Family-Led Care Package - everypreemie.org · Tool 3: Facility Monitoring Form for KMC Babies . Tool 4 (Chichewa): Basic Care Family Monitoring Form . ... Weight Babies . Tool 5 (English):

Family-Led Care Package

Malawi

Contents Tool 1: Facility 2 Hour Feeding Chart (less than 1500g) Tool 2: Facility 3 Hour Feeding Chart (more than 1500g)

Tool 3: Facility Monitoring Form for KMC Babies

Tool 4 (Chichewa): Basic Care Family Monitoring Form

Tool 4 (English): Basic Care Family Monitoring Form

Tool 5 (Chichewa): Flip Chart – Basic Care of Preterm and Low Birth Weight Babies

Tool 5 (English): Flip Chart – Basic Care of Preterm and Low Birth Weight Babies

Tool 6 (Chichewa): Leaflet – Basic Care of Preterm and Low Birth Weight Babies

Tool 6 (English): Leaflet – Basic Care of Preterm and Low Birth Weight Babies

Every Preemie—SCALE Family-Led Care Materials – Tool 1: Facility 2 Hour Feeding Chart (less than 1500g) *Adapted from Government of Malawi form

2 HOUR FEEDING CHART FOR NEONATES LESS THAN 1500g

Patient name…………………………………………………… Birth weight……………………

Lowest acceptable weight during first 10 days = Birthweight – (10% x Birthweight) = ________g

Date Age (Days)

Time (24 hrs) Feed e.g EBM

Cup (tick)

NGT (tick)

Amount Required

Amount Taken Remarks Guide Actual

02 04 06 08 10 12

Weight Gain/Loss 14 16

18 20 22 24

TODAY’S TOTAL AMOUNT

Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


02 04 06 08 10 12


18 20 22 24


Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


02 04 06 08 10 12


18 20 22 24


Every Preemie—SCALE Family-Led Care Materials – Tool 1: Facility 2 Hour Feeding Chart (less than 1500g) *Adapted from Government of Malawi form

Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


02 04 06 08 10 12


18 20 22 24


Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


02 04 06 08 10 12


18 20 22 24


Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required

Amount Taken Remarks

Guide Actual 02

04 06 08 10 12


18 20 22 24


Every Preemie—SCALE Family-Led Care Materials – Tool 2: Facility 3 Hour Feeding Chart (more than 1500g) *Adapted from Government of Malawi form

3 HOUR FEEDING CHART FOR NEONATES MORE THAN 1500g

Patient name…………………………………………………… Birth weight……………………

Lowest acceptable weight during first 10 days = Birthweight – (10% x Birthweight) = ________g

Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


Guide Actual 03

06 09


18 21 24


Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


Guide Actual 03

06 09


18 21 24


Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


03 06 09


18 21 24


Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


03 06 09


18 21 24


Every Preemie—SCALE Family-Led Care Materials – Tool 2: Facility 3 Hour Feeding Chart (more than 1500g) *Adapted from Government of Malawi form

Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


Guide Actual 03

06 09


18 21 24


Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


Guide Actual 03

06 09


18 21 24


Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


03 06 09


18 21 24


Date Age (Days)


Cup (tick)

NGT (tick)

Amount Required


03 06 09


18 21 24


Normal findings: Temperature >36.5 <37.4 C; Respirations 40-60 breaths/minute; Tone: normal /abnormal (for gestational age; flexed from 36 wks); color: normal/abnormal

Every Preemie—SCALE Family-Led Care Materials – Tool 3: Facility Monitoring Form for KMC Babies *Adapted from Government of Malawi forms

MONITORING FORM FOR KMC BABIES Mother’s Name: Baby’s Name (if given): Baby’s Sex:

Date of Birth: Time of Birth: Location of Birth:

Weight at Birth (if known):

Day 1: (date)

Day 2: (date)

Day 3: (date)

Day 4: (date)

Day 5: (date)

Day 6: (date)

AM PM AM PM AM PM AM PM AM PM AM PM Temperature Respirations Tone Color Urine Stool

Day 7:

(date) Day 8: (date)

Day 9: (date)

Day 10: (date)

Day 11: (date)

Day 12: (date)




Day 13:


Day 15: (date)

Day 16: (date)

Day 17: (date)

Day 18: (date)


Day 19:


Day 21: (date)

Day 22: (date)

Day 23: (date)

Day 24: (date)


Day 25:


Day 27: (date)

Day 28: (date)

Day 29: (date)

Day 30: (date)




Day 31: (date)

Day 32: (date)

Day 33: (date)

Day 34: (date)

Day 35: (date)

Day 36: (date)


Day 37:


Day 39: (date)

Day 40: (date)

Day 41: (date)

Day 42: (date)


Day 43:


Day 45: (date)

Day 46: (date)

Day 47: (date)

Day 48: (date)


Every Preemie—SCALE Family-Led Care Materials – Tool 4: Basic Care Family Monitoring Form

Kadi lounikira chisamaliro cha mwana osakhwima ndi obadwa ndi sikero yotsika pabanja

Tsiku 1 Tsiku 2 Tsiku 3 Tsiku 4 Tsiku 5 Tsiku 6 Tsiku 7 Tsiku 8 Tsiku 9 Tsiku 10 Tsiku 11 Tsiku 12 Tsiku 13 Tsiku 14 Ndinamwetsa mwana mkaka

wa mmawere

Ndinaona kutentha kwa thupi

la mwana

Ndinaona mwana ngati ali ndi

chikasu; ngati pamchombo pali magazi kapena mafinya

Ndinaona momwe mwana akupumira

Ndinaona kutakataka kwa

mwana

Ndinaona ngati mwana akukomoka kapena ayi

Every Preemie—SCALE Family-Led Care Materials – Tool 4: Basic Care Family Monitoring Form

BASIC CARE FAMILY MONITORING FORM

Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8 Day 9 Day 10 Day 11 Day 12 Day 13 Day 14 Fed breast milk

Checked temperature

Checked for jaundice, infected

belly button, eyes or skin

Checked breathing

Checked energy level

Checked for convulsions

Chisamaliro Cha Ana Obadwa Masiku Osakwana komanso

Obadwa ndi Sikero Yotsika

This flip chart is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Every Preemie—SCALE and do not necessarily reflect the views of USAID or the United States Government.

Filipi chati ya chisamaliro cha ana obadwa masiku osakwana komanso obadwa ndi sikelo yotsika yapangidwa kuti ithandize ogwira ntchito za umoyo kupereka upangiri komanso kuphunzitsa makolo omwe ali ndi ana obadwa masiku osakwana komanso otsika sikero zakasamalidwe ka ana amenewa.

Pulojekiti ya Every Preeme imene ikulandira thandizo kuchokera ku bungwe la USAID ndipo ikugwiridwa ndi mabungwe a Project Concern International (PCI), Global Alliance to Prevent Prematurity and Still Births (GAPPS) komanso American College of Nurse Midwives (ACNM) ikuthokoza bungwe la USAID kamba ka thandizo la ndalama zomwe zagwira ntchito potulutsa fulipichatiyi. Tikuthokozanso Unduna wa za Umoyo m’Malawi kudzera mu thambi ya Uchembere Wabwino (RHD), Health Education Services komanso Ofesi ya zaumoyo ku Balaka ndi anthu awa kamba ka kudzipereka kwao ndi thandizo pa ntchitoyi.

Kuthokoza

Patricia Burkhardt Indira Chikomoni Rodgers Chilemba Mercy Chinkhunda Jeffrey Chisale Chelsea Dunning Blessings Genti Mtisunge Kachingwe Eneles Kachule Elimase Kamanga Fredson Kamcira Eugene Katenga-Kaunda Tobias Kunkumbira Jim Litch

ACNMZomba Central HospitalGraphic DesignerBalaka District Health Office PCIPCISave the Children (SSDI-S) Balaka District Health Office Reproductive Health Directorate PCIHealth Education Services Balaka District Health OfficeHealth Education Services GAPPS

Madalitso Luhanga Bwaila Hospital - LilongweAustin Makwakwa Health Education ServicesEuphrasia Mpakiza Machinga District HospitalGertrude Ngwalo-Banda Machinga District HospitalPeter Ntuta Zomba Central HospitalMercy Nyirenda Balaka District Health OfficeRichard Nyirenda Mzimba District HospitalJudith Robb-McCord PCIDamiano Semu Health Education ServicesPatricia Siyabo Queen Elizabeth Central HospitalSuzanne Stalls ACNMMorris Tengatatenga PCIPatrice White ACNM

Every Preemie—SCALE Family-Led Care Materials – Tool 5: Flip Chart

ZamkatimuGawo loyamba: Chisamaliro chakuchipatala cha mwana obadwa masiku osakwana komanso otsika sikelo

Gawo lachiwiri: Chisamaliro cha mwana kunyumba

C. Kumwetsa mwana mkaka wa m’mawere...........................................................................................................D. Kukhala tcheru ndi zizindikiro zoopsa kwa mwana.............................................................................................E. Thandizo lochokera kwa achibale kapena anthu amdera...................................................................................

Gawo lachitatu: Chisamaliro cha mwana patsiku lodzamuonetsa kuchipatala A. Kudziwa mmene chisamaliro cha mwana chinayendera kunyumba.................................................................

101112

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B. Kuteteza mwana ku matenda.............................................................................................................................. 9A. Kupitiriza kusamalira mwana mu njira ya Kangaruu kunyumba.......................................................................... 8

G. Kuona m’mene mwana akukulira.........................................................................................................................F. Kukhala tcheru ndi zizindikiro zoopsa kwa mwana.............................................................................................. 6E. Kumwetsa mwana mkaka wa m’mawere............................................................................................................. 5D. Kuteteza mwana ku matenda............................................................................................................................... 4C. Kaikidwe ka mwana pa Kangaruu........................................................................................................................ 3B. Kuonetsetsa kuti mwana ali malo ofunda/otenthera bwino................................................................................ 2A. Kuunikira makolo ndi achibale zakusamalira mwana mu njira ya Kangaruu........................................................1

F. Kuunikira zakubweranso ku Chipatala................................................................................................................

B. Ndondomeko yoyesera mwana patsiku lodzamuonetsa........................................................................................

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13

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Funsani:Kodi mukuona chiyani pa chithunzichi? Kodi chikuchitika ndi chiyani pamenepa?Munaonako wina aliyense akuchita zimenezi?

Fotokozani:Zikomo kwambiri. Pachithunzipa tikuona anamwino akuphunzitsa makolo zosamalira mwana obadwa masiku osakwana kapena obadwa ndi sikelo yotsika.

Pano, tikambirana tanthauzo la kusamalira mwana mu njira ya Kangaruu.

Funsani:Kodi muli ndi mafunso kapena ndemanga iliyonse pa zomwe takambiranazi?

Kumbukirani:Takambirana kuti Kangaruu ndi njira yabwino yosamalira mwana amene wabadwa masiku osakwana kapena otsika sikero (yochepera makilogalamu awiri ndi theka; 2.5kgs) pomuika pa chifuwa. Njirayi imathandizira mwana kuti akule ndi moyo wathanzi polimbikitsa kuyamwitsa,kusunga mwana potethera, kuteteza mwana ku matenda komaso kulimbikitsa chikondi pakati pa mwana ndi makolo.

Kangaruu ndi njira yabwino yosamalira mwana amene wabadwa masiku osakwana kapena otsika sikero (yochepera makilogalamu awiri ndi theka; 2.5kgs) pomuika pa chifuwa. Njirayi imathandizira mwana kuti akule ndi moyo wathanzi polimbikitsa kuyamwitsa,kusunga mwana potenthera, kuteteza mwana ku matenda komaso kulimbikitsa chikondi pakati pa mwana ndi makolo.

Tsopano tikambirana za ubwino wakusamalira mwana munjira ya Kangaruu.

Njira ya kangaruu: Imathandizila kuti mwana azimva kutentha bwino.

Ndikwapafupi kuti ana obadwa masiku osakwana kapenaamene abadwa ndi sikero yotsika azizidwe.

Imathandiza kuti mwana aziyamwa pafupipafupi.

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A. Kuunikira makolo ndi achibale zakusamalira mwana mu njira ya Kangaruu

Imalimbikitsa kuti mwana azipuma bwinobwino chifukwa amamva kugunda kwa mtima wa amene wamuika pa kangaruu.Imachepetsa chiopsezo choti mwana azidwaladwala.Imathandiza kuti ana azikhala ndi moyo.Imapereka chilimbikitso kwa makolo cha kusamalira mwana obadwa masiku osakwana kapena obadwa ndi sikero yotsika. Imachepetsa nthawi yogonekedwa m'chipatala.Imalimbikitsa chikondi pakati pa mwana ndi makolo. Imathandiza kuti ubongo ndi ziwalo zina za mwana zikule bwino.

Gawo loyamba: Chisamaliro chakuchipatala cha mwana obadwa masiku osakwana komanso otsika sikelo

cdunning

Typewritten Text

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Funsani:Kodi mukuona chiyani pa chithunzichi? Mukuganiza kuti chikuchitika ndi chiyani?

Funsani:Kodi pali mafunso kapena ndemanga pa zomwe takambiranazi?

Kumbukirani:Onetsetsani kuti mwana wanu akutenthedwa bwino chifukwa atha kumwalira kamba kozizidwa.

Fotokozani:Zikomo kwambiri, Pachinthunzipa tikuona mmene tingapangire kuti mwana akhale malo ofunda/otenthera bwino.

Ndikwapafupi kuti ana obadwa masiku osakwana kapena amene abadwa ndi sikero yotsika azizidwe ndipo akhoza kumwalira chifukwa cha kuzizidwako . Mungathandize mwana wanu kuti adzimva kutethera bwino pochita izi:

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B. Kuonetsetsa kuti mwana ali malo ofunda/otenthera bwino

Musamamusambitse mwana wanu koma mudzingomupukuta. Mudziika mwana pachifuwa mu njira ya Kangaruu kuti adzimva kutenthera kwa thupi lanu.Mudziveka mwana chipewa, sokosi, ndi thewera louma. Mudzisintha thewera likangonyowa.Pangani izi ngati mwana amene ali pakangaruu akuzizidwabe:

Sinthani thewera ngati lanyowa.Muvekeni chipewa ndi sokosi.Onjezerani nsalu zoberekera mwana.Pitirizani kumuika pa kangaruu.Tsekani mawindo ndi zitseko za nyumba yomwe muli mwana kuti mufundire bwino.Ngati simukuona kusintha patatha ola limodzi, adziwitseni adokotala.

2

Funsani:Kodi mukuona chiyani pa chithunzichi?Kodi mukuganiza kuti chikuchitika ndi chiyani?

Ndondomeko yakaikidwe ka mwana pa Kangaruu:

1) Sambani mmanja ndi sopo.Vekani mwana sokosi, thewera ndi chipewa basi.Oyika mwana pa kangaruu avule zovala za kumtunda.Ikani mwana pakati pa mawere moyang'anana ndi ameneakumuika pa kangaruu ndipo mutu wa mwana uyang'anecha m'mbali.Mangani nsalu/chitenje mozungulira mwana ndi ameneakuyika mwana pa kangaruu ndipo mangirani ku mbuyo.Ikani nsalu kapena shawelo pamwamba pa nsalu yoyambaija ndipo mangirani chakutsogolo.Valani chovala chotsegula kutsogolo. Onetsetsani kutimwana ali chatsonga kuti azipuma bwino.

3)4)

5)

6)

7)


Kumbukirani:Onetsetsani kuti mwatsatira ndondomeko yakaikidwe ka mwana pa kangaruu. Muikeni mwana pakangaruu kwa nthawi yosachepera maola makumi awiri. Onetsetsani kuti mwana ali chatsonga panthawi yomwe ali pangangaruu kuti azipuma bwino.

Fotokozani:Zikomo kwambiri. Pachithunzipa tikuona ndondomeko yoikila mwana pa kangaruu. Ana obadwa masiku osakwana kapena obadwa ndi sikero yotsika ayenera kusamalidwa pogwiritsa ntchito njira ya kangaruu. Masiku oyambirira ana ena amanyinyirika kukhala pa kangaruu koma kenako amazolowera.Aliyense ngakhale abambo akhoza kuika mwana pa kangaruu.

Aliyense ngakhale abambo atha kuika mwana pa kangaruu.

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C. Kaikidwe ka mwana pa Kangaruu

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1

4

3

5

Aonetseni kaikidwe ka mwana pa kangaruu potsatira ndondomekozi.

Malangizo kwamakolo:Muzionetsetsa kuti mwana ali chatsonga pamene mukuyenda kapena mwakhala pansi.Panthawi imene mukugona onetsetsani kuti mwagona chagada motsamira chinthu kuti mwana azipuma bwino.Onetsetsaninso kuti mwana ali pa kangaruu kosachepera maola makumi awiri patsiku.

2)

3

2

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3

5

1) Sambani m'manja pa nthawi izi:

2) Pukutani mwana thupi lake lonse ndi ka nsalu

konyowetsedwa m'madzi ofunda.Vekani mwana thewera la ukhondo nthawi zonse. Tsukani ziwiya zomwetsera mwana mkaka.Mchombo wamwana udzikhala panja pa thewera kuti ukhale wouma nthawi zones. Izi zimathandiza kuti mchombo upole msanga.Osamalira mwana akhale a ukhondo nthawi zonse. Chepetsani anthu odzaona mwana.Samalirani mwana kutali ndi anthu omwe akudwala.

3)4)5)

6)7)8)

Funsani:Kodi mukuona chiyani muchithunzi? Kodi mukuganiza kuti chikuchitika ndi chiyani?

Funsani:Pali mafunso kapena ndemanga iliyonse pa zomwe takambiranazi?

Fotokozani:Zikomo kwambiri. Pachithunzipa tikuona amayi akusamba mmanja. Ndikwapafupi kuti mwana obadwa masiku osakwana kapena wobadwa ndi sikero yotsika adwale. Tsatilani izi kuti muteteze mwana wanu ku matenda.

Kumbukirani:Ndikwapafupi kuti mwana obadwa masiku osakwana kapena wobadwa ndi sikero yotsika adwale. Choncho onetsetsani kuti mukusatira ndondomeko takambiranazi kuti mwana atetezedwe ku matenda.

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D. Kuteteza mwana ku matenda

Musanagwire mwana.Musanam'mwetse komanso mukamaliza kumwetsa mkaka mwana.Musanasinthe komanso mukamaliza kusintha thewera.Mukachoka ku chimbudzi.

4

Funsani:Kodi mukuona chiyani pa chithunzichi? Kodi mukuganiza kuti chikuchitika ndi chiyani?

Fotokozani:Zikomo kwambiri. Pazithunzipa tikuona njira zosiyanasiyana zomwetsera mwana mkaka.


Kumbukirani:Mkaka wa m'mawere ndicho chakudya choyenera cha mwana wa khanda. Kumbukirani kuyamwitsa mwana wanu usana ndi usiku omwe.

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E. Kumwetsa mwana mkaka wa m’mawere

Mkaka wa m'mawere ndicho chakudya choyenera kwa mwana wa khanda.Mwana apatsidwe mkaka wa m'mawere okha okha kosachepera pakati pa kasanu ndi katatu (8) kapena ka khumi ndi kawiri (12) kapena maola atatu kapenanso awiri aliwonse tsiku lirilonse potengera sikero ya mwanayo. Kwa ana amene akukanika kuyamwa, finyani mkaka wa mmawere ndi kuwamwetsa pogwiritsa ntchito kapu kapena chubu chodyera. Mkaka wa mmawere utha kusungidwa muziwiya zosamalika bwino kwa maola 8 usanaonongeke.Mwana amene akumwetsedwa mkaka wammawere pogwiritsa ntchito kapu kapena chubu, alimbikitsidwe kuyamwa pomuika ku bere kwa ka nthawi kochepa.Mwana amene akutha kuyamwa kubere, apatsidwenso mkaka wammawere oonjezera pogwiritsa ntchito kapu. Akayamba kuyamwa bwino kubere, yamwitsani mwana wanu mwakathithi. Mudzichonga nthawi imene mwana wanu wayamwa kapena wamwa mkaka wa m'mawere pa pepala limene tikupatseni. Amayi a mwana adzidya zakudya zamagulu asanu ndi limodzi (6) kosachepera kanayi komanso azimwa madzi ambiri. Izi zimathandizira kuti mkaka uzituluka wambiri.

5

Funsani:Mukuona chani pa chithunzipa?Kodi munaonako mwawa akuonetsa zizindikiro ngati izi?

Kumbukirani:Awuzeni a dokotala ngati mwana akuwonetsa chimodzi kapena zina mwa zizindikiro zoopsazi. Musadikire kuti adokotala abwere koma muwafunefune kuti amuone mwana.

Fotokozani:Zikomo kwambiri. Pazithuzizi tikuona zina mwa zizindikiro zoopsa kwa mwana wa khanda.

Ngati muona zizindikiro izi kwa mwana wakhanda, musachedwe adziwitseni a namwino kapena a dokotala:

Uzani a dokotala msanga ngati mwana akutsokomola mopitiriza chifukwa chikhonza kukhala chizindikiro choti mwana wa tsamwa.

Funsani:Kuchokera pa zimene takambairanazi pali mafunso kapena ndemanga?

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F. Kukhala tcheru ndi zizindikiro zoopsa kwa mwana wakhanda

Kulephera kapena kukana kuyamwa. Mwana sakutha kuyamwa kapena akusanza kayamwa.Kutentha kapena kuzizira thupi kwambiri: thupi la mwana likuzizira kapena kutentha kwambiri.Thupi la mwana likuoneka chikasu. Izi zimakonda kuyambira mmanja komanso mmapazi. Kuvutika kupuma: mwana akupuma mwamsangamsanga, kubuula popuma, kupuma mobanika kapena kupuma mosiyiza.Kusatakataka kwa mwana: mwana wafooka kwambiri.Kutuluka magazi kapena mafinya pa mchombo: kufiira kwa khungu lozungulira mchombo.Kukomoka: Kodi mwana wakhanda akamakomoka amaonetsa zizindikiro zanji?

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KULEPHERA KAPENA KUKANA KUYAMWA

CHIKASU KUTULUKA MAGAZI KAPENA MAFINYA PA MCHOMBO,

MANTHONGO MMASO KAPENA ZILONDA PA KHUNGU

KUZIZIRA KAPENA KUTENTHA THUPI KWAMBIRI

KUVUTIKA KUPUMA KUFOOKA KUKOMOKA

Funsani:Kodi mukuona chiyani pa chithunzichi?Mukuganiza kuti chikuchitika ndi chiyani?

Aonetseni ndikuwaphunzitsa zokhudzana ndi pepalali.


Kumbukirani:Mwana adziyezedwa sikelo tsiku lililonse. Achipatala adzipima mwana kawiri patsiku ndikukufotokozerani za umoyo wake. Azikuphunzitsani mmene inunso mungamayesere mwana wanu.

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G. Kuona m’mene mwana akukulira

Fotokozani:Zikomo kwambiri. Pachithunzipa tikuona a dokotala akuyesa mwana. Pamene muli m'chipatala: Mwana adziyezedwa sikelo tsiku lililonse.

Achipatala adzikuuzani mulingo woyenera wa mkaka wam'mawere ndi nthawi yomwetsera mwana.Achipatala adziyesa mwana kawiri patsiku ndi kukufotokozerani za umoyo wake.Achipatala azikuphunzitsani m'mene mungadziwire ngatimwana wanu ali ndi vuto lililonse. Dziwitsani achipatalamukaona vuto lililonse pa mwana wanu.Mudzichonga pa pepala pamene mwaona ngati mwana alindi zizindikiro zoopsa kapena ayi.

Mudzichonga bokosi limodzi nthawi iriyonse imene mwana wanu wamwa mkaka wa mmawere. Mudziona kutentha kwathupi la mwana wanu pogwira mapazi ake ndikufananitsa ndi kutentha kwa pachifuwa panu. Mapazi a mwana wanu akuyenera kutentha momwe pachifuwa panu pakutenthera. Adziwitseni adokotala mukaona kuti mapazi ake akuzizira kapena kutentha kwambiri. Mudzichonga mbokosi limodzi nthawi iliyonse imene mwayesa mwana wanu.

Mudzichonganso mbokosi limodzi nthawi imene mwaona mmene mwana wanu akupumira. Adziwitseni adokotala ngati mwana wanu akupuma mofulumira kapena pango’ono pang’ono kapenanso kubanika.Mudzichonganso mbokosi mukaona ngati mwana wanu ali ndi chikasu, akutuluka mafinya kapena magazi pamchombo. Chonde muziwadziwitsa adokotala ngati muona vuto pa mwana wanu.

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Funsani:Kuchokera pa zimene takambairanazi pali mafunso kapena ndemanga?

Funsani:Mukuona chiani muzithunzi?Chikuchitika ndi chiyani?

Fotokozani:Zikomo kwambiri. Pachithunzipa tikuona a dokotala akupitiliza kukambirana ndi makolo za kasamalidwe ka mwana.

Kumbukirani:Mwana obadwa masiku osakwana kapena wobadwa ndi sikero yotsika ayenera kupitiliza kusamalidwa m'njira ya Kangaruu. Mwana ayenera kukhala pofunda.

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Gawo lachiwiri: Chisamaliro cha mwana kunyumba

A. Kupitiriza kusamalira mwana mu njira ya Kangaruu kunyumba

Mwana wanu akukula bwino moti atha kukasamalidwa kunyumba komabe akufunika chisamaliro chokwanira kuti apitirize kukula bwino.Mwanayu akupuma bwino, akuyamwa komanso sakuzizidwa. Sikelo yake yakhala ikukwera kwa masiku atatu otsatana. Masiku omwe mwakhala muli kuno mwaphunzira za kangaruu ndi ubwino wake.Nkofunika kukapitiliza kumuika mwana pa kangaruu. Nkofunikanso kumuyika mwana pa Kangaruu nthawi ina iliyonse kwa maola osachepera makumi awiri (20). Achibale atha kuthandinzanso pogwira ntchito za pakhomo komanso pomunyamula mwanayo pa kangaruu pamene inu mukugwira ntchito zina.

Sinthani thewera ngati lanyowa.Muvekeni chipewa ndi sokosi.Onjezerani nsalu zoberekera mwana.Pitirizani kumuika pa kangaruu.Tsekani mawindo ndi zitseko za nyumba yomwe muli mwana kuti mufundire bwino.Ngati simukuona kusintha patatha ola limodzi, kamutengereni kuchipatala msanga.

Muzikapanga izi ngati mwana amene ali pakangaruu akuzizidwabe:

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Funsani:Kodi mukuona chiani pa chithunzipa?Chikuchitika ndi chiani pa chithunzipa?

Funsani:Kodi pazomwe takambiranazi pali mafunso kapena ndemanga?

Kumbukirani:Ndikwapafupi kuti mwana obadwa masiku osakwana kapena wobadwa ndi sikero yotsika adwale. Mutetezeni mwana ku matenda poonetsetsa kuti mwana komanso omusamalira ndi aukhondo. Pakhomo panunso pazikhala paukhondo nthawi zonse.

Explain:Zikomo kwambiri. Pachithunzipa tikuona amayi akusamba mmanja ndi sopo.Ndikwapafupi kuti mwana obadwa masiku osakwana kapena wobadwa ndi sikero yotsika adwale. Muzikapanga izi kuti mukamuteteze mwana wanu kumatenda:

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B. Kuteteza mwana ku matenda

Muzikasamba m'manja ndi sopo pa nthawi izi:

Musanagwire mwana.Musanam'mwetse komanso mukamaliza kumm'wetsa mwana mkaka.Musanasinthe kapena mukamaliza kusintha thewera. Mukachoka ku chimbuzi.

Muzikaonetsetsa chisamaliro cha mwana potsatira izi:

Muzikachepetsa anthu odzaona mwana.Muzikagona muukonde wonyikidwa m'mankhwala usiku uliwonse, chaka chonse.Muzikamulandiritsa mwana katemera mwandondomeko

Mudzikamsamalira mwanayu kutali ndi anthu omwe akudwala.Muzikampukuta mwana thupi lake lonse ndi ka nsalu konyowetsedwa m'madzi ofunda tsiku lililonse. Mudzikamveka mwana thewera la ukhondo nthawi zonse. Mudzikatsuka makapu/ ziwiya zomwetsera mwana mkaka nthawi zonse. Mchombo wamwana udzikhala panja pa thewera kuti ukhale wouma nthawi zones. Izi zimathandiza kuti mchombo upole msanga.Osamalira mwana azikakhala a ukhondo nthawi zonse. Pakhomo panunso pazikakhala paukhondo nthawi zonse.

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Funsani:Kodi mukuona chiyani pa chithunzi ichi?Kodi mukuganiza kuti chikuchitika ndi chiyani?

Fotokozani:Zikomo kwambiri. Pachithunzipa tikuona abambo akumwetsa mwana mkaka komanso amayi akuchonga pa pepala.

Kumbukirani:Mkaka wa m'mawere ndi chakudya chopambana cha mwana. Mwana akuyenera kumwetsedwa mkaka kosachepera kasanu ndi mphambu zitatu (8) kapena kuti pa maola taturi aliwonse usiku ndi usana. Muzikakumbukira kuchonga pa pepala nthawi iliyonse mukamumwetsa mwana. Ngati mwana sakukodza komanso kubiba, chitha kukhala chizikiro mwana sakuyamwa mokwanira.

Funsani:Kodi pali mafunso kapena ndemanga pazomwe takambiranazi?

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C. Kumwetsa mwana mkaka wa m’mawere

Ana obadwa masiku osakwana komanso ana obadwa ndi sikelo yotsika amayenera kuyamwa mkaka wa m'mawere pafupipafupi kuti akule bwino.Tikupatsaninso pepala lomwe mumagwiritsa ntchito kuno ku chipatala kuti mukapatirize kugwiritsa ntchito kunyumba posamalira mwana wanu moyenera. Chonde muzikakumbukira kuchonga pa pepalalo nthawi iliyonse pamene mwamwetsa mwana wanu mkaka kuti muthe kudziwa ngati mwana akumwa mkaka wa mmawere motsatira.

Awonetseni pepala la chisamaliro cha mwana.

Mkaka wa mmawere ndicho chakudya chabwino kwa mwana. Mwana akuyenera kumakayamwa kosachepera kasanu ndi mphambu zitatu (8) kapena kuti maola atatu aliwonse usiku ndi usana.Ana omwe akulephera kuyamwa okha afinyireni mkaka ndi kuwamwetsa pogwiritsa ntchito kapu. Mwana akuyenera kuyamwa mkaka wa m'mawere mwakathithi ngati akukwanitsa kuyamwa yekha popanda vuto lirilonse.

Ngati mwana sakukodza kapena sakuchita chimbudzi ndichizindikiro choti mwana sakumwa mkaka okwanira.Amayi azikadya zakudya zamagulu asanu ndi limodzi (6) kosachepera kanayi patsiku komanso azikamwa madzi ambiri. Izi zimathandiza kuti mayi azitulutsa mkaka wambiri.

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Funsani:Kodi mukuona chiyani pa chithunzi ichi?Kodi mukuganiza kuti chikuchitika ndi chiyani?

Kumbukirani:Ngati mwana wanu akuonetsa zizindikiro zoopsa pitani naye kuchipatala mwachangu kuti akawonedwe ndi adokotala.

Fotokozani:Zikomo kwambiri. Pazithunzipa tikuona zina mwa zizindikiro zoopsa kwa mwana wakhanda.


Kodi takambirana kuti zizindikiro zoopsa kwa mwana ndi ziti?

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D. Kukhala tcheru ndi zizindikiro zoopsa kwa mwana

Kulephera kapena kukana kuyamwa: Mwana sakutha kuyamwa kapena akusanza kayamwa.Kutentha kapena kuzizira thupi kwambiri: Thupi la mwana likuzizira kapena kutentha kwambiri.Thupi la mwana likuoneka chikasu: Izi zimakonda kuyambira mmanja komanso mmapazi.Kuvutika Kupuma: Mwana akupuma mwamsangamsanga, kubuula popuma, kupuma mobanika kapena kupuma mosiyiza.Kusatakataka kwa mwana: Mwana wafooka kwambiriKutuluka magazi kapena mafinya pa mchombo: Kufiira kwa khungu lozungulira mchombo. Kukomoka: Kodi mwana wakhanda akamakomoka amaonetsa zizindikiro zanji?

Ana obadwa masiku osakwana komanso obadwa ndi sikelo yotsika amadwalika kwambiri munthawi yochepa. Ngati mwana wanu akuonetsa chimodzi mwazizindikio zoopsa nditchulezi, mukathamangire naye kuchipatala.

Awonetseni ndikuwakumbutsa momwe momwe azikagwiritsira ntchito pepala.

Pepalali likukukumbutsani kuti muzikaona mwana wanu kawiri pa tsiku ngati ali ndi zizindikiro zoopsa kwa mwana kapena ayi.Muzikachonga pa pepalali mukamuona mwana wanu monga mumachitira mchipatala muno.Pepalali silikuonetsa zizindikiro zonse koma inu mukuyenera kukhala tcheru ndi zizindikiro zonse zoopsa kwa mwana.Muzikakumbukira kubweretsa pepala lachisamaliro cha mwana pa masiku odzaonetsa mwana.

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KUVUTIKA KUPUMA KUFOOKA KUKOMOKA

Funsani:Kodi mukuona chiyani pa chinthunzi ichi?Kodi mukuganiza kuti chikuchitika ndi chiyani?

Fotokozani:Zikomo kwambiri. Pachithunzipa tikuona amayi akuphika komanso mtsikana wanyamula mwana pa kangaruu komanso akukonza ndiwo.

Lero tikutulutsani koma mukuyenera kuti mukabwerenso kuno kuchipatala kapena mukapite ku chipatala chakufupi ndi kwanu.


Kumbukirani:Amayi ndi oloredwa kugwira ntchito zina za pakhomo zomwe sizifuna kuwerama. Achibale atha kuthandiza kugwira ntchito zofuna kuwerama kapena atha kukulandirani mwana kuti inu mugwire ntchitozo. Mkofunikira kubweranso kuchipatala kudzaonetsa mwana monga takambirana kale.

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E. Thandizo lochokera kwa achibale kapena anthu amdera

Ndikofunika kutsatira ndondomeko za masiku obweranso kuchipatala kudzaonetsa mwana (AUZENI TSIKU LIMENE AKUYENERA KUBWERANSO KUCHIPATALA).Mukawadziwitse a keya gulupu komanso azaumoyo kuti mwabwerako kuchipatala. Iwo azikakuyenderani monga mwa ntchito yawo.Achibale akhonza kumakakuthandizani kuika mwana pa kangaruu.Amayi ndi oloredwa kugwira ntchito zina za pakhomo zomwe sizifuna kuwerama. Tchulani zitsanzo zantchito zimenezi.Ntchito zofuna kuwerama zigwiridwe ndi achibale kapena inuyo ngati akulandirani mwana.Nzotheka kuyenda naye mwana kunja ali pa Kangaruu.Mukamuteteze mwana wanu kumatenda monga takambirana kale. Kodi paja tinati mwana tingamteteze bwanji kumatenda? Nthawi zonse muzikagona chatsonga potsamira zithu monga thumba la mchenga wa kumadzi, pilo kapena zovala.Kumbukirani kuti mayi ayenera kumakadya zakudya zamagulu 6 kosachepera kanayi patsiku ndikumamwa madzi ambiri.Kumbukirani kubweranso ku chipatala pa nthawi zomwe azikuuzani.

Akumbutseni makolo momwe azikagwiritsira ntchito mapepala lomwe akupatsidwa potulukapa. Akumbutseni za zizindikiro zoopsa ndi zomwe ayenera kuchita akawona chimodzi mwa zizindikirozo. Perekani mapepala lokawerenga kunyumba.

Tsopano mupita kunyumba, ndipo dziwani izi:

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Fotokozani:Zikomo kwambiri. Pachithunzipa tikuona amayi aika mwana pakangaruu atakwezedwa panjinga. Akuoneka kuti akupita kuchipatala.

Muzipita kunyumba koma nkofunikira kwambiri kuti muzibwera kuchipatala kudzaonetsa mwana monga takambirana kale. Izi zimathandizira kuti mwana wanu akule bwino. Pamene mukubwera kudzaonetsa mwana, muzikakumbukira kubweretsa pepala limene muzikachonga mukamwetsa mwana wanu mkaka wa mmawere komanso mukamuona ngati ali ndichizindikiro choopsa kwa mwana kapena ayi. Muzikakumbukiranso kubweretsa buku la mwana la ku sikelo.

Patsiku lodzaonetsa mwana:

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F. Kuunikira zakubweranso ku Chipatala

Muzidzatiuza mmene zayendera kunyumba. Tidzafuna tidziwe momwe chisamaliro chamwana chinayendera kunyumba komanso kudziwa nawo mafunso omwe achibale kapena amzanu amakufunsani ndikuti munathana nawo bwanji.Tizidzaona pepala lachisamaliro cha mwana.Tizidzamuyesa mwana sikelo kuti tione momwe akukulira. Tizidzamuyesa mwana kuyambira kumutu mpaka kumiyendo kuti tidziwe ngati pali vuto kapena ayi.


Funsani:Kodi mukuona chiyani pachithunzichi?Mukuona ngati chikuchitika ndichiyani?

Kumbukirani:Nkofunikira kwambiri kuti muzibwera kuchipatala kudzaonetsa mwana monga takambirana kale. Izi zimathandizira kuti mwana wanu akule bwino. Pamene mukubwera kudzaonetsa mwana, muzikakumbukira kubweretsa pepala la chisamaliro cha mwana. Muzikakumbukiranso kubweretsa buku la mwana la ku sikelo.

Tizidzakuyankhani mafunso omwe muli nawo. Tikukupemphani kuti muzizatifunsa mafunso. Mukhonza kulemba mafunso omwe mukufuna kudzafunsa kuopetsa kuiwala. Mutha kuwalemba pa pepala lachisamaliro cha mwana lija.

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Fotokozani: Takulandirani ndipo tikuthokoza chifukwa chobwera kuchipatala kudzaonetsa mwana. Kodi mwanayu ali bwanji?

Funsani:Kodi mukuona chiyani pa chinthunzi ichi?Kodi mukuganiza kuti chikuchitika ndi chiyani?

Fotokozani:Zikomo kwambiri. Pachithunzipa tikuona a namwino akulandira banja lomwe likusamalira mwana wao munjira ya kangaru.

Lero tikambirana zammene chisamaliro cha mwana chinayendera kunyumba komanso ndimuyesa kuti tione ngati pali chovuta chirichonse.

Tiuzeni mmene zinayendera kunyumba.Anthu amati chiyani? Amakufunsani mafunso anji? Amakuthandizani mndani? Zinayenda bwanji? (Athandizeni molingana ndi zomwe anakumana nazo.)

Kodi mwanayu anakumanako ndivuto lanji kunyumba? Munapanga chiyani kuti mwana athandizidwe pavutolo? (Alimbikitseni moyenera.)

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Gawo lachitatu: Chisamaliro cha mwana patsiku lodzamuonetsa kuchipatala

A. Kudziwa mmene chisamaliro cha mwana chinayendera kunyumba

Onani ngati mwana ali ndi chizindikiro choopsa ndipo muthandizeni musanapitilize.

Pano ndikufuna ndidziwe zammene kuika mwana pa kangaruu kumayendera kunyumba.

Ndiuzeni ngati panali zovuta zirizonse kuika mwana pa kangaruu kunyumba. Nanga munathana nazo bwanji?Mukamuika mwanayu pakangaruu, amaonetsa zotani?Kodi mwana amalira kapena kukhala ngati kukwawa mukamuika pangaruu?

Alimbikitseni pazomwe anachita bwino ndipo athandizeni pamene anafooka/kulephera.

Pano ndikufuna ndidziwe momwe mwana amamwera mkaka wa mmawere kunyumba.

Kodi mwana amamwa bwanji mkaka wa mmawere? Amayamwa kapena mumagwiritsa ntchito kapu?Amamwa kangati patsiku?Panali zovuta zanji ndipo munathana nazo bwanji?

Onani pepala lomwe amachonga kunyumba kuti muone ngatii mwana amayamwa moyenera kapena ayi?

Tsopano ndimuyesa mwanayu kuyambira kumutu mpaka kumiyendo, ndimuyesa kutentha kwathupi komanso mmene akupumira kuti tione ngati pali vuto kapena ayi. Ndimuyesanso sikero kuti tione momwe akukukulira.

Onani tsamba lotsatira likuuzani zochita poyesa mwanayu.

Kodi mwanayu mumamuika kangati kapena kuti maola angati pakangaruu patsiku?Amamuika pakangaruu ndindani?

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B. Ndondomeko yoyesera mwana patsiku lodzamuonetsa

Tsatirani ndondomeko iyi kuti muyese mwanayu mwadongosolo.

Sambani mmanja ndi sopo musanamgwire mwana.Yesani kutentha kwa thupi lake pogwirtsa ntchito chida choyesera kutetentha kwa thupi (thermometer).Yesani momwe akupumira, werengani mapumidwe ake kuti mudziwe ngati akupuma moyenera pa mphindi. Muonenso pachifuwa pake (nganga) ndikuona ngati akupuma bwinobwino kapena ayi.Muyeseni thupi lonse kuyambira kumutu mpaka kumiyendo.Mukamaliza, sambani mmanja ndi sopo.Alongosolereni makolo zomwe mwapeza.Alimbikitseni pazomwe zikuyenda bwino ndipo athandizeni pamene akufooka. Adziwitseni zoyenera kuchita molingana ndi zomwe mwapeza.

Lembani zomwe mwapeza mubuku la mwana komanso mu kaundula (regisita).Athokozeninso chifukwa choti anabwera kudzaonetsa mwana kuchipatala. Akumbutseni tsiku lomwe akuyenera kubweranso ngati akuyenera kubweranso.Kumbukirani kelemba dzina la mwana komanso adilesi yake mu dayale patsiku lomwe akuyenera kubweranso kudzaonetsa mwana.

Funsani:Kodi muli ndi funso kapena ndemanga?

Kumbukirani:Chonde mukapitirize kugwirtsa ntchito pepala lachisamaliro chamwana ndipo mudzabweretse pobwera kudzaonetsa mwana. Mubweranso kuno kuchipatala pa (akumbutseni stiku lomwe akuyenera kubwera) Kabwereni kuchiptala tsiku lina lilonse ngati mukaone chimodzi mwazizindikiro zoopsa kwa mwana.

Muwadziwitse ngati mukuwatulutsa mu ndondomeko ya kangaruu.

Auzeni makolo tsiku lobweranso kuchipata ngati akuyenera kupitiriza kusamalira mwana mu njira ya kangaruu. Alimbikitseni kubwera tsikuli lisanakwane ngati mwana aonetsa chizindikiro choopsa kwa mwana. Adziwitseni ngati mukuwatumiza kuchipatala china kapena ngati mukuwagoneka mchipatala chifukwa chazomwe mwapeza.

Auzeni makolo zomwe mwapeza pa mwana wawo.

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SAMBANI MMANJA

SAMBANI MMANJA AUZENI MAKOLO ZOMWE MWAPEZA

YESANI SIKERO LEMBANI SIKERO YA MWANA

YESANI MWANA

Basic Care of Pretermand

Low Birth Weight Babies

This flip chart is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Every Preemie—SCALE and do not necessarily reflect the views of USAID or the United States Government.

The Basic Care of Preterm and Low Birth Weight Babies flip chart was developed to provide a standardized guide to health workers for counselling and educating families with premature and low birth weight babies.

Every Preemie—SCALE, a USAID-funded project implemented by Project Concern International (PCI), the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), and the American College of Nurse-Midwives (ACNM), would like to sincerely thank USAID for funding the development and production of this flip chart. We are also particularly grateful to the Ministry of Health in Malawi through the Reproductive Health Directorate, Health Education Services, Balaka District Health Office and the following individuals for their support and contributions (in alphabetical order):

Acknowledgements

Patricia Burkhardt Indira Chikomoni Rodgers Chilemba Mercy Chinkhunda Jeffrey Chisale Chelsea Dunning Blessings Genti Mtisunge Kachingwe Eneles Kachule Elimase Kamanga Fredson Kamcira Eugene Katenga-Kaunda Tobias Kunkumbira Jim Litch

ACNMZomba Central HospitalGraphic DesignerBalaka District Health Office PCIPCISave the Children (SSDI-S) Balaka District Health Office Reproductive Health Directorate PCIHealth Education Services Balaka District Health OfficeHealth Education Services GAPPS

Madalitso Luhanga Bwaila Hospital - LilongweAustin Makwakwa Health Education ServicesEuphrasia Mpakiza Machinga District HospitalGertrude Ngwalo-Banda Machinga District HospitalPeter Ntuta Zomba Central HospitalMercy Nyirenda Balaka District Health OfficeRichard Nyirenda Mzimba District HospitalJudith Robb-McCord PCIDamiano Semu Health Education ServicesPatricia Siyabo Queen Elizabeth Central HospitalSuzanne Stalls ACNMMorris Tengatatenga PCIPatrice White ACNM

Every Preemie—SCALE Family-Led Care Materials – Tool 5: Flip Chart

Table of ContentsSection 1: Introduction to Basic Care for Preterm and Low Birth Weight Babies

B. Keeping Baby Warm............................................................................................................................................C. Putting Baby in Skin-to-Skin Position...................................................................................................................D. Preventing Infections............................................................................................................................................E. Feeding Baby.......................................................................................................................................................

Section 2: Preparing to Go Home

B. Preventing Infections at Home.............................................................................................................................C. Feeding Baby at Home.......................................................................................................................................D. Watching for Danger Signs at Home..................................................................................................................E. Family and Community Support.........................................................................................................................

Section 3: Follow-Up Care for Preterm and Low Birth Weight BabiesA. Reviewing Care of Baby at Home.......................................................................................................................

101112

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9A. Continuing Care at Home.................................................................................................................................... 8

G. Monitoring Baby in the KMC Unit......................................................................................................................... 7F. Checking for Danger Signs.................................................................................................................................. 6

5 4 3 2

A. Introducing Kangaroo Mother Care (KMC) to Parents and Family....................................................................... 1

F. Preparing for Follow-Up Visit..............................................................................................................................13

B. Baby Weighing and Exam During Follow-Up Visit..............................................................................................15

Ask:What do you see in this picture? What do you think is happening?Have you ever seen anyone doing this?

Explain:Thank you. In the picture, we see a nurse teaching parents how to care for a premature or low birth weight baby.

Now we will talk about Kangaroo Mother Care (KMC).Invite Discussion:Do you have any questions or comments on what we have discussed?

Remember:Kangaroo Mother Care (KMC) is a good way to meet preterm and low birth weight babies' needs for warmth, adequate breast milk feeding, protection from infection, stimulation, safety and love. All babies less than 2500g who can breathe air and have no major health problems should be started on KMC.

KMC is a good way of caring for preterm (less than 37 weeks) and low birth weight (weighing less than 2500g) newborns. It promotes improved growth and survival by providing warmth, adequate breast milk feeding, protection from infection, stimulation, safety and love.

Any baby who weighs less than 2500g, can breathe air, and has no major health problems is eligible to begin KMC.

Let's talk about how KMC can help your baby: KMC helps to keep the baby warm. Small babies have

difficulty staying warm.

KMC encourages frequent breastfeeding, helping babiesgain weight and grow faster.

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A. Introducing Kangaroo Mother Care (KMC) to Parents and Family

Babies have more regular breathing and less episodesof stopping breathing.

Babies have fewer and less severe infections. Babies have a better chance of surviving.Families feel more confident in handling their preterm or low birth weight baby.Hospital stay for mother and baby is reduced (early discharge), and cost to the family is reduced. KMC encourages bonding and love.The baby's brain and other body parts grow better.

Section 1: Introduction to Basic Care for Preterm and Low Birth Weight Babies

cdunning

Typewritten Text

1

Ask:What do you see in this picture?What do you think is happening?

Invite Discussion:Do you have questions or comments on what we have discussed?

Remember:Ensure that your baby is kept warm, because they may die if they become cold.

Explain:Thank you. In the picture we see how we can keep the baby warm.

Preterm and low birth weight babies can't stay warm the way that full-term babies can and don't gain weight or grow well. Some babies can even die from being cold. You can help your baby to stay warm by doing the following:

2

B. Keeping Baby Warm

Do not bathe them; only wipe them clean and immediately dry.Keep babies in skin-to-skin position to gain warmth from the caretaker's body.Dress your baby in hats, socks and dry nappies. Change nappies once soiled.Do the following if your baby's feet feel colder than your chest:

Remove wet wrapper or diaper.Practice continuous skin-to-skin contact.Cover caretaker and baby with more layers of jumpers, wrappers, or blankets.If not yet dressed, put a hat and socks on the baby.Close windows and doors to keep the room warm. If temperature does not improve after 1 hour, please take your baby to the health worker.

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Steps for putting the baby in skin-to-skin position:

1) Wash your hands with soap and water before handling thebaby.Dress the baby in a hat, socks, and a dry nappy.

3) The person putting the baby skin-to-skin should bedressed from the waist down.

4) Place the baby between the breasts of the person doing skin-to-skin, and turn baby's head to the side in the sniffing position.

5) Secure the baby in a frog-like position with arms and hipsflexed on the person's chest with a wrapper, with thewrapper supporting the baby's head. The top of the wrappershould be just under the level of the baby's ear. Make surethe feet are covered by the wrapper.

6) Put a blanket or shawl on top for additional warmth.7) The person doing skin-to-skin should wear a top that

opens in the front.


Remember:Follow each step in order. Missing one step may lead to incorrect positioning. Keep skin-to-skin throughout the day and keep baby in upright position while mother sleeps.

Explain:Thank you. In the picture we see the steps for putting the baby skin-to-skin. This helps preterm and low birth weight babies stay warm. Your baby should be held in skin-to-skin position throughout the day and night, even while nursing and sleeping.

Everyone, including men, can have the baby in the skin-to-skin position.

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C. Putting Baby in Skin-to-Skin Position

2

1

4

3

5

Demonstrate to the family how to put the baby in skin-to-skin position.

Instruct the family:The person doing skin-to-skin should keep the baby upright when walking or sitting.The person doing skin-to-skin should sleep in a half-sitting position to keep the baby upright.The baby should be in continuous skin-to-skin contact for at least 20 hours each day. Skin-to-skin contact should only be interrupted for brief periods, such as changing a nappy.

2)

3

2

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3

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1) Wash hands with soap and water:

2) Clean or wipe baby daily (head to toe) and immediately dry.3) Clean all cups and feeding utensils for the baby.4) Keep nappy below the umbilicus to make sure the cord

remains dry.5) Mother and caretakers should clean themselves daily.6) Limit visitors.7) Keep the baby away from people who are sick.8) Keep your family and surroundings clean.



Explain:Thank you. In the picture we see a mother washing her hands. Preterm and low birth weight babies are more prone to infections.

Prevent infections by following the steps below:

Remember:Preterm and low birth weight babies are more prone to infections. It is important to prevent infections by using the steps we have discussed so that you and your baby are protected from infections.

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D. Preventing Infections

Before touching the baby.Before and after feeding the baby. Before and after changing nappies. After using the toilet.

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Explain:Thank you. In the picture we see different ways of feeding the baby.


Remember:Breast milk is the best and only recommended food for small babies. Remember to breastfeed the baby day and night.

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E. Feeding Baby

Breast milk is the best and only recommended food for small babies.Your baby should be exclusively breastfed at least 8-12 times each day or every 2-3 hours, depending on baby's weight.Babies who are not able to suckle well should be fed expressed breast milk by cup feeding.Breast milk should be hand expressed into a clean cup. It can be stored at room temperature for up to 8 hours if kept in a cup with a lid or cover.After the baby cup feeds, the baby should be put on the breast to stimulate breast milk production and help the baby learn to suckle.Once the baby can suckle well, the baby should be exclusively breastfed from the breast.Record each feeding on a form we will give you.

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Ask:What do you see in this picture?Have you ever seen a baby with any of these danger signs?

Remember:Tell a staff member immediately if the baby has any danger sign. Do not wait for someone to check on you.

Explain:Thank you. In the picture we see the danger signs for the baby.

Mother and family should watch and report to a staff member if your baby has any of the following danger signs:

Tell a staff member if the baby is coughing; it may be a sign of choking.


Please tell me all the danger signs.

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F. Checking for Danger Signs

TROUBLE FEEDING: Baby fails to feed, does not feed normally, or is vomiting. TOO HOT OR TOO COLD: The baby feels too hot or too cold.JAUNDICE: Any part of the baby's body is yellow. This is usually noticed first on the hands or feet.INFECTED BELLY BUTTON, EYES OR SKIN: Skin around the cord is red, there is pus or blood coming from the cord, or there is pus around the eyes. TROUBLE BREATHING: The baby's breathing is too fast, the baby is grunting, or the baby's chest draws inward between the ribs when the baby takes a breath. The baby stops breathing, even if only for a brief period. LESS ENERGY: The baby is not active or doesn't move.CONVULSIONS: The baby has convulsions. Convulsions are repeated back-and-forth movements of the arms and legs that cannot be stopped by holding the arm or leg.

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TROUBLE FEEDING JAUNDICE, INFECTED BELLY BUTTON, EYES OR SKIN

TOO HOT OR TOO COLD

TROUBLE BREATHING LESS ENERGY CONVULSIONS


Show and teach the family how to use the Basic Care Family Monitoring Form.


Remember:While you are in the hospital, the providers will be checking on your baby's condition twice every day. They will also teach you how to monitor your baby's condition every day to help your baby grow.

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G. Monitoring Baby in the KMC Unit

Explain:Thank you. In the picture we see the health care provider examining the baby. While you are here at the hospital: The provider will measure and record the baby's weight

every day. The provider will discuss with you how often the baby

needs to be fed and how much milk the baby needs tobe fed at each feeding.The provider will check and record the baby's conditiontwice a day, or more frequently if needed. They willshare this information with you and your family.The provider will teach you how to monitor your baby'scondition while in the hospital, and you will continue tomonitor your baby's condition at home after discharge.You will record the baby's condition on a form which wewill give you. Remember to report to the health workerimmediately if something is wrong with your baby.

You will tick a box every time you feed your baby.You will check your baby's temperature by feeling their foot; their foot should be as warm as your chest. You will tick a box every time you check your baby's temperature. If your baby's foot is cold, you will tell a staff member. You will check your baby's breathing and tick the box. If the baby is breathing fast or slow, you will tell a staff member.You will tick the box when you check the cord and eyes for pus or blood and the body to make sure it isn't yellow. If you see pus or blood or the body is yellow, you will tell a staff member.

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Explain:Thank you. In the picture we see a nurse talking to a family using a flip chart. The nurse is telling the family:

Remember:A preterm or low birth weight baby needs basic care. The baby needs to stay warm and be fed every 2 to 3 hours. Other family members can carry the baby skin-to-skin and help with household chores. Watch for danger signs and report to a health worker immediately if your baby shows any danger signs.

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Section 2: Preparing to Go Home

A. Continuing Care at Home

Your baby is doing well enough to go home but still needs care and support to grow.Your baby is breathing well, feeding well, and is staying warm.Your baby has been gaining weight for the past three days. While you've been here, you've learned about basic care and why it is helpful. It is important to continue all aspects of basic care at home.It is important to keep the baby in skin-to-skin position for at least 20 hours each day to keep the baby warm.Other members of your family can carry the baby skin-to-skin and help with household chores.Do the following if your baby feels cold while skin-to-skin:

Remove wet wrapper or diaper.Practice continuous skin-to-skin contact.Cover caretaker and baby with more layers of jumpers, wrappers, or blankets.Put a hat and socks on the baby if they are not yet dressed. Close windows and doors to keep the room warm.If temperature doesn't improve after 1 hour, bring your baby to the health facility.

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Remember:Preterm and low birth weight babies are more likely to become sick. It is important to keep the baby, caretakers and the home clean to prevent infection.

Explain:Thank you. In the picture we see a mother washing her hands helped by a grandmother. Preterm and low birth weight babies are more likely to become sick.

Mothers and families can help to prevent infections and illness by following the steps below:

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B. Preventing Infections at Home

Wash hands with soap and clean water (just like we've been doing here):

Before and after breastfeeding or expressing breast milk. Before and after changing nappies.After using the toilet.

Before and after touching the baby.

Keep the baby away from people who are sick.Clean or wipe baby daily (head to toe) and dry immediately. Change nappies when they become wet or soiled/dirty. Clean the baby's feeding utensils with soap and clean water before and after use.Keep nappy below the umbilicus to make sure the cord remains dry.Mother and caretakers should bathe daily.Keep the home environment clean.Limit visitors.

Sleep with the baby skin-to-skin under a treated mosquito net every night, all year round. When the baby is not skin-to-skin, make sure the baby is still sleeping under a treated mosquito net.Ensure that the baby receives immunizations according to the schedule advised by the health worker.

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Explain:Thank you. In the picture we see a father cup-feeding the baby and a mother ticking on the paper form.

Remember:Breast milk is the best and only recommended food for small babies. Remember to breastfeed the baby day and night, and place a tick on the form each time you feed the baby. If the baby is not passing urine and stool, it could be an indication that the baby is not getting enough milk.


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C. Feeding Baby at Home

Breast milk is the best and only recommended food for small babies.The baby should be exclusively breastfed at least 8-12 times day and night (every 2-3 hours).Small babies may not have the strength and coordination to feed adequately from the breast. If your baby has trouble suckling, you will need to supplement with cup feeds using expressed breast milk.If the baby is not passing urine or stool, it could be an indication that the baby is not getting enough milk.

Show and remind the family how to use the Basic Care Family Monitoring Form to track number of feeds.

Preterm and low birth weight babies need to breastfeed frequently in order to grow.We are sending you home with the same forms that you used in the facility. Place a tick on the form each time you feed the baby so you know how many times you have fed the baby each day.

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Remember:If you see the baby have any of these danger signs go with the baby to the hospital immediately. Use the form to help you remember to check for danger signs.

Explain:Thank you. In the picture we see the newborn danger signs.

Small babies can become very ill very quickly. If your baby shows any of these signs, seek medical help right away:


Please tell me all the danger signs.

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D. Watching for Danger Signs at Home

Show and remind the family how to use the Basic Care Family Monitoring Form to check for danger signs.

The form reminds you to check for danger signs 2 times each day.When you check for each danger sign, place a tick mark in the box.The form does not show all of the danger signs. It is important to remember the danger signs and check for all danger signs, even though they are not shown on the form.Bring the form to show the provider at each of your baby's follow-up visits.

TROUBLE FEEDING: Baby fails to feed, does not feed normally, or is vomiting. TOO HOT OR TOO COLD: The baby feels too hot or too cold.JAUNDICE: Any part of the baby's body is yellow. This is usually noticed first on the hands or feet.INFECTED BELLY BUTTON, EYES OR SKIN: Skin around the cord is red, there is pus or blood coming from the cord, or there is pus around the eyes. TROUBLE BREATHING: The baby's breathing is too fast, the baby is grunting, or the baby's chest draws inward between the ribs when the baby takes a breath. The baby stops breathing, even if only for a brief period. LESS ENERGY: The baby is not active or doesn't move.CONVULSIONS: The baby has convulsions. Convulsions are repeated back-and-forth movements of the arms and legs that cannot be stopped by holding the arm or leg.

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TROUBLE FEEDING JAUNDICE, INFECTED BELLY BUTTON, EYES OR SKIN

TOO HOT OR TOO COLD

TROUBLE BREATHING LESS ENERGY CONVULSIONS


Explain:Thank you. In the picture we see a mother cooking while a girl has put the baby in skin-to-skin position.

Today you will be discharged. Now that you are going home, you should remember the following:


Remember:You can do some household chores with the baby skin-to-skin, especially those which do not require bending. Relatives and family should help with other chores and holding the baby skin-to-skin. It is important to bring the baby back to the facility for follow-up visits.

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E. Family and Community Support

It is important to come back to the facility or go to the facility in your area for your baby's checkup as instructed (TELL THE FAMILY THE DATE THEY ARE EXPECTED TO COME BACK FOR FOLLOW-UP CARE).When you get home, inform the Lead Mother or the Care Group and HSA in your area that you are back at home. They will also come visit you to check on you and your baby. They will remind you when the baby needs to return to the facility for checkups.Close family members should assist you with carrying the baby in skin-to-skin position.You can do some household chores with the baby in skin-to-skin position, especially those which do not require bending. What are some examples of these chores in your home?The rest of the chores should be done by family/relatives, or family members should hold the baby skin-to-skin while you do these chores.It is possible to move around outside with the baby in skin-to-skin position, but do not bend over. Keep baby upright.Prevent infections by following the steps we have already discussed. What are the ways you can prevent your baby from getting infections?

Always sleep on your back, propped upright with baby skin-to-skin under a treated mosquito net. You can use a pillow, a bag of river sand, or clothes to help prop you upright while sleeping.Baby should be kept away from indoor smoke from cooking fires.Breastfeeding places increased demands on mother's energy and protein stores. Extra food should be made available to mothers, and mothers should consume enough water to avoid thirst.Lactating women should eat food from all six groups, eat one extra meal a day, and drink a lot of water.Remember to bring your baby to the facility for follow-up visits.

Provide and explain the take home leaflet to the family. Provide a referral if applicable. Provide family with clear instructions for the date, time and place of the next follow-up visit for baby.

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Explain:Thank you. In the picture we see a mother with her baby in skin-to-skin position being carried on a bicycle to the hospital.

You will be going home once we feel your baby is growing well. It is very important that all KMC babies return to the facility for follow-up visits so that we can make sure they continue to grow well. When you come you will need to bring your Basic Care Family Monitoring Form and the baby's health passport.

We will give you a specific day to return for this follow-up visit, but you should return immediately if your baby has any danger signs before your scheduled visit.

During this visit:

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F. Preparing for Follow-Up Visit

We will hear your story of what has happened since you returned home. We will want to know what questions your friends and family asked, how you coped with the questions, and how you were able to manage your baby. We will review the Basic Care Family Monitoring Form with you.We will weigh your baby and determine if your baby has gained enough weight.We will examine your baby.We will answer any questions you or your family may have. We encourage you to write down any questions on the back of the Basic Care Family Monitoring Form so that you don't forget them.



Remember:It is important to bring your baby for their follow-up visit. Bring your Basic Care Family Monitoring Form and the baby's health passport to this visit. If your baby has any danger signs before this visit, you should return immediately.

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Welcome the Family: We are very thankful that you have brought your baby to the hospital for a checkup. How is the baby?


Explain:Thank you. In the picture we see a nurse welcoming a family which has placed their baby skin-to-skin. The family has returned with the baby for a follow-up visit.

Today we will hear how you and your baby did at home and will weigh and examine the baby for any problems.

Please tell us your story. (Use prompts if needed: What did people say? What did they ask you? Who helped you? What was your experience?)

Now I would like to know how you practiced skin-to-skin contact at home:

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Section 3: Follow-Up Care For Preterm And Low Birth Weight Babies

A. Reviewing Care of Baby at Home

Check the baby for danger signs before you proceed.

How many hours was the baby in skin-to-skin position each day?Who held the baby in skin-to-skin position?Were there any challenges with putting the baby skin-to-skin? If so, how did you manage those challenges?When you put the baby skin-to-skin, how did the baby respond? Was the baby wiggling, pulling out limbs, or crying when being put back in skin-to-skin position after nappy changes?

Praise them on what they did well and assist them with what they did not do properly.

Now I would like to know how the baby was feeding at home:How was the baby feeding? Were you putting the baby to the breast or using a cup?How many times each day were you feeding the baby?What challenges did you have and how did you deal with them?

Check the Basic Care Family Monitoring Form to see if they were making tick marks to track how many times the baby was fed at home. Praise them for what they did well and encourage them to keep tracking feeds.

Now I will examine the baby from head to toe, check body temperature, and check how the baby is breathing to see if there are any problems. I will also weigh the baby to see how the baby is growing.

Use the next page as a job aid to guide you while examining the baby.

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B. Baby Weighing and Exam During Follow-Up Visit

Follow the steps below to weigh and examine the baby:

Wash your hands with soap and water before touching the baby. Weigh the baby and record the weight.Calculate number of grams per day the baby has gained or lost; evaluate if this is normal.Examine the baby.When you are done examining the baby, wash your hands with soap and water.Explain the findings to the parents.Praise them for what they did well and teach/encourage them on how they can better care for their baby.

Tell the family the date when they should bring the baby back for another visit. Inform them if you are referring them to another hospital or if you are discharging them from KMC care.Record the visit in the baby's health passport and in the register. Thank them and remind them of the date when they should bring the baby back to see you again. Encourage them to return earlier if the baby has any danger signs.


After examining the baby, discuss results with the family.

Remember:Continue to track your baby's feeds and check for danger signs at home. It is important to return for your next follow-up visit. If your baby has any danger signs before this visit, you should return immediately.

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WASH HANDS

WASH HANDS DISCUSS WITH PARENTS

WEIGH BABY RECORD WEIGHT

EXAMINE BABY

Chisamaliro Cha Ana Obadwa Masiku Osakwana

komanso Obadwa ndi Sikero Yotsika

Tsatirani ndondomeko za masiku obweranso ku chipatala kudzaonetsa

mwana.

Ndondomeko yoikira mwana pa kangaruu

A chipatala azidzayesa mwana wanu kuti adziwe

ngati pali vuto kapena ayi, komanso kuti aone mmene

mwana akukulira.

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1

4

3

5 This leaflet is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Every

Preemie-SCALE and do not necessarily reflect the views of USAID or the United States Government. Every Preemie—SCALE Family-Led Care Materials – Tool 6: Leaflet

Kuteteza mwana ku matenda.

Onetsetsani kuti mwana ali malo ofunda/otenthera bwino nthawi zonse.

Khalani tcheru ndi zizindikiro zoopsa kwa mwana.

Chongani pa pepala lachisamaliro cha mwana mukamuona mwana wanu ngati ali ndizizindikiro zoopsa kwa mwana kapena ayi.

Mkaka wammawere ndicho chakudya chabwino kwa mwana.

Khalani aukhondo

ndikusamala pakhomo panu nthawi zonse.

Sambani mmanja ndi sopo:Musanagwire mwana.Musanam’mwetse komanso mukamalizakummwetsa mwana mkaka.Musanasinthe komanso mukakamaliza kusinthathewera.Mukachoka ku chimbudzi.

Mwana azigona mu ukonde usiku uliwonse.Mwana alandire katemera mwandondomeko.

Chongani pepala la chisamaliro cha mwana nthawi iliriyonse imene mwana wayamwa/wamwa mkaka wammawere.Ngati mwana wanu akuvutika kuyamwa, mu mwetseni mkaka wammawere pogwiritsa ntchito kapu.





KUVUTIKA KUPUMA

KUFOOKA KUKOMOKA

Thamangirani kuchipatala ndi mwana

ngati iye awonetsa chimodzi mwa

zizindikiro zoopsa kwa mwana wa khanda.

Basic Care of Preterm and Low

Birth Weight Babies

Remember to come back to the hospital with the baby

as scheduled.

Steps for Skin-to-Skin Positioning

At the hospital, the health worker will check on your

baby and advise you based on your baby's condition.

2

1

4

3

5 This leaflet is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Every

Preemie-SCALE and do not necessarily reflect the views of USAID or the United States Government.

Every Preemie—SCALE Family-Led Care Materials – Tool 6: Leaflet

Prevent infections in your baby.

Keep your baby warm at all times.

Monitor your baby and check for danger signs.

Use the Basic Care Family Monitoring Form to record your baby's condition.

Breast milk is the best and only recommended food for small babies.

Keep your family and

surroundings clean.

Wash hands with soap and water:Before and after touching the baby.Before and after feeding the baby.Before and after changing nappies.After using the toilet.

Baby should sleep under a treated mosquito net every night.Baby should receive vaccines as per schedule.

Use the Basic Care Family Monitoring Form to track number of feeds each day.If your baby has trouble suckling, supplement with cup feeds using expressed breast milk.

TROUBLE FEEDING TOO HOT OR TOO COLD

JAUNDICE, INFECTED BELLY

BUTTON, EYES OR SKIN

TROUBLE BREATHING

LESS ENERGY CONVULSIONS

Rush to the hospital if you see any

danger signs on the baby.

Documents

Family-Led Care Package - everypreemie.org · Tool 3: Facility Monitoring Form for KMC Babies . Tool 4 (Chichewa): Basic Care Family Monitoring Form . ... Weight Babies . Tool 5 (English):