SOP 29: NCU

Follow-Up of NCU Patients

Indications for Follow-Up What do we assess?
All NCU patients: History:
- Prematurity and LBW ✓ Feeding problems?
- Asphyxia ✓ Supplements given?
- Sepsis ✓ Stool? Urine? Excessive crying?
- Congenital malformations ✓ KMC practiced?
✓ Maternal problems?
(depending on the management)
✓ Any other problems?
- Complications in neonatal period
- Birth injury Physical examination:
✓ Complete physical examination
Location and Timing ✓ Specific examinations (e.g. neurologic in
HIE patients)
Clinic close to NCU or RCH
Temperature:
First visit: 2-7 days after
✓ If > 37.5 °C: Admit the baby, examine
discharge depending on thoroughly, inform the doctor to
the condition review, and treat for sepsis
Following visits: ✓ If < 36 °C: Examine thoroughly. If no
Depending on the obvious reasons (e.g. sepsis), rewarm
findings on the actual visit baby on KMC and check temperature
(usually weekly) again

Clinician Consult if: Weight:

✓ Compare actual weight with last ones
- Fever or hypothermia ✓ Aim: Weight gain of about 200g/week
- Feeding problems (If not, search for reason)
- Weight loss or inadequate weight Investigations:
gain ✓ According to findings
- Fast breathing /difficulty breathing
- Convulsions Information to caretakers:
- Jaundice ✓ Findings, progress
- Skin lesions or rashes ✓ Explanations on further management
✓ Encourage communication and play
- Malformations
with baby
- Any unclear symptoms or signs
✓ Encourage asking questions
Ending Follow-Up Visits
- Prematurity/LBW: Graduation at 2500 g, if no other complaints
- Other conditions: If no pathological findings, no need for further management
- HIE, other neurological and chronic conditions: Long-term follow-up required
- Encourage the mother to attend the routine RCH visits
MoHCDGEC (2019) National Guideline for Neonatal Care and Establishment of Neonatal Care Unit, p 230-231