Key Features

• Fast breathing (>= 60 breaths/minute) is the key sign.
• Applies ONLY to infants aged 7 days to 59 days.
• Absence of severe chest indrawing and other signs of PSBI/Very Severe Disease is crucial for this classification.
• Requires treatment with oral Amoxicillin.

Classification

• Fast breathing (>= 60 breaths/minute) AND Age 7 days to 59 days AND No severe chest indrawing AND No other signs of PSBI/Very Severe Disease -> PNEUMONIA

Management

Non-Pharmacological Management

• Advise mother on keeping infant warm.
• Advise on continued exclusive breastfeeding.
• Advise on clearing blocked nose if interfering with feeding.
• Advise mother on signs to return immediately.

Pharmacological Treatment

• Give oral Amoxicillin twice daily for 7 days. Dosage (using 75-100mg/kg/day range, divided twice daily): Weight 1.5-2.4kg: 125mg per dose (1/2 of 250mg DT or 2.5ml of 250mg/5ml syrup). Weight 2.5-3.9kg: 125mg per dose (1/2 of 250mg DT or 2.5ml of 250mg/5ml syrup). Weight 4.0-5.9kg: 250mg per dose (1 of 250mg DT or 5ml of 250mg/5ml syrup). (Note: Dosages derived from page 42, aiming for mid-range).
• Give Paracetamol if fever >=38°C (Dosing needs careful calculation for neonates, often 10-15mg/kg/dose q6-8h - refer to specific neonatal dosing guidelines, IMCI chart doesn't specify neonatal paracetamol dose here).

Monitoring & Follow-Up

• Follow up on day 4 (Page 47).
• At follow-up (Day 4): Reassess for PSBI/VSD signs, pneumonia signs. Check feeding.
• If PSBI/VSD signs develop -> Refer URGENTLY.
• If improving (breathing slower, feeding well): Continue Amoxicillin to complete 7 days.
• If not improving or worse: Refer URGENTLY (consider treatment failure/alternative diagnosis).

Counselling Points

• Explain the diagnosis (pneumonia) and the need for antibiotic.
• Teach mother how to give oral Amoxicillin: correct dose (demonstrate measurement), frequency (twice daily), full duration (7 days).
• Advise on keeping infant warm.
• Advise on exclusive breastfeeding.
• Advise on WHEN TO RETURN IMMEDIATELY: Breathing becomes difficult, breathing becomes faster, feeding poorly, becomes sicker, develops fever or feels cold.
• Advise on follow-up visit on day 4.

Key Features

• ANY ONE of the specified signs indicates PSBI or Very Severe Disease.
• Signs include severe feeding problems, convulsions, respiratory distress (severe chest indrawing or fast breathing <7d), temperature instability (high or low), or significantly reduced movement.
• This is a life-threatening emergency in young infants.

Classification

• Any ONE of the following signs:
• Not able to feed since birth, stopped feeding well, or not feeding at all
• Convulsions
• Severe chest indrawing
• Fast breathing (>= 60 breaths/minute) in infants LESS THAN 7 DAYS OLD
• Fever (>= 38°C axillary)
• Low body temperature (< 35.5°C axillary)
• Movement only when stimulated or no movement at all
• -> POSSIBLE SERIOUS BACTERIAL INFECTION OR VERY SEVERE DISEASE

Management

Non-Pharmacological Management

• Quickly complete assessment for all necessary pre-referral treatments.
• Keep the infant warm: Initiate skin-to-skin contact (Kangaroo Mother Care) if possible OR wrap infant in warm, dry clothes, including hat/socks, cover with blanket. Ensure no draughts.
• Handle gently.

Monitoring & Follow-Up

• To be managed at referral hospital facility.

Counselling Points

• Explain that the baby is very sick and needs urgent hospital care.
• Explain treatments given (antibiotics, sugar/milk).
• Teach the mother how to keep the infant warm on the way to the hospital (skin-to-skin contact or warm wrapping).
• Advise mother to continue trying to breastfeed if possible.
• Write a detailed referral note including all signs, classification, and treatments given (drug, dose, time).

Key Features

• Absence of any sign classifying as PSBI/VSD, Pneumonia, or Local Bacterial Infection.
• Indicates low likelihood of significant bacterial infection requiring antibiotics.
• Focus is on home care advice and monitoring.

Classification

• No signs of PSBI/Very Severe Disease AND No signs of Local Bacterial Infection AND No Fast Breathing (if 7-59 days) -> INFECTION UNLIKELY

Management

Non-Pharmacological Management

• Advise mother on home care for the young infant:
• Keep infant warm (skin-to-skin, appropriate clothing/wrapping).
• Exclusively breastfeed frequently, day and night.
• Ensure good hygiene (handwashing).
• Advise on signs requiring immediate return.

Pharmacological Treatment

• No antibiotics needed.

Monitoring & Follow-Up

• No specific follow-up needed unless another problem identified.
• Advise return immediately if any danger signs develop.

Counselling Points

• Reassure mother that the infant does not show signs of serious infection.
• Provide counselling on essential newborn care: warmth, exclusive breastfeeding, hygiene.
• Advise WHEN TO RETURN IMMEDIATELY: Difficulty feeding, becomes sicker, develops fever, feels cold, fast breathing, difficult breathing.
• Address any other concerns the mother has.