How Antimicrobial Resistance Threatens Neonatal Mortality Rates Globally
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.
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.
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.
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
Credit: Ministry of Women and Child/X
India's Ministry of Women and Child Development today launched the 8th edition of Poshan Pakhwada, under the flagship Poshan Abhiyaan mission to fight against malnutrition and improve the country's nutritional status.
The nutrition campaign will run from April 9 to 23, and focuses on improving the nutritional and cognitive health of young children under six years.
"A well-nourished child is the foundation of a strong nation. Poshan Abhiyaan is not just a government programme, but a people’s movement to ensure holistic nutrition for every mother and child,” said Prime Minister Narendra Modi, while underscoring the importance of nutrition.
"This year's theme focuses on laying a strong foundation for our children's bright future. This campaign will not only strengthen the resolve for a malnutrition-free India but also promote public awareness and community participation," said WCD Minister Annpurna Devi, in a post on social media platform X.
The theme for Poshan Pakhwada 2026 is “Maximizing Brain Development in the First Six Years of Life”.
It recognizes that early childhood—particularly the first 1,000 days—is critical for brain development, physical growth, and overall well-being.
Scientific evidence indicates that over 85 percent of brain development occurs by the age of six, underscoring the importance of optimal nutrition, responsive caregiving, and early learning.
Also read:Silent Deficiency, Rising Risk: Why Protein May Be The Missing Link In Diabetes Care
The key focus areas under this year’s theme include:
During the Pakhwada, activities will be organized across States and Union Territories through Anganwadi Centers, with participation from mothers, caregivers, families, community institutions, and local bodies.
These will include Poshan Panchayats, awareness sessions, early stimulation activities, play-based learning initiatives, and campaigns promoting healthy lifestyles and reduced screen time among young children.
Through Poshan Pakhwada 2026, the Ministry aims to further strengthen the Jan Andolan by reinforcing that nutrition, care, early learning, and community participation together lay the foundation for a healthy, educated, and empowered India.
Also read: Longevity: How Eating Right For A Long Life Is An Everyday Endeavor
Poshan Abhiyaan was launched by the Prime Minister on March 8, 2018, in the Jhunjhunu district of Rajasthan. The focus of Abhiyaan is to emphasize the nutritional status of adolescent girls, pregnant women, lactating mothers, and children from 0-6 years of age.
Poshan Pakhwada serves as a key pillar of this movement by driving awareness, behavioural change, and community mobilisation at the grassroots level. The major objectives include:
Credit: Canva
The birth of a baby is a joyous occasion, accompanied by celebrations as well as well-meaning advice from friends and family. "Don't feed for 24 hours!" "Give honey first!" "Discard the first milk!" These traditional and generational beliefs leave new mothers confused about what is appropriate for their baby.
As a neonatologist with years of experience, I have seen how these myths can harm the delicate newborns. Let us separate fact from fiction with simple, but evidence-based truths.
Myth 1: Wait Before First Feed
Traditional Belief: Many families delay breastfeeding for hours—waiting for an auspicious time, a particular relative, or to follow traditions and customs.
Fact: Babies should be breastfed within the first hour of birth (Golden hour) right in the labor room! The yellowish first milk (colostrum) is packed with antibodies and nutrition. Early feeds can prevent low blood sugar levels, build immunity, increase the mother’s milk supply, and lead to bonding between the mother and the newborn.
Myth 2: Honey or Jaggery First
Traditional Belief: Elders give honey, jaggery, or butter at birth for strength and good virtues.
Fact: Short-cuts are dangerous! Stick to mother's milk only. Anything else can cause infections (botulism with honey) and delay colostrum administration.
Myth 3: Throw Away Colostrum
Traditional Belief: "First milk is dirty—discard it!"
Fact: Colostrum is liquid gold! It is a natural vaccine, full of maternal antibodies and high in proteins. Discarding it deprives the baby of natural immunity.
Myth 4: 40-Day Lockdown
Traditional Belief: Keep mother-baby indoors for 40 days to avoid colds.
Fact: Fresh air and sunlight are rich sources of oxygen and vitamin D. Confining them in dark, stuffy rooms increases the risk of post-partum depression in the mother. Take short, safe outdoor trips, avoiding windy weather.
Myth 5: Gripe Water and Janam Ghutti
Traditional Belief: Essential for digestion, teething, and excessive crying.
Fact: Avoid completely as the ingredients are not standardized or regulated. Contents vary wildly—many contain alcohol, opioid derivatives, or bacteria, causing loose stools and sedation. Breast milk is the panacea.
Myth 6: Kajal Makes the Eyes Beautiful
Traditional Belief: Surma/kajal improves eyesight and makes the eyes bigger
Fact: May contain lead that causes eye infections, allergies, and lead poisoning if used excessively
Myth 7: Babies need water before 6 months.
Fact: Breast milk or formula is 88 percent water and meets the water requirement even in hot months. Early water intake increases the risk of sodium imbalance (hyponatremia). Start water in a sippy or cup, after 6 months, with complementary foods (150-250 ml water split into multiple times).
Myth 8: Sneezing = Cold
Traditional Belief: Any sneeze means an upcoming cold.
Fact: Newborns sneeze to clear mucus— a sign of healthy airways! Consult a doctor if it is accompanied by fever, cough, or runny nose.
Myth 9: Mother's 'Cold' Foods Harm The Baby
Traditional Belief: Curd, rice, and ice cream can cause cold or colic in the baby.
Fact: The temperature of the maternal diet does not influence the breast milk temperature or quality, so no cold food bans!
Myth 10: Teething Causes Fever/Diarrhea
Traditional Belief: Fever and loose stools indicate tooth eruption
Fact: Red flag! These signals indicate infections from dirty objects that babies put into their mouths during the mouthing phase of development. See a doctor immediately.
Myth 11: Protruding Navel = Doctor Error
Traditional Belief: Caused by excessive pull on the cord during delivery.
Fact: Commonly due to lax abdominal muscles. It usually resolves by one year of age. No tapes/coins are needed. Consult a doctor immediately if the swelling does not retract or becomes red.
Myth 12: Warm Head = Fever
Traditional Belief: A warm forehead means fever
Fact: Normal newborn temp is 97.6-99.5°F. The head feels warmer due to increased blood flow. Check the armpit if concerned.
Tips For Parents:
Credit: Joe Thompson/Instagram
Continuing the legacy of football legend Joe Thompson, his wife Chantelle revealed she is pregnant with his baby after IVF treatment using frozen embryos.
Joe Thompson died in 2025 after developing cancer for a third time - beating the illness twice.
But after the former Manchester United star was diagnosed with Hodgkin Lymphoma for a third time, which had spread to his lungs, he died aged 36.
"It just means absolutely everything. I know it's never going to replace Joe obviously. Joe's Joe. But to be able to bring his baby into the world again is beautiful," Chantelle said.
She said Joe had two visions of their family with a baby boy before he died, and he even gave her the name for the baby boy he predicted, and she got pregnant on her first attempt of IVF after he had died.
Egg freezing, also known as oocyte cryopreservation, is an option that has gained significant traction in recent years. It offers women the ability to pause their biological clock and preserve the possibility of having children in the future.
Egg freezing takes a woman's unfertilized eggs from her ovaries and stores them at sub-zero temperatures to be utilized later. It is made to enable women to keep their fertility intact, especially if they are not yet ready to have a baby.
Dr. Pavithra M, Obstetrician, Gynecologist, and Infertility Specialist, told HealthandMe that the workup begins with hormone workup and evaluation of various parameters, such as age, body mass index (BMI), and ovarian reserve.
"On the second day of the menstrual cycle, baseline ultrasound scanning is performed to assess the number of follicles; thereafter, various tests of blood are conducted to assess hormone levels. If a woman's parameters are all normal, then she is administered hormonal injections for about 10-12 days."

It causes ovarian hyperstimulation and multiple mature eggs, monitored through ultrasound scans. A trigger shot is administered once the follicles have reached optimal size to help with final egg maturation. It takes 34-35 hours from the trigger shot, wherein eggs are retrieved by minimally invasive procedures under general anesthesia.
"Using a transvaginal ultrasound probe with a needle, each follicle is punctured, and the follicular fluid is aspirated. The retrieved eggs are then screened for quality before undergoing vitrification—a rapid freezing technique that minimizes ice crystal formation and cellular damage," Dr. Pavithra added. The eggs are then stored in liquid nitrogen tanks for long-term preservation.
While egg freezing is possible at various stages of life, experts recommend doing it at an optimal age -- in the late 20s or early 30s when the eggs are of higher quality-- for better outcomes.
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