Sick Newborn Baby

SICK NEWBORN BABY

A newborn baby is sick if it is  Breathless or grunting (making a noise each time it breathes out)  Not able to feed or suck milk  Not crying, drowsy or tired (lethargic)  Repeatedly vomiting  Not able to maintain a body temperature of 35C taken rectally  Not passed urine in 24 hours in a newborn or less than ½ the daily usual urine.

Sick newborn babies die quickly. You must start treatment early.

If a newborn baby is sick, start treatment fast.

1. Check blood glucose. If blood glucose is <50mg% then put an NG tube. For a baby less than 1-2 day old give 5% dextrose 5mls for 1kg baby, 7.5ml for 1.5kg baby, 10ml for 2kg baby, and 12.5ml for 2.5kg bay and 15ml for 3kg or more. Repeat hourly if BGL <50mg% till you reach a doctor. For baby older than 3 days old add 5ml more dextrose 5% to the fluid given. If a doctor is available they can give this fluid by IV drip. 2. Oxygen if baby is breathless or oxygen saturation is <94% but saturation in newborn baby can be hard to measure with equipment available. If you are not sure start oxygen anyway. Use a mask or nasal prongs. If you only have oxygen cylinders use a nasal catheter inserted to the level of earlobes. Do not insert the cannula beyond the level of ear lobes. Run at 0.5L per minute or just a one or two bubbles a second. If you have an O2 saturation meter, keep the give enough oxygen to keep O2 at 95%. Too much oxygen for too long can be harmful. 3. Give gentamicin injection 7.5mg for each kg weight of baby: If you have the usual 80mg/2ml vial, give 0.2ml for 1kg baby, 0.25ml for 1.25kg, 0.3ml for 1.5kg baby, 0.33ml for 2kg baby, 0.4ml for 2.5kg and 0.5ml for 3kg baby. 4. Give injection CP (benzyl penicillin or crystalline penicillin). To a 10Lakh unit vial add 1.8ml water (gives 5Lakh per ml). For 1kg baby give 0.2ml IM, 1.25KG Baby give 0.25ml, 1.5kg give 0.3ml, 1.75kg give 0.35ml, 2kg give 0.4ml, 2.5 kg give 0.5ml, 3kg give 0.6ml. 5. Keep the baby warm- use an incubator if possible. 6. If there is a delay getting the baby to hospital, start IV fluid if you can. If not give NG feeds if there is no vomiting. The amount given IV is the same as amount given NG. Give 5% dextrose IV or NG in these babies. Give 2.5ml/kg every hour for babies 1 day old, 4ml/kg every hour for babies 2 days old, 5ml/kg every hour for babies 3 days old and 6ml/kg every hour for babies more than 4 days old. 7. Get these babies to a doctor as soon as possible.