Even though your role in the management of these danger signs is to assess and refer the baby to the higher health service institutions, there are also some problems which can be managed by you at health post levels. The following table shows the management of newborn babies with danger signs.

Ask and check	Classify	Action taken
History of difficulty feeding or unable to feed now History of convulsion or convulsing now Newborn is lethargic or unconscious Movement only when stimulated Fast breathing Severe lower chest in-drawing Fever Hypothermia	If there are any one of the general danger signs, classify as POSSIBLE SERIOUS INFECTION	Refer URGENTLY to the hospital or health centre. Keep the newborn baby warm and give him or her breast milk on the way.
Baby developed yellowish discoloration before 24 hours of age. Jaundice observed on the palms and soles There is swelling of the eyes or eye discharge Umbilicus is draining pus More than ten pustules are found on the skin	If there are any one of these danger signs, classify as POSSIBLE INFECTION OR JAUNDICE	Refer URGENTLY to the hospital or health centre Keep the newborn baby warm and give him or her breast milk on the way.
None of the above	Normal baby	Breastfeeding and care to prevent infection and keep the baby warm.

Table 6.2. Neonatal assessment checklist.

Prevention of neonatal infections

Many early neonatal infections can be prevented by:

Always ensuring clean and safe delivery; Good basic hygiene and cleanliness during delivery of the baby.
Make sure the delivery room is clean and delivery equipment are sterile or at least clean
Special attention to cord care and eye care.
Many late neonatal infections are acquired in hospitals. These can be prevented by exclusive breastfeeding and strict procedures for hand washing for all staff and families before and after handling babies.