3.6.1  Possible serious bacterial infection or very severe disease

An infant may have pneumonia, sepsis or meningitis, and it can be difficult to distinguish between these infections. It is not necessary for you to make this distinction, however, since your responsibility for a young infant with any sign of possible serious bacterial infection is to refer the young infant to hospital as a matter of urgency. Before referral, there are several things you can do to minimise the risk to the young infant’s health. For example:

• Give a first dose of intramuscular and oral antibiotics.
• Treat to prevent low blood sugar; this can be done by:
  • the mother breastfeeding the child
  • if the young infant is unable to breastfeed, offering expressed breastmilk or a breastmilk substitute
  • offering sugar water if neither of the above options is available.
  • The young infant should have 30‒50 ml of milk or sugar water before departure for medical treatment.

• Keep the young infant warm. Advising the mother to keep her sick young infant warm is very important. Young infants have difficulty in maintaining their body temperature. Low temperature alone can kill young infants.

Malaria is unusual in young infants, so you don’t need to give any treatment for possible severe malaria.