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4.6 Head or whole body cooling in management of hypoxic ischaemic
encephalopathy
Head or whole body cooling should not be done outside well-resourced, tertiary neonatal intensive care units, because there is potential for harm from this therapy
in low-resource settings.
Strong recommendation, moderate quality evidence
4.7 Antibiotics for treatment of necrotizing enterocolitis
Young neonates with suspected necrotizing enterocolitis NEC should be treated with IV or IM ampicillin or penicillin and gentamicin as irst line antibiotic
treatment for 10 days.
Strong recommendation, low quality evidence
4.8 Kangaroo Mother Care
Low birth weight LBW neonates weighing 2000 g who are clinically stable should be provided Kangaroo Mother Care KMC early in the irst week of life.
Strong recommendation, moderate quality evidence
4.9 Prevention of hypothermia immediately after birth in LBW infants
LBW neonates weighing 1200g who do not have complications and are clinically stable should be put in skin-to-skin contact with the mother soon ater birth and
ater drying them thoroughly to prevent neonatal hypothermia.
Weak recommendation, low quality evidence
Recommendations for treatment of cough and difficulty in breathing 4.10
Treatment of non-severe pneumonia with wheeze
Antibiotics are not routinely recommended for children aged 2–59 months with non- severe pneumonia i.e. fast breathing with no chest indrawing or danger sign with
a wheeze but no fever temperature 38 °C, as the cause is most likely to be viral.
Strong recommendation, low quality evidence
4.11 Antibiotic treatment for non-severe pneumonia with no wheeze
a Children with non-severe pneumonia i.e. fast breathing with no chest indrawing or danger sign should be treated with oral amoxicillin. he exception is in patients
with HIV: — With low HIV prevalence, give amoxicillin at least 40mgkgdose twice daily
for 3 days.
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— With high HIV prevalance, give amoxicillin of at least 40mgkgdose twice daily for 5 days.
Weak recommendation, moderate quality evidence
b Children with non-severe pneumonia who fail on the irst line treatment with amoxicillin should have the option of referral to a facility where there is appropriate
second line treatment.
Weak recommendation, expert opinion
4.12 Antibiotics treatment for severe pneumonia
a Children aged 2–59 months with severe pneumonia chest indrawing should be treated with oral amoxicillin at least 40mgkgdose twice daily for 5 days.
Strong recommendation, moderate quality evidence
b In HIVAIDS infected children, speciic guidelines for treatment of severe pneumonia in the context of HIV should be followed.
Strong recommendation, low quality evidence
4.13 Antibiotic treatment for very severe pneumonia
a Children aged 2–59 months with very severe pneumonia should be treated with parenteral ampicillin or penicillin and gentamicin as a irst line treatment.
— Ampicillin: 50 mgkg, or Benzyl penicillin: 50,000 units per kg IMIV every 6 hours for at least 5 days
— Gentamicin: 7.5 mgkg IMIV once a day for at least 5 days
Strong recommendation, moderate quality evidence
b Cetriaxone should be used as a second line treatment in children with severe pneumonia with failure on the irst line treatment.
Strong recommendation, expert opinion
4.14 Inhaled salbutamol for treatment of acute wheezeasthma and
bronchoconstriction
a Children with acute wheezeasthma and bronchoconstriction should be treated with inhaled salbutamol using a metered dose inhaler MDI with spacer devices
to relieve bronchoconstriction.
Strong recommendation, low quality evidence
b Oral salbutamol should not be used for treatment of acute or persistent wheeze except where inhaled salbutamol is not available. Oral salbutamol is not useful in
testing response to bronchodilators.
Strong recommendation, low quality evidence
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