Young Infant

Assess and Classify Young
Infant
VERY SEVERE DISEASE AND LOCAL
BACTERIAL INFECTION
Check young infant for very severe
disease and local bacterial infection
By the end of this training unit you should know:
• clinical signs of very severe disease and local infection
• actions to be taken, when one or more signs are present.
After completing clinical practice relevant to this training
unit, you should have the skills to:
• assess and classify the sick young infant according to the
IMCI clinical guidelines
– check every young infant for signs and symptoms suggesting
very severe disease and local bacterial infection
– classify the young infant based on signs and symptoms found
during examination.
CLINICAL ASSESSMENT
Many clinical signs point to possible bacterial infection in sick
young infants. The most informative and easy to check
signs are:
• difficulty in feeding
• convulsions
• fast breathing
• severe chest indrawing
• fever or low body temperature
• movement only when stimulated or no movement at all
• umbilicus red or draining pus
• skin pustules.
ASK: Is the infant having difficulty in feeding?

• Ask the mother this question.
• Any difficulty mentioned by the mother is important.
• A newborn who has not been able to feed since birth
may be premature or may have complications such
as birth asphyxia.
• A young infant who was feeding well earlier but is
not feeding well now may have a serious infection.
ASK: Is the infant having difficulty in feeding?
• These infants who are either not able to feed or are
not feeding well should be referred urgently to
hospital.
• The mother may also mention difficulties like: her
infant feeds too frequently, or not frequently
enough; she does not have enough milk; her nipples
are sore; or she has flat or inverted nipples.
• You will assess these difficulties later during
breastfeeding assessment.
• ASK: Has the child had convulsions?
Ask the mother if the young infant has had

convulsions during this current illness. Use
words the mother understands. For example,
the mother may know convulsions as "fits" or
"spasms". During a convulsion, the young
infant's arms and legs may become stiff.
• ASK: Has the child had convulsions?
The infant may stop breathing and become

blue. Many times there may only be rhythmic
movements of a part of the body, such as
rhythmic twitching of the mouth or blinking of
eyes. The young infant may lose
consciousness.
LOOK: Count the breaths in one minute. Repeat
the count if elevated.
• Young infants usually breathe faster than older
infants and young children.
• The breathing rate of a healthy young infant is
commonly more than 50 breaths per minute.
• Therefore, 60 breaths per minute or more is
the cut-off used to identify fast breathing in a
young infant.
LOOK: Count the breaths in one minute. Repeat
the count if elevated.
• If the first count is 60 breaths or more, repeat the
count.
• This is important because the breathing rate of a
young infant is often irregular.
• The young infant will occasionally stop breathing
for a few seconds, followed by a period of faster
breathing.
• If the second count is also 60 breaths or more,
the young infant has fast breathing.
LOOK for severe chest indrawing.
• Mild chest indrawing is normal in a young
infant because the chest wall is soft.
• Severe chest indrawing is very deep and easy
to see.
• Severe chest indrawing is a sign of pneumonia
and is serious in a young infant.
FEEL: Measure axillary temperature (or feel for fever or low
body temperature).
• Fever (axillary temperature more than 37.5°C or rectal
temperature more than 38.0°C) is uncommon in the first two
months of life.
• If a young infant has fever, this may mean the infant has very
severe disease. Fever may be the only sign of a serious
bacterial infection.
• Young infants can also respond to infection by dropping their
body temperature to below 35.5°C axillary temperature (36°C
rectal temperature). Low body temperature is called
hypothermia.
• If you do not have a thermometer, feel the infant's abdomen or
axilla (underarm). Does the infant feel hot or unusually cool?.
LOOK at the umbilicus. Is it red or draining pus?
• There may be some redness of the end of the

umbilicus or the redness may extend to the
skin, or the umbilicus may be draining pus.
(The cord usually drops from the umbilicus by
one week of age.)
LOOK for skin pustules.
• Examine the skin on the entire body.

• Are there pustules?
• Skin pustules are red spots or blisters which
contain pus.
LOOK at the young infant's movements. Does the young
infant move on his or her own? Does the infant move only
when stimulated but then stops? Does the infant not
move at all?
• Young infants often sleep most of the time, and this is not a
sign of illness.
• Observe the infant's movements while you do the
assessment.
• If a young infant does not wake up during the assessment,
ask the mother to wake him or her.
• If you watch an awake young infant closely for a minute,
you will normally see several movements of the arms or
legs, or turning of the head.
LOOK at the young infant's movements. Does the
young infant move on his or her own? Does the
infant move only when stimulated but then stops?
Does the infant not move at all?
• If the young infant is awake but has no spontaneous
movements, gently stimulate the young infant.
• If the infant moves only when stimulated and then
stops moving, or does not move at all, it is a sign of
severe disease.
• An infant who cannot be waken up even after
stimulation also should also be considered to have
this sign.
CLASSIFICATION
• To classify the sick infant for VERY SEVERE DISEASE and
LOCAL BACTERIAL INFECTION you need to compare the
young infant's signs to the signs listed in the IMCI
YOUNG INFANT chart and choose an appropriate
classification.
• If the infant has any sign in the top (pink) row, select
VERY SEVERE DISEASE. If the infant has any sign in the
second (yellow) row, select LOCAL BACTERIAL
INFECTION.
• An infant who has none of these signs (green row) is
classified as SEVERE DISEASE OR LOCAL INFECTION
UNLIKELY.
VERY SEVERE DISEASE
• A young infant with any one sign in this classification may
have a serious disease and be at high risk of dying.
• The infant may have pneumonia, sepsis or meningitis.
• It is difficult to distinguish between these infections in a young
infant.
• Fortunately, it is not necessary to make this distinction.
• A young infant who has difficulty in feeding may also have a
life-threatening problem.
• This could be caused by a bacterial infection such as neonatal
tetanus or another sort of problem
•Not feeding well or
•Convulsions or
•Fast breathing (60 breaths per minute or more) or
•Severe chest indrawing or VERY SEVERE DISEASE
•Fever (37.5°C or above) or
•Low body temperature (less than 35.5°C) or
•Movement only when stimulated or no movement at all
Treatment. Refer the young infant urgently to hospital. Before

departure give a first dose of intramuscular antibiotics. Also
treat the infant to prevent low blood sugar by giving breast
milk, other milk or sugar water by naso-gastric tube. Advising
the mother to keep her sick young infant warm on the way to
hospital is very important.
• LOCAL BACTERIAL INFECTION
• Young infants with this classification have
an infected umbilicus or a skin infection.
•Umbilicus red or draining pus OR LOCAL BACTERIAL
•Skin pustules INFECTION
Treatment. Give an appropriate oral antibiotic at home for 5

days. The mother will also treat the local infection at home
and give home care. She should return for follow-up in 2 days
to be sure that the infection is improving. Bacterial infections
can progress rapidly in young infants.
SEVERE DISEASE OR LOCAL INFECTION
UNLIKELY
Young infants with this classification have none of
the signs of very severe disease or local bacterial
infection.
•None of the signs of very severe disease or SEVERE DISEASE OR LOCAL
local bacterial infection INFECTION UNLIKELY
Treatment. Advise the mother to give home care.

Record your assessment and classifications on the case
recording form for young infants.
Classify Very Severe Disease and
Local Bacterial Infection
Case study Henri - signs
• Henri is a 3-week-old infant. His weight is 3.6 kg. His axillary
temperature is 36.5°C.
• He is brought to the clinic because he is having difficulty
breathing.
• The health worker first checks the young infant for signs of very
severe disease and local bacterial infection. The mother says that
Henri has not had convulsions.
• The health worker counts 74 breaths per minute. He repeats the
count. The second count is 70 breaths per minute.
• He finds that Henri has mild chest indrawing. The umbilicus is
normal, and there are no skin pustules.
• Henri is calm and awake, and his movements are normal.
Classify Very Severe Disease and Local
Bacterial Infection
Not feeding well
Convulsions
Fast breathing
Severe chest indrawing
Fever
Low body temperature
Movement only when stimulated or no
movement at all
Umbilicus red or draining pus
Skin pustules
Bacterial Infection
• Case study Sashie - signs
• Sashie is 5 weeks old. Her weight is 4 kg. Her axillary
temperature is 37°C.
• Her mother brings her to the clinic because she has a rash.
• The health worker assesses Sashie for signs of very severe
disease and local bacterial infection.
• Sashie's mother says that there were no convulsions.
Sashie's breathing rate is 55 per minute.
• She has no chest indrawing. Her umbilicus is normal.
• The health worker examines her entire body and finds a
red rash with just a few skin pustules on her buttocks.
• Sashie is awake and her movements are normal.
Bacterial Infection
Not feeding well
Convulsions
Fast breathing .
Fever
movement at all
Skin pustules
Bacterial Infection
Case study Ebai - signs
• Ebai is a tiny baby who was born exactly 2 weeks ago. His
weight is 2.5 kg. His axillary temperature is 36.5°C. His
mother says that he was born prematurely, at home, and
was born much smaller than her other babies.
• She is worried because his umbilicus is infected. She says
he has had no convulsions.
• The health worker counts Ebai's breathing and finds he
is taking 55 breaths per minute. He has no chest indrawing.
• His umbilicus has some pus on the tip and a little redness
at the tip only.
• The health worker looks over Ebai's entire body and finds
no skin pustules. Ebai is awake and content. He is moving
normally.
Bacterial Infection
Not feeding well
Convulsions
Fast breathing
Fever
movement at all
Skin pustules
Bacterial Infection
Case study Henna - signs
• Henna was born 6 hours ago at home. His weight is 3.0 kg. His
axillary temperature is 36.5° C. He is brought to the health facility
because he did not cry immediately after birth and is having
difficulty breathing.
• The health worker first checks the young infant for signs of VERY
SEVERE DISEASE and LOCAL BACTERIAL INFECTION.
• The baby's father says that the baby has not had convulsions and
has not yet been fed.
• The health worker counts 67 breaths per minute. He repeats the
count. The second count is 62 breaths per minute.
• He finds that the baby has severe chest indrawing. The baby moves
only when he is stimulated.
• The umbilicus is normal, and there are no skin pustules.
Bacterial Infection
Not feeding well
Convulsions
Fast breathing
Fever
movement at all
Skin pustules
JAUNDICE
Check Young Infant for Jaundice
Always check ALL young infants for jaundice. Jaundice
is a yellow discoloration of skin and mucus membranes.
• Many normal young infants, particularly small babies
(less than 2.5 kg at birth or born before 37 weeks
gestation), may have jaundice during the first week
of life.
• The jaundice usually appears on the third or fourth
day of life.
• This type of jaundice is mild and disappears before
the age of two weeks in full-term and by the age of
three weeks in preterm babies.
• It does not need any treatment.
• Jaundice that appears on the first day of life is always
caused by an underlying disease.
• Deep jaundice that extends to the palms and soles can

be severe and requires urgent treatment.
• If not treated, it may damage the young infant's brain.
• Jaundice that persists beyond the age of two weeks in

a normal-weight infant and beyond three weeks in a
small baby needs further investigation.
At the end of this training unit you should know how
to:
• assess the signs and symptoms of jaundice
• classify the young infant's jaundice.
After completing clinical practice relevant to this
training unit, you should have the skills to:
• check every young infant for jaundice
• when jaundice is present, assess the young infant
further for signs related to it
• classify jaundice according to the signs which are
present.
Check Infant for Jaundice
• More than 50% of normal newborns, and 80% of
preterm infants, have some jaundice.
• Most jaundice in newborns is a normal event and is
not serious.
• This is often called physiologic jaundice. It is caused
by the infant's body breaking down extra red blood
cells after birth.
• When the red blood cells break down, they release
bilirubin.
• The bilirubin causes the yellow color.
• The newborn infant eliminates bilirubin slowly
because the liver is immature.
• In normal infants jaundice sometimes starts on the
third or fourth day of life and goes away without any
treatment by 2 weeks.
Serious jaundice occurs when the bilirubin in the blood
becomes very high.
o The yellow color starts first on the head and moves
down the body as the bilirubin level increases.
o For example: an infant with a blood disease or sepsis
may make too much bilirubin.
o An infant that is low birth weight (less than 2500 g) or
premature, not sucking well, or not passing stool, may
not be able to get rid of the bilirubin.
o If the young infant has serious jaundice, the extra
bilirubin may affect the infant's brain and cause brain
damage.
CLINICAL ASSESSMENT
Assess all young infants for jaundice.
LOOK: Are the eyes or skin yellow? Are the palms and
soles yellow?
• It is important to look for jaundice in natural light.
• To look for jaundice, press the infant's skin over the
forehead with your fingers to blanch, remove your
fingers and look for yellow discoloration.
• If there is yellow discoloration, the infant has jaundice.
• To assess for severity, repeat the process over the palms
and soles.
CLINICAL ASSESSMENT
If jaundice is present, ASK: When did the
jaundice appear first? Is the young infant more
than 14 days old?
• Any jaundice that appears on the first day of life
should be considered as severe.
• In normal infants jaundice disappears without
any treatment by 2 weeks.
• If a young infant has jaundice and is more than
14 days old, he or she needs further
assessment.
CLASSIFICATION OF JAUNDICE
SEVERE JAUNDICE
• If the young infant is less than 24 hours old
and has jaundice, classify the young infant as
having SEVERE JAUNDICE.
• Any young infant who has yellow palms and
soles should also be classified as having
SEVERE JAUNDICE.
 Any jaundice if age less than 24 hours

or SEVERE JAUNDICE
 Yellow palms and soles at any age
Treatment. Refer the young infant urgently to hospital.

Before departure treat the young infant to prevent low
blood sugar by giving breast milk or sugar water by naso-
gastric tube.
Advising the mother to keep her sick young infant warm on
the way to hospital is very important.
JAUNDICE
If the jaundice (yellow eyes or skin) appears after 24 hours of life AND
the palms and soles are not yellow, classify the young infant as having
JAUNDICE.
 Jaundice appearing after 24 hours of age
and JAUNDICE
 Palms and soles are not yellow
Treatment. Young infants with JAUNDICE need home care just like
those without any problem. They do not need any medication.
• The mother needs to be counselled to return immediately if the palms
and soles appear yellow.
• Also, you should follow up infants with jaundice in 1 day to assess
whether jaundice is worsening.
• If an infant is older than 14 days, refer him or her for further
assessment
NO JAUNDICE
• If the young infant does not have
jaundice, classify the young infant as
having NO JAUNDICE
• No jaundice NO JAUNDICE
Treatment. Advise the mother to give

home care for the young infant
Classify Jaundice
Case 1 : Peter
• Peter is 4 days old. His mother comes to see the health worker
because she thinks that Peter's skin is yellow in color.
• When the health worker asks the mother about Peter's
jaundice, the mother replies that it appeared 1 day ago.
• The health worker checks Peter for signs of very severe disease
and local infection. He finds none of them.
• Then he looks at Peter's skin. He does not think that the color
of the skin is unusual, but when he presses Peter's skin over the
forehead with his fingers and removes them, he sees yellow
discoloration.
• Finally, the health worker checks for yellow discoloration of
Peter's palms and soles. They are normal in color.
• Use your IMCI chart booklet. How you would classify Peter's
jaundice?
Classify Jaundice
Case 2: Mary
Mary was born yesterday (less than 24 hours). Her weight is 2
kg.
Mary is brought to the clinic because her mother and
grandmother are worried that she is too small.
The health worker assesses the young infant for signs of very
severe disease and local bacterial infection. He finds none of
them.
The health worker examines Mary's entire body and finds
yellow discoloration of the skin. He also checks Mary's palms
and soles, but their color looks normal to him.
Mary is awake and moves spontaneously.
Use your IMCI chart booklet. How you would classify Mary's
jaundice?
When And How To Check For Jaundice
Tick the correct statements about jaundice in young infants.
Jaundice in young infants is always a sign of severe disease.
 Health workers should check for jaundice only in infants
less than one week old.
 All young infants brought to the clinic should be checked
for jaundice.
 It is important to look for jaundice in natural light.
 It is important to use artificial light to see better the yellow
discoloration of the skin.
 Yellow color of an infant's palms and soles is a sign of
SEVERE JAUNDICE.
 Yellow color of eyes in an infant 20 hours old is NOT a sign
of SEVERE JAUNDICE
DIARRHEA
Assess Young Infant’s Diarrhea
For ALL sick young infants, ASK: "Does the infant have
diarrhea?"
If the mother answers "No", DO NOT ASSESS the

young infant for diarrhea. Go to the next question.
If the mother answers "Yes", ASSESS and CLASSIFY

diarrhoea as described in the IMCI chart booklet.
A young infant with diarrhea may be severely

dehydrated - a condition that may lead to death
At the end of this training unit you should know how to:
• assess the signs and symptoms of diarrhea
• classify the young infant's illness.
After completing clinical practice relevant to this
training unit, you should have the skills to:
• ask the mother about the main symptom - diarrhea
• when diarrhea is present, assess the young infant
further for signs related to it
• classify diarrhea according to the signs which are
present or absent
Diarrhea is also called loose or watery stools.
 It is common in babies under 6 months of age who are
drinking cow's milk or infant formulas.
 The normally frequent or loose stools of a breastfed infant are
not diarrhea. The mother of a breastfed infant can recognize
diarrhea because the consistency or frequency of the stools is
different from normal.
• A young infant has diarrhea if the stools have changed from

usual pattern and are many and watery (more water than
fecal matter).
• The normally frequent or semi-solid stools of a breastfed
baby are not diarrhea.
CLINICAL ASSESSMENT
Assess all young infants for the following signs of
dehydration:
• general condition
• sunken eyes
• reaction to skin pinch
• The assessment of dehydration is similar to that in older
children described in the training unit "Assess diarrhea",
part "Assess and classify child" of the component 'Care of
the child aged 2 months to 5 years". However the thirst is
not assessed for a young infant. This is because it is not
possible to distinguish thirst from hunger in a young
LOOK at the young infant's general condition. Does the
young infant move on his or her own? Does the infant
move only when stimulated but then stops? Does the
infant not move at all? Is the infant restless and irritable?
• When you check for very severe disease and local

bacterial infection, you observe the infant's movements.
• If the infant moves only when stimulated and then stops
moving, or does not move at all, it is a sign of a severe
condition.
• An infant who cannot be waken up even after
stimulation should also be considered to have this sign.
LOOK at the young infant's general condition. Does the young
infant move on his or her own? Does the infant move only
when stimulated but then stops? Does the infant not move
at all? Is the infant restless and irritable?
• Now look to see if the young infant seems restless and
irritable.
• Only children who cannot be consoled and calmed should be
considered restless and irritable.
• If an infant is calm when breastfeeding but again restless and
irritable when he or she stops breastfeeding, the infant has
the sign "restless and irritable".
LOOK for sunken eyes
• The eyes of a dehydrated infant may look sunken.
• In a low-weight infant, the eyes may always look

sunken, even if the young infant is not dehydrated.
• Even though the sign "sunken eyes" is less reliable in a

low-weight infant, it can still be used to classify the
young infant‘s dehydration.
PINCH the skin of the abdomen. Does it go back very
slowly (longer than 2 seconds)? Or does it go back
slowly?
Check this sign as described for an older child in the

training unit "Assess diarrhea", part "Assess and
classify child" of the component "Care of child aged 2
months to 5 years".
CLASSIFICATION
There are three possible classifications of dehydration in a young infant with
diarrhea:
SEVERE DEHYDRATION
If the young infant has two or all three of the following signs - movements
only when stimulated or no movements at all, sunken eyes, skin pinch goes
back very slowly - classify the infant as having SEVERE DEHYDRATION.
Two of the following signs:
 Movement only when stimulated or no movement at all
SEVERE DEHYDRATION
 Sunken eyes
 Skin pinch goes back very slowly
Treatment. A young infant classified as having SEVERE DEHYDRATION needs

fluids quickly. Infants and young children who have SEVERE DEHYDRATION
require immediate intravenous infusion, or nasogastric or oral fluid replacement, as
described in Plan C in the part "Treat the child" of the component "Care of child
aged 2 months to 5 years".
SOME DEHYDRATION
• If the young infant has two or all three of the following signs -
restless and irritable, sunken eyes, skin pinch goes back slowly -
classify the infant as having SOME DEHYDRATION. Remember
that if a young infant has one sign in the pink (top) row of the
IMCI chart and one sign in the yellow (middle) row, this infant
should also be classified as having SOME DEHYDRATION.
Two of the following signs:
 Restless and irritable
SOME DEHYDRATION
 Sunken eyes
 Skin pinch goes back slowly

Treatment. Young infants who have SOME DEHYDRATION require oral treatment with ORS
solution, as described in Plan B in the training unit "Give extra fluid for diarrhoea and
continue feeding", the part "Treat the child" of the component "Care of child aged 2 months
to 5 years".
DEHYDRATION
• A young infant who does not have enough signs to be
classified as having SOME or SEVERE DEHYDRATION is
classified as having NO DEHYDRATION.
 Not enough signs to classify as

NO DEHYDRATION
some or severe dehydration.
Treatment. Young infants with diarrhea but no signs of dehydration need more fluid
than usual to prevent dehydration, and thus need home treatment, as described in
Plan A in the training unit "Give extra fluid for diarrhea and continue feeding", the
part "Treat the child " of the component "Care of child aged 2 months to 5 years".
Remember:
• Antibiotics should not be used routinely for
treatment of diarrhea. Most diarrheal episodes are
caused by agents for which antimicrobials are not
effective for example viruses, or by bacteria that
must first be cultured to determine their sensitivity to
antimicrobials. A culture, however, is costly and you
would have to wait several days to receive the test
results. Moreover, most laboratories are unable to
detect many of the important bacterial causes of
diarrhea.
Remember:
• Antidiarrheal drugs - including antimotility agents
(such as loperamide, diphenoxylate, codeine,
tincture of opium), adsorbents (such as kaolin,
attapulgite, smectite), live bacterial cultures (such
as Lactobacillus, Streptococcus faecium), and
charcoal - do not provide practical benefits for
children with acute diarrhea, and some may have
dangerous side-effects. These substances should
never be given to infants and children younger than
5 years of age.
Classify Young Infant’s Diarrhea
Case study Rainer
One-month-old Rainer has had diarrhea for three
days. The boy is crying and moving his arms and
legs about. He cannot be consoled. His eyes
look normal, and a skin pinch goes back slowly.
How would you classify Rainer?

Case study Naryan
Naryan is 6 weeks old. She has had diarrhea for
one day. The girl has spontaneous
movements and does not have sunken eyes.
She is restless and irritable. A skin pinch goes
back immediately.
How would you classify Naryan?

Case study Sukhman
One-month-old Sukhman has had diarrhea for
five days. The boy makes no movements
during the assessment and only moves when
he is stimulated. His eyes are sunken, and a
skin pinch goes back slowly.
How would you classify Sukhman?

Classify Young Infant
Case study Jenna - Very severe disease and local bacterial infection
• Jenna is 7 weeks old. Her weight is 3 kg. Her axillary temperature is
36.4°C. Her mother brings her to the clinic because she has diarrhea.
• The health worker first assesses Jenna for signs of very severe disease
and local bacterial infection.
• Her mother says that Jenna does not have difficulty in feeding and
she has not had convulsions. Jenna's breathing rate is 58 breaths per
minute.
• She was sleeping in her mother's arms but awoke when her mother
unwrapped her. She has slight chest indrawing.
• Her umbilicus is not red or draining pus. She has a rash in the area of her
diaper, but there are no pustules. She is crying and moving her arms and
legs about.
How would you classify Jenna for severe disease or local bacterial infection?
Case study Jenna - Jaundice
• Then the health worker checks Jenna for
jaundice. The young infant does not have
yellow discoloration of skin, eyes, palms or
soles.
How would you classify the young infant for

jaundice?
Case study Jenna - Diarrhea
When the health worker asks the mother about
Jenna's diarrhea, the mother replies that it began 3
days ago. Jenna is still crying. She stops at once
when her mother puts her to the breast. She
begins crying again when she stops breastfeeding.
Her eyes look normal, not sunken. When the skin
of her abdomen is pinched, it goes back slowly.
How would you classify Jenna's diarrhea?

Case study Neera - Very severe disease and local bacterial infection
• Neera is 6 weeks old. Her weight is 4.2 kg. Her axillary temperature is
36.5°C. Her mother brings her to the clinic because she has diarrhea
and seems very sick.
• The mother says that Neera has not been feeding well since yesterday.
When the health worker asks the mother if Neera has had convulsions,
she says no.
• The health worker counts 50 breaths per minute. Neera has severe
chest indrawing. Her umbilicus is not red or draining pus. There are no
pustules on her body.
• Neera makes no movements during the assessment and only moves
slightly on stimulation.
How would you classify Neera for severe disease or local bacterial
infection?
Case study Neera - Jaundice
Then the health worker checks Neera for
jaundice. The young infant does not have yellow
discoloration of the skin, eyes, palms, or soles.
How would you classify the young infant for

jaundice?
Case study Neera - Diarrhea
Neera makes no movements during the
assessment and only moves slightly on
stimulation. The health worker finds that
Neera's eyes are sunken. When the skin on her
abdomen is pinched, it goes back very slowly.
How would you classify Neera's diarrhea?

Young Infant

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Assess and Classify Young

ASK: Is the infant having difficulty in feeding?

Ask the mother if the young infant has had

The infant may stop breathing and become

• There may be some redness of the end of the

• Examine the skin on the entire body.

Treatment. Refer the young infant urgently to hospital. Before

Treatment. Give an appropriate oral antibiotic at home for 5

Treatment. Advise the mother to give home care.

• Deep jaundice that extends to the palms and soles can

• If not treated, it may damage the young infant's brain.

• Jaundice that persists beyond the age of two weeks in

 Any jaundice if age less than 24 hours

Treatment. Refer the young infant urgently to hospital.

Treatment. Advise the mother to give

If the mother answers "No", DO NOT ASSESS the

If the mother answers "Yes", ASSESS and CLASSIFY

A young infant with diarrhea may be severely

• A young infant has diarrhea if the stools have changed from

• When you check for very severe disease and local

• In a low-weight infant, the eyes may always look

• Even though the sign "sunken eyes" is less reliable in a

Check this sign as described for an older child in the

 Skin pinch goes back very slowly

Treatment. A young infant classified as having SEVERE DEHYDRATION needs

 Skin pinch goes back slowly

 Not enough signs to classify as

How would you classify Rainer?

How would you classify Naryan?

How would you classify Sukhman?

How would you classify the young infant for

How would you classify Jenna's diarrhea?

How would you classify the young infant for

How would you classify Neera's diarrhea?

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