6.5  Neonatal assessment check list for critical conditions

After asking the mother about any neonatal problems and doing the basic assessment and examination yourself, you can classify the newborn baby based on the following assessment check list (Table 6.1).

After assessing the baby for critical conditions, remember to check again for any gross signs of congenital anomaly and/or gross signs of birth trauma (e.g. defects on the back, swelling of the head, excessive bruises), which can be a cause of acute blood loss leading to anaemia.

In Study Session 7 we will describe everything that you and the new mother need to know about breastfeeding. Checking that the baby is feeding well and that the mother is managing to breastfeed adequately is part of every postnatal visit. You should also weigh the baby at every visit to make sure that it is gaining weight normally. This is particularly important for babies who were not born at term (37 to 42 weeks of gestation), or whose birth weight was below the normal range (equal to or greater than 2,500 gm).

Preterm babies (born at 32 to 36 weeks gestation), very preterm babies (less than 32 weeks of gestation), and those who are low birth weight (1,500 to under 2,500 gms) or very low birth weight (less than 1,500 gms) may have serious additional problems because coordination of swallowing and breathing is not well established, so they cannot feed properly. You will learn all about special care for these tiny babies in Study Session 8.

Table 6.1  Neonatal assessment checklist: the ‘Assess and Classify’ chart.
Ask and checkClassifyAction taken
  • History of difficulty feeding or unable to feed now
  • History of convulsion or convulsing now
  • Newborn is lethargic or unconscious
  • Movement only when stimulated
  • Fast breathing
  • Severe lower chest in-drawing
  • Fever
  • Hypothermia

If there is any one of the general danger signs, classify as:


Refer URGENTLY to hospital or health centre.

Keep the newborn baby warm and give him or her breast milk on the way.

  • Baby developed yellowish discoloration before 24 hours of age
  • Jaundice observed on the palms and soles
  • There is swelling of the eyes or eye discharge
  • Umbilicus is draining pus
  • More than 10 pustules are found on the skin
  • None of the above

If there is any one of these danger signs, classify as:


Refer URGENTLY to hospital or health centre

Keep the newborn baby warm and give him or her breast milk on the way.


Breastfeeding and care to prevent infection and keep the baby warm.

6.4.5  How can you prevent infection in newborns?

Summary of Study Session 6