This section describes the steps you should take to assess and classify a sick young infant at the initial visit.
When a sick child is brought to your health post for an initial visit you should always do the following:
If you find a reason that a young infant needs urgent referral, you should continue the assessment. However, you should not carry out the breastfeeding assessment because this can take some time. Figure 15.4 below summarises these steps.
Assessing for bacterial infection is critically important and must be done for every sick young infant. In this step you are particularly looking for signs of a serious infection. A young infant can become sick and die very quickly from serious bacterial infections such as pneumonia, sepsis and meningitis.
You should assess and classify all sick young infants for bacterial infection and jaundice. Compare the infant's signs with the signs listed on the appropriate chart and choose the appropriate classification.
Remember that you should always ask the mother whether the young infant has diarrhoea. If she says yes, or you see that the young infant has diarrhoea, you should classify for diarrhoea. You learned about this in Study Session 5 of this Module, and should be able to recall that a young infant with diarrhoea is assessed for:
Diarrhoea in a young infant is classified in the same way as it is in an older infant or young child.
Look at the chart on assessing and classifying the sick young infant for HIV infection. You should ask the mother whether she or her child has had a positive HIV test. Remember this can be a very sensitive issue for the mother so you should ask her in a respectful way and reassure her that the information is confidential.
If the child has had an HIV test, determine whether the test was a rapid test for HIV antibodies, or a DNA PCR test for the virus, and then classify the sick young infant for HIV infection base on the test result.
Assessing feeding and/or low weight problems has two steps. If you look at page 8 in your chart booklet you will see there are two sections in the box separated by a dashed line. In the first (upper) part are the questions you should ask the mother. You need to determine if she is having difficulty feeding the infant, what the young infant is fed and how often. You also need to determine weight for age.
If the infant has any problems with breastfeeding or is low weight for age, you assess how the infant breastfeeds. You will see this is the second (lower) part of the box on page 8 in your chart booklet.
There are three possible classifications for feeding problems or low weight:
You should check the immunization status by checking the immunization card, and if this is not available you should ask the mother what vaccinations her child has received
Assess any other problems mentioned by the mother or observed by you.
You are now going to look at how to assess and classify children aged between two months and five years.