (Infections)
Puerperal sepsis is infection of the genital
tract at any time between the onset of
rupture of membranes or labour and till 42
days after delivery or abortion.
Action – Referral for mother is required to the
nearest facility since she needs antibiotics
treatment. Immediate referral on the same day is
advisable.
Signs of Puerperal sepsis
(Infections)Abnormal and foul-smelling lochia
(discharge), may be blood-stained
Fever (temperature >38°C or > 100.5ºF)
Lower abdominal pain and tenderness
Burning micturition (urine)
Uterus not well contracted
Feeling of weakness
Vaginal bleedingAny two or more of the following signs and symptoms are present.
Painful
Cracked/fissured Nipples
Breast engorgement and
infection
Sore nipples, or a breast
infection
Breast problem
Action – Advise on breast Hygiene and use of emollients such as milk
cream and then refer the mother to the nearest facility to consult a doctor
Properties of GV
Gentian violet is an antiseptic dye used to
treat fungal infections of the skin
It also has weak antibacterial effects and
may be used on minor cuts and scrapes to
prevent infection.
It has antibacterial, anti fungal, and
pantheistic properties and is an important
as a topical antiseptic.
Use in baby
Apply Gentian Violet paint twice daily after
gently washing off pus and crusts with
soap and water dry the area and paint with
0.5% G V.
Umbilical cord infection & skin pustules
Use in baby
Treat skin pustules or Umbilical cord or
local skin infection or Cracks or redness
on the skin by 0.5% Gentian Violet (GV) in
children over 2 months
• Treat skin pustules or Umbilical cord or
local skin infection or Cracks or redness
on the skin by 0.25% Gentian Violet (GV)
in children under 2 months (eg newborns)
Oral Thrush
To treat oral thrush by
0.25 % Gentian violet
paint in children under 2
months (eg newborns)
and by 0.5% GV paint in
children over 2 months.