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HealthPhone™: Referring a Sick Baby - Newborn Care Series

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Referring a Sick Baby

To provide the best care for a sick baby there will be times when you will need to refer them urgently to a higher-level facility.

This video will show the important features of a referral process.

This baby has an umbilical infection and needs urgent referral.

First explain the need for referral to the family. It’s important to gain their confidence, especially of the key decision maker – often the husband or mother-in-law. Carefully describe the urgent condition of the baby and that a higher level of care can probably save the baby’s life. Be patient and sensitive in answering their questions.

Then arrange for transport of the mother and baby together plus the other family member. Notify the facility about the baby’s condition and when they should be expected. Be sure to let them know if the mother has just given birth.

Communities should develop ways to meet emergency referral needs. This community has established ties with private transport drivers whose vehicles are reliably maintained. They have also organized a small emergency fund with contributions from all villagers.

Prepare the baby for the journey by giving the first doses of antibiotics. Guide the mother to breastfeed or give expressed breast milk by cup or feeding tube before their departure. Positioning the baby skin-to-skin will keep him warm during the journey.

Write a referral note. Include your exam findings, the reason for the referral, and all treatments given. Ask them to give you feedback. Include any other important notes such as maternity and newborn records.

Advise the mother to feed the baby and keep him warm and protected during transport.

There are many reasons that referral to a higher level facility may not be possible. Some reasons include remoteness, lack of transportation, lack of money, and lack of trust in the higher-level facility by the family.

In cases when referral is really not an option, do your best with the resources you have, even though the care will not be equivalent.

Keep the mother and baby at your clinic. Continue to support the family. The treatment, including antibiotics, should be continued.

Make sure the baby is fed every 3 hours with breast milk and kept warm with skin-to-skin contact.

Discharge the baby when the illness has resolved, she’s feeding well, gaining weight, the temperature is stable and the family feels capable of caring for the baby at home.


Explain the need for referral carefully to the family

Develop a community referral plan including transport and funds

Give the first doses and keep the baby fed & warm during journey.

Video Details

Duration: 4 minutes and 19 seconds
Year: 2012
Country: Nigeria
Language: English
Producer: Global Health Media Project
Views: 279
Posted by: nand on Jun 29, 2012

This film shows the essential features of a referral process. It covers involving the family, arranging transport, preparing the baby for the journey, and writing the referral note. It also includes what to do if referral is not an option.

The primary audience are frontline health workers in primary and district level facilities. This video was filmed in Nigeria and the Dominican Republic and produced by Global Health Media Project with support from USAID/MCHIP.

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