Danger Signs in Newborn Teaching Aids NNF DS

Danger Signs in Newborn Teaching Aids: NNF DS- 1

Sick newborn Early detection, prompt treatment and referral (if required) are necessary to prevent high mortality Teaching Aids: NNF DS- 2

Problems in early diagnosis of sick newborn v Non-specific signs v Difficulties in preterm and LBW babies Teaching Aids: NNF DS- 3

Lethargy and poor sucking v In a term baby who was feeding earlier indicates neonatal illness (as perceived by mother) v In a preterm baby needs careful assessment because it may be due to cold stress or immaturity Teaching Aids: NNF DS- 4

Capillary refill time (CRT) v Indicates tissue perfusion v Normal CRT < 3 seconds v Prolonged CRT > 3 seconds * v Use 10 ml/kg normal saline bolus * Hypotension, hypothermia, acidosis Teaching Aids: NNF DS- 5

Capillary refill time (CRT) Teaching Aids: NNF DS- 6

Respiratory problems v RR > 60 / min* v Retractions v Grunt v Central cyanosis v Apnea *Rate should be counted in a quiet state and not immediately after feed Teaching Aids: NNF DS- 7

Teaching Aids: NNF R E T R A C T I O N S DS- 8

Body temperature in o newborn infant ( C) Normal range Cold stress Moderate hypothermia Severe hypothermia Teaching Aids: NNF 37. 5 o 36. 5 o Cause for concern 36. 0 o Danger, warm baby 32. 0 o Outlook grave, skilled care urgently needed DS- 9

Failure to pass meconium and urine Failure to pass meconium Majority pass within 24 hrs v Delayed passage v May have passed in –utero v Lubricated per-rectal thermometer may be therapeutic v Suspect obstruction Failure to pass urine Majority pass within 48 hrs v Delayed passage v Exclude obstructive uropathy or renal agenesis Teaching Aids: NNF DS-10

Causes of vomiting* v Ingestion of meconium stained amniotic fluid v Systemic illness v Congestive cardiac failure v Raised ICP – IVH, asphyxia v Metabolic disorders (CAH, galactosemia) *Persistent, projectile or bile stained - r / o intestinal obstruction Teaching Aids: NNF DS-11

Causes of diarrhea v Infective diarrhea* (often non breast fed baby) v Maternal ingestion of drugs (ampicillin, laxatives) v Metabolic disorders v Thyrotoxicosis v Maternal drug addiction *Infective diarrhea needs treatment with systemic antibiotics Teaching Aids: NNF DS-12

Cyanosis Peripheral v Normal at birth v Seen in extremities due to cold Central v Always needs appropriate referral v Seen on lips and mucosa v Indicates cardiac or pulmonary disease Teaching Aids: NNF DS-13

Peripheral cyanosis Teaching Aids: NNF DS-14

Central cyanosis Teaching Aids: NNF DS-15

Yellow Palms & Soles Teaching Aids: NNF DS-16

Yellow staining of soles Teaching Aids: NNF DS-17

Tracheo-esophageal fistula v Excessive drooling; choking; cyanosis during feeds; respiratory distress v Failure to pass red rubber catheter beyond 8 to 10 cm from mouth Teaching Aids: NNF DS-18

Tracheo-esophageal fistula Teaching Aids: NNF DS-19

Suspect cardiac disease v Cyanosis v Tachycardia v Murmur v Hepatomegaly v Shock v Cardiomegaly Teaching Aids: NNF DS-20

Abnormal weight loss pattern v > 10 percent of birth weight in term v > 15 percent in preterm v > 5 percent acute weight loss Teaching Aids: NNF DS-21

Danger signs : Summary v Lethargy v Bleeding v Hypothermia v Yellow palms/ v Respiratory distress soles v Excessive wt. loss v Vomiting v Diarrhea v Cyanosis v Convulsion v Abd. distension Teaching Aids: NNF DS-22