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

Public health officials in South Wales, UK, have issued an alert on a localized outbreak of hepatitis A, and have urged residents to maintain hygiene as well as vaccinate children.

Cases of hepatitis A involving the same strain have been identified in three separate households in Barry, according to Public Health Wales.

The health body, in a statement, said the strain’s characteristics “suggest the infection may be spreading locally.” Investigations into the “small number” of cases are ongoing.

To curb the outbreak, the officials have also issued an urgent appeal to parents to ensure their children remain “vigilant with their handwashing.”

Those infected are “receiving appropriate care and are recovering well,” Public Health Wales said. As a precaution, close contacts of the affected individuals have also been offered vaccination.

What Is Hepatitis A?

Hepatitis A is a viral liver infection caused by the hepatitis A virus (HAV). It spreads mainly through contaminated food or water, or through close personal contact with an infected person.

The infection can lead to liver inflammation, jaundice, extreme fatigue, and stomach pain. In most cases, it is a short-term illness that clears on its own without specific treatment, although severe cases can occur. Unlike hepatitis B or C, hepatitis A does not usually cause long-term liver damage.

According to the World Health Organization (WHO), vaccination remains the most effective way to prevent infection.

Also read: Hepatitis Infections Claims 1.3 Million Lives Worldwide, India Among Top Contributors: WHO

Symptoms of Hepatitis A

Symptoms usually appear a few weeks after exposure to the virus, although some people may not develop noticeable signs. According to the Cleveland Clinic, symptoms can include:

• Persistent fatigue and weakness
• Sudden nausea, vomiting, or diarrhea
• Pain or discomfort in the upper right side of the abdomen near the liver
• Pale or clay-colored stools
• Reduced appetite
• Mild fever
• Dark-colored urine
• Joint pain
• Yellowing of the skin and eyes (jaundice)
• Severe itching

Can Hepatitis A Be Prevented?

Read More: UK Parliament Bans Smoking For People Born After 2008: Know All About It

“The best way to prevent the spread of hepatitis A is to wash hands thoroughly with soap and water. This is important after using the toilet, changing nappies, and before preparing or eating food,” said Susan Mably, Consultant in Health Protection for Public Health Wales.

Vaccination against hepatitis A is also highly effective in preventing the disease.

Doctors recommend the vaccine for:

• Children older than 12 months
• Adults at risk of exposure at home or work
• Travelers visiting regions where the virus is more common
• People with existing liver conditions

• drinking boiled or bottled water,
• avoiding food from unhygienic sources,
• peeling fruits at home and not getting pre-cut from stores.

If someone in the household is infected, cleanliness becomes even more important. Surfaces should be disinfected, food prepared carefully, and personal items not shared.

Safe sexual practices also matter, as the virus can spread through oral-anal contact. On a broader level, preventing future outbreaks requires more than short-term fixes. Improving water quality, repairing sewage systems, and strengthening public health surveillance are essential to stop the cycle from repeating.

The rates of resistance to recommended antibiotics are rising among newborns in the US, according to an analysis of invasive Escherichia coli samples.

E coli is a major neonatal pathogen in the United States and a leading cause of sepsis and mortality in newborns.

“Mortality due to E. coli sepsis remains high, especially in preterm newborns. Resistance to beta-lactams and aminoglycosides, the most common empiric treatments for E. coli sepsis, is worsening,” said researchers from the University of Missouri.

They called for tailoring treatment regimens against neonatal E. coli sepsis according to evolving antibiotic resistance trends.

“Neonatal sepsis isolates are characterized by specific genomic traits indicative of virulent phenotypes that need continued surveillance,” they added in the research published in the Open Forum Infectious Diseases journal.

What Are the Key Findings?

The researchers identified and analyzed E coli isolated from blood cultures of newborns at the hospital from 2006 to 2021. They intended to investigate the clinical characteristics of newborns with E coli bacteremia (bacteria in the blood), and the pattern of antibiotic resistance in E coli isolates over time.

“This knowledge is crucial to develop effective preventative and treatment strategies for this devastating disease,” the researchers wrote.

Of the 54 newborns identified with E coli bacteremia

• 7 developed early-onset sepsis (within 72 hours of birth or less),
• 12 were treated for E coli meningitis,
• 2 had necrotizing enterocolitis.
• Five of the newborns died, including three who were born preterm.

Antibiotic susceptibility analysis found 54 per cent of E coli isolates overall were non-susceptible to ampicillin and 11 per cent were non-susceptible to gentamicin—the two antibiotics recommended for first-line treatment in newborns with sepsis.

Also read: US CDC Links Recent Salmonella Outbreak To Backyard Poultry

Meanwhile, nonsusceptibility to ampicillin rose from 46 per cent to 61 per cent between 2006-2013 and 2014-2021.

The percentage of isolates that were non-susceptible to cefazolin, an alternative therapy, rose from 8 per cent to 36 per cent.

Whole genome sequencing revealed that the most prominent E coli sequence types (STs) were

• ST95 (17 per cent),
• ST69 (11 per cent),
• ST131 (7 per cent),
• 43 per cent of isolates contained the K1 capsule, which plays a crucial role in disease progression.

“Understanding genomic traits and molecular epidemiology trends of neonatal E. coli invasive strains is also crucial to develop novel preventative and treatment strategies that are urgently needed,” they wrote.

What Is Antibiotic Resistance?

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According to the National Foundation for Infectious Diseases, antibiotic resistance happens when bacteria learn to withstand the medicines(antibiotics) that are supposed to kill them. It's like the bacteria have developed a suit of armor against the drug.

When this happens, doctors have to switch to different antibiotics. These backup medicines might not work as well or might cause more side effects. Sometimes, a bacteria can become resistant to all available drugs, which leaves the patient with a dangerous infection that doctors have no way to treat. The alarming thing is that these tough, drug-resistant bacteria can spread from one person to another, both in hospitals and at home.

A 2025 report from the World Health Organization (WHO) stated that one out of every six serious infections confirmed in labs worldwide in 2024 could not be killed by the antibiotics meant to treat them.

The report noted that the standard, first-choice antibiotic is failing against over 40 per cent of E. coli.

Asthma is one of the most common chronic respiratory conditions in children. Recently, there has been a noticeable increase in cases.

According to the American College of Allergy Asthma and Immunology, the signs of asthma can range from a cough that lingers for days or weeks to a sudden and scary inability to breathe effectively.

Coughing, wheezing, or a whistling sound is often mistaken for a common cold. However, experts warn that these symptoms should not be ignored and advise consulting an allergist.

Why Asthma Is Rising Among Children?

Dr Shivanshu Raj Goyal, Associate Director & Unit Head - Pulmonology, Max Hospital, Gurugram, told HealthandMe that "increasing levels of air pollution, exposure to allergens, changing weather, respiratory infections, and lifestyle factors are the major reasons behind a surge in asthma cases among children."

Children in urban areas are particularly at risk due to ongoing exposure to vehicle emissions, dust, and indoor pollutants.

Dr. Robin Gupta, Associate Director - Pulmonology, Paras Health Panchkula, also attributed the rising cases of asthma among children to worsening air quality and increased exposure to dust and indoor irritants."

The experts warned that parents should be aware of the early warning signs of asthma. These signs are often mistaken for frequent colds or seasonal allergies.

Symptoms include

• recurring coughing,
• especially at night or after physical activity,
• wheezing,
• shortness of breath,
• chest tightness,
• frequent respiratory infections.

Common asthma triggers include

• dust mites,
• pollen,
• pet dander,
• mold,
• smoke,
• strong scents,
• viral infections.

Asthma: Diagnosis And Treatment

Early diagnosis and timely treatment are crucial to preventing complications. Parents should talk to a pediatrician or pulmonologist if symptoms continue or happen often. Asthma is usually manageable with inhalers, prescribed medications, and avoiding known triggers.

It’s important to know that inhalers are safe and often the most effective way to deliver medication directly to the lungs.

Dr. Gupta told HealthandMe that early diagnosis makes a significant difference, as asthma can be effectively managed with the right treatment.

Other measures include:

• Keeping the home environment clean,
• Avoiding smoke exposure,
• Following medical advice can help prevent frequent flare-ups and support A child’s overall well-being.
• Parents can help reduce the risk of flare-ups by keeping
• homes free of dust,
• Avoiding smoking around children,
• Ensuring good ventilation,
• Promoting physical activity, and staying up to date on vaccinations.
• With proper management and awareness, children with asthma can lead healthy, active, and normal lives. Early intervention is key to better long-term respiratory health.