Neonatal mortality remains a major health challenge across the world, which involves neonatal sepsis and other related factors of prematurity. Though many strides have been done in reducing NMR, there is a need for more appropriate interventions and strategies directed towards addressing the rise in the escalation of AMR. Combating AMR will be critical in improving neonatal survival rates while giving each newborn a healthier start into life globally.

The newborn period is the key period for infant health, and the first 28 days of life are critically important-both for survival and as a base to set lifetime health and development. Neonatal deaths globally have witnessed a significant decline over the past couple of decades. The neonatal mortality count has significantly reduced dropping from a high of 5 million in 1990 to as low as 2.3 million as of 2022. However, this decline notwithstanding, neonatal mortality is still staggeringly high across low-and middle-income nations.

Neonatal mortality rates are 22 per 1000 live births in India. Neonatal sepsis and prematurity are the main causes of neonatal deaths in these tragic events. Recognizing the gravity of the issue the Indian government started the Indian Newborn Action Plan (INAP) in 2014. The goal is to take NMR down to the single digits by 2030. This initiative has brought in several key interventions, including antenatal care (vaccines, micronutrient supplementation), skilled birth attendance, clean birth practices, and neonatal resuscitation techniques. More promisingly, postnatal interventions, including early initiation of breastfeeding and skin-to-skin contact, have been proven to work well in improving newborn survival rates.

Despite these improvements, one of the biggest concerns in neonatal care today is the growing problem of antimicrobial resistance (AMR) which seriously threatens efforts to reduce neonatal mortality.

What is Antimicrobial Resistance?

Antimicrobial resistance occurs when microorganisms such as bacteria, viruses and fungi evolve over time and become resistant to commonly used antibiotics and other medications. This resistance makes infections more difficult to treat, increasing the risk of mortality and complicating treatment options. The World Health Organization has classified AMR as one of the most urgent global health threats since it not only causes death and disability but also places immense pressure on healthcare systems, significantly raising the economic burden.

The sources of AMR are many, including poor hygiene and infection control in healthcare settings, overuse and misuse of antibiotics. Contributing factors to this rapidly growing problem are antibiotic prescriptions for patient needs that do not require them and failure to complete antibiotic courses, as prescribed.

AMR and Newborn Health

For neonates, the risk is much more vital for AMR. Neonates are particularly prone to developing infections due to their rather weak immune systems. Neonatal sepsis, severe bacterial infection, is one of the leading causes of neonate deaths and it often manifests complications when it is because of drug-resistant pathogens.

According to Dr. Apoorva Taduri, Consultant Neonatologist, "Neonatal sepsis accounts for a significant proportion of neonatal deaths, and AMR is making it worse. MDR pathogens cause around 30% of neonatal sepsis mortality globally.

Maternal health and care are also factors influencing AMR in neonates. Over-prescription of antibiotics during pregnancy increases the risk of neonatal sepsis and the development of multi-drug-resistant pathogens in newborns. This calls for prudent use of antibiotics during pregnancy and at the time of delivery. In fact, studies indicate that indiscriminate use of antibiotics in mothers has a direct impact on neonatal health, which may eventually lead to resistant infections in newborns.

One of the major issues is that the drug-resistant bacteria are causing an increasing number of healthcare-associated infections in the neonatal care settings, which include NICUs. Infections by such bacteria prove to be challenging to treat; they require more advanced, expensive interventions, and the period of risk of mortality and morbidity is extended.

Counteracting AMR in Neonatal Care

To combat AMR and reduce neonatal mortality a multifaceted approach is necessary. Dr. Taduri emphasizes the continuation of the strategies outlined by the Indian Newborn Action Plan (INAP), specifically in reducing neonatal sepsis and improving infection control. However, to combat AMR more must be done to ensure proper use of antibiotics in both maternal and neonatal care settings.

Key strategies for reducing AMR in neonatal care are:

1. Improving Infection Prevention Practice: This implies, therefore, that more efforts would be made regarding stricter hospital hygiene standards, strict equipment sterilization after its usage and even maintaining adequate hand hygiene. Enhanced infection control practices greatly impact minimizing AMR pathogens distribution.

2. Antibiotic Stewardship- Teaching the healthcare providers how not to use antibiotics is a crucial thing in preventing overuse prescription. Antibiotic stewardship programs are designed to promote use of antibiotics only when truly required; appropriate drug, dose and length of treatment should be taken.

3. Improved access to WASH: Access to clean water and sanitation is a fundamental aspect of preventing infections in mothers and newborns. WASH interventions such as clean birthing practices, can reduce the risk of neonatal sepsis due to unsanitary conditions.

4. Maternal Health Strengthening: Proper maternal care, such as proper vaccination, antenatal steroids, and supplementation of micronutrients, can reduce the risk of prematurity and neonatal infection. Prevention of infection in mothers is the first step towards prevention of infection in newborns.

5. Early Diagnosis and Treatment: Early identification and treatment of neonatal infections are very important. This includes proper screening for sepsis and the use of appropriate antibiotics based on the local resistance patterns. It also involves ensuring that infants receive adequate neonatal care, such as those provided in Special Newborn Care Units (SNCUs).

The rise of antimicrobial resistance is a global health challenge that requires urgent action. Combating AMR requires a coordinated effort from governments, healthcare systems and communities worldwide. In neonatal care, addressing AMR is essential to further reducing neonatal mortality rates and ensuring that every newborn has the opportunity to thrive.

As Dr. Taduri concludes, "While we have made substantial progress in reducing neonatal mortality, the emerging risk of antimicrobial resistance creates a major challenge for our efforts. Combating AMR requires a global collective effort, with priorities on infection prevention, responsible use of antibiotics, and enhancement of healthcare practices to ensure a healthier future for all newborns."

Dr Apoorva Taduri is a Consultant Neonatologist at Fernandez Hospital

The monsoon brings welcome relief from the heat, but it also creates the perfect environment for viruses, bacteria, fungi, and mosquitoes to thrive. As a result, babies become more vulnerable to infections such as coughs and colds, diarrhoea, skin rashes, fungal infections, and mosquito-borne illnesses like dengue and malaria.

Since an infant’s immune system is still developing, they require extra care during the rainy season. Fortunately, many monsoon-related illnesses can be prevented by avoiding a few common mistakes.

Not Changing Damp Clothes Promptly

Leaving babies in damp clothes for long periods can cause discomfort, heat rash, skin irritation, and fungal infections, especially in skin folds. Whether clothes become wet from rain, sweat, or spills, they should be changed immediately. Dress your baby in soft, clean, breathable cotton clothing.

Neglecting Hand Hygiene

Hand hygiene is one of the simplest and most effective ways to prevent infections. Parents and caregivers should wash their hands with soap and water before touching or feeding the baby and after returning home. Anyone with symptoms such as cough, cold, fever, vomiting, or diarrhoea should avoid close contact with infants.

Also read: Breastfeeding Can Help Reduce Mothers' Risk of Type 2 Diabetes, Breast Cancer and More

Giving Stale or Improperly Stored Food

If your baby has started complementary feeding, always offer freshly prepared home-cooked meals. During humid weather, bacteria multiply rapidly in improperly stored food, increasing the risk of stomach infections. Avoid feeding leftovers that have been kept at room temperature for long periods.

Ignoring Mosquito Protection

The rainy season is associated with a rise in mosquito-borne diseases such as dengue and malaria. Use mosquito nets, eliminate stagnant water around your home, and dress your baby in light, full-sleeved clothing. Avoid applying mosquito repellents directly to infants younger than two months unless specifically recommended by your paediatrician.

Also read: Study Links Excessive Screen Time To Poorer Body Image in Teens With Skin Conditions

Keeping the Home Damp and Poorly Ventilated

Damp surroundings encourage mould and fungal growth, which can trigger allergies and respiratory problems. Keep your home well-ventilated, dry wet areas promptly, and ensure that your baby’s bedding, blankets, mattresses, and soft toys are completely clean and dry before use.

Overdressing Your Baby

Many parents assume babies need extra layers during the monsoon. In reality, overdressing can lead to overheating, excessive sweating, and skin rashes. Dress your baby according to the indoor room temperature rather than the weather outside. To assess whether your baby is comfortable, feel the neck or chest instead of the hands or feet, which are naturally cooler.

Also read: Should Children Take Protein Powders? A Dietitian’s Perspective

Trying Home Remedies Without Medical Advice

Avoid steam inhalation, balms, herbal oils, over-the-counter cold medicines, or traditional remedies unless advised by your paediatrician. Honey should never be given to babies under one year of age because of the risk of infant botulism. Always seek medical advice before giving any medication or home remedy.

Taking Young Babies to Crowded Places Unnecessarily

Crowded indoor spaces such as shopping malls, family gatherings, and social events increase the risk of viral infections. Limiting unnecessary exposure, especially during the first few months of life, can significantly reduce the chances of your baby falling ill.

A baby’s first monsoon can be a worrying time for new parents, but a few simple precautions can go a long way in keeping your little one healthy and comfortable. Good hygiene, fresh food, mosquito protection, a clean and dry environment, and timely medical advice are the keys to preventing most monsoon-related illnesses.

If your baby develops persistent fever, breathing difficulty, poor feeding, repeated vomiting, diarrhoea, decreased activity, or signs of dehydration, seek medical attention without delay.

Breastfeeding is widely recognized as the best source of nutrition for infants, but its benefits extend far beyond a baby's health, experts said as part of World Breastfeeding Week, observed annually from August 1 to 7.

The theme for World Breastfeeding Week 2026 is "Breastfeeding for a Sustainable Start in Life: Strengthen What Works," focusing on tracking progress, evaluating impact and scaling proven approaches that improve breastfeeding outcomes.

While providing essential nutrition for babies, breastfeeding also offers significant long-term health benefits for mothers. Studies show it can help lower the risk of several non-communicable diseases (NCDs), including:

• Type 2 diabetes
• Hypertension
• Cardiovascular disease
• Breast cancer
• Ovarian cancer

According to the World Health Organization, scaling up breastfeeding could prevent nearly 400,000 child deaths and around 140,000 maternal deaths every year.

How Breastfeeding Protects Mothers

Dr. V. Mohan, Chairman and Chief Diabetologist at Dr. Mohan's Diabetes Specialities, told HealthandMe that women who have had gestational diabetes and breastfeed for longer are considerably less likely to develop type 2 diabetes later in life.

According to Dr. Asha Dalal, Director of Obstetrics and Gynaecology at Sir H.N. Reliance Foundation Hospital, breastfeeding helps the body recover after pregnancy by improving glucose metabolism, increasing insulin sensitivity and gradually using the fat stores built up during pregnancy.

"These changes support better metabolic health and may lower the risk of chronic diseases later in life. Studies also suggest that the longer a woman breastfeeds, the greater the health benefits, although even shorter durations can have a positive impact," she said.

Dr. Dalal added that while breastfeeding is not a guarantee against NCDs, it is an important part of a healthy lifestyle.

"When combined with a balanced diet, regular physical activity and routine health check-ups, it can contribute to better long-term health for mothers. Lactation is not just about nourishing the baby—it also gives the mother's body an opportunity to reset and recover metabolically after pregnancy," she said.

Benefits Extend to Mental Health

Breastfeeding also supports maternal mental well-being by stimulating the release of oxytocin, often called the "feel-good" hormone. Oxytocin promotes relaxation, strengthens the bond between mother and baby, and may help reduce the risk of postpartum depression.

Dr. Smriti Uppal, Senior Consultant - Obstetrics & Gynaecology at Pacific One Health, described breastfeeding as "nature's first gift of love, nourishment, and protection" for a child while also strengthening a mother's health.

"Breastfeeding also supports a mother's mental well-being by releasing hormones such as oxytocin, which encourage relaxation and bonding. Every mother's experience is unique, and while breastfeeding may sometimes require patience and support, its lifelong benefits for both mother and child are remarkable," she said.

Dr. Uppal stressed that support from families, healthcare providers and communities is essential to help more mothers breastfeed successfully and improve the health of future generations.

Supports Recovery After Childbirth

Dr. Tripti Raheja, Director - Obstetrics & Gynaecology at CK Birla Hospital, Delhi, told HealthandMe that breastfeeding speeds up recovery after delivery by helping the uterus return to its original size and reducing the risk of postpartum haemorrhage.

She added that breastfeeding has also been linked to a lower risk of breast cancer, ovarian cancer, type 2 diabetes and cardiovascular disease, while strengthening the emotional bond between mother and baby.

Breastfeeding May Lower Diabetes Risk

Dr. Mohan said breastfeeding is especially important for women who develop gestational diabetes during pregnancy.

"Women who have had gestational diabetes and breastfeed for longer are considerably less likely to develop diabetes themselves. Test every pregnancy. Then support every mother to breastfeed. It costs almost nothing and protects two lives," he said.

He explained that high blood sugar during pregnancy exposes the baby to excess glucose, increasing the child's risk of obesity, insulin resistance and eventually type 2 diabetes.

Dr. Mohan also noted that many Indian babies are born with a "thin-fat" body composition—lower muscle mass but relatively higher body fat—which increases their long-term metabolic risk.

How Breastfeeding Protects Babies

Experts say breast milk provides complete nutrition along with antibodies and enzymes that help protect infants from infections, allergies and illnesses during early life.

Exclusive breastfeeding for the first six months, followed by continued breastfeeding alongside complementary foods, supports healthy growth, reduces the risk of childhood obesity and may lower a child's future risk of metabolic diseases such as type 2 diabetes.

Dr. Uppal added that breast milk is economical, always available at the right temperature and requires no preparation, making it a convenient and sustainable feeding choice.

She said encouraging breastfeeding through families, healthcare providers and communities can improve the health of both mothers and children, making it a valuable investment in future generations.

Pain in the breast region is not uncommon during the first few weeks following childbirth; however, the presence of breast pain coupled with fever or redness might indicate something more severe.

The early weeks of motherhood involve a lot of learning, and feeding your baby through breast milk is one of them. Some degree of breast tenderness and engorgement is normal while the body adjusts to its new role; however, there are certain symptoms that extend beyond that. The following are six examples:

Mastitis

Mastitis is one of the most frequent complications associated with breasts in nursing women. The condition arises due to the accumulation of milk in the breast and causes inflammation.

The signs of mastitis include a red and warm swelling in the breast, accompanied by fever, chills, and pain all over the body. In severe cases, without proper treatment, mastitis may lead to an abscess that needs draining.

Blocked Milk Duct

Most blocked ducts can be cured with home remedies such as the use of warm compresses prior to breastfeeding, massaging the lump toward the nipple area, and frequent nursing or pumping to keep the milk flowing.

Nevertheless, if there is persistence of the lump for more than a few days, worsening pain or increasing size of the lump, fever, chills, or reddening of the skin, it is necessary to consult a doctor.

Also read: Breastfeeding Can Help Prevent 400,000 Child and 140,000 Maternal Deaths Annually, Says WHO

Breast Abscess

An untreated infection can progress into a pocket of pus beneath the skin. This presents as a painful, fluctuant lump, often with fever and visible redness.

An abscess typically requires drainage along with antibiotics, making timely diagnosis essential to avoid more invasive treatment later.

Engorgement With Complications

Engorgement itself is a normal part of milk coming in, usually settling within a few days. But severe, one-sided swelling with fever or skin that appears shiny, tight, and increasingly painful may point to a secondary infection rather than simple engorgement and warrants a check-up.

Also read: World Breastfeeding Week: How The First 1,000 Days Of Breastfeeding Shapes A Child's Health For Life

Nipple Infection Or Thrush

Cracked or damaged nipples can become a gateway for bacterial or fungal infection. Persistent burning pain, deep breast pain during or after feeds, or visible discharge can indicate an infection that needs targeted treatment rather than home remedies alone.

Inflammatory Breast Cancer

Also read: NHS Breast Cancer Screening Misses 95% Of High-Risk Young Women In UK: Why Personalized Care Could Be Key

While uncommon in postpartum women, inflammatory breast cancer can mimic mastitis, presenting with redness, warmth, and swelling. What sets it apart is a lack of response to antibiotics within the expected timeframe. Any breast symptom that doesn't improve after a course of appropriate treatment should be re-evaluated, and imaging considered.

New mothers are often told that some discomfort is just part of the journey. While that's true to an extent, it's also easy to overlook signs that something more serious may be going on. A fever above 101°F, redness that's spreading quickly, a lump that's getting bigger, or symptoms that don't improve after 48 hours of home care shouldn't be ignored.

Getting medical attention early can help prevent complications, protect the mother's health, and make it easier to continue breastfeeding.