3.7.2  Treatment for a young infant who does not need urgent referral

You can identify the appropriate treatment for each classification by reading the chart in your health post. You should enter on the record form what treatment you give the young infant. When you advise the mother on how to care for her young infant at home you should also tell her when she needs to return for a follow-up visit. A young infant who receives antibiotics for local bacterial infection should return for a follow-up visit in two days.

Follow-up visits are especially important for a young infant. If you find at the follow-up visit that the infant’s condition is worse, you must refer the infant to the hospital.

Oral antibiotics

For local bacterial infection you should give the young infant an appropriate oral antibiotic. Give amoxicillin as indicated in Table 3.2 below. However you should avoid giving cotrimoxazole to infants less than one month of age who are premature or jaundiced. Instead you should give the young infant amoxicillin.

Table 3.2  Treatment for local bacterial infection.



Give three times daily for five days


250 mg


125 mg in 5 ml

Birth up to one month (


1.25 ml

One month up to two months (3‒4 kg)


2.5 ml

Give first dose of intramuscular antibiotics

Table 3.3 below sets out the appropriate dose of intramuscular gentamycin that you should give the young infant with possible serious bacterial infection or very severe disease.

Table 3.3  Treatment for possible serious bacterial infection or very severe disease



Dose: 2.5 mg per kg body weight (IM)


Use the undiluted 20 mg/2 ml formulation or dilute the 80 mg/2 ml formulation by adding 6 ml of sterile water

1 kg

0.25 ml*

2 kg

0.50 ml*

3 kg

0.75 ml*

4 kg

1.00 ml*

5 kg

1.25 ml*


*Avoid using undiluted 40 mg/ml Gentamycin. The dose is a quarter of that listed above and will be very difficult to measure accurately.

Referral is always the best option for a young infant classified with possible serious bacterial infection. However as taking the child to hospital is not always an option, or if you know that the mother is unlikely to take the child to hospital, the guidelines on Where referral is not possible state that you should advise the mother that she must treat the young infant with amoxycillin every eight hours and gentamycin every 12 hours for at least seven days. You would also tell her to come back for a follow-up visit in two days, so that you can check whether the infant is making progress. When the baby is a newborn you should explain to the mother the circumstances when she should bring her baby back to the health post immediately.

3.7.1  Urgent pre-referral treatment

3.8  Follow-up visits and care for the sick young infant