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

Felicity-Jo, a 13-year-old girl in the UK’s Lancashire, has survived a life-threatening bout of sepsis and two weeks of induced coma, after her symptoms were initially dismissed by doctors as a stomach bug.

In early February, Felicity-Jo suffered vomiting and abdominal cramps, and was admitted at the Royal Blackburn Teaching Hospital where the medical team administered intravenous fluids. They discharged her the following day as the teen girl showed temporary improvement, and attributed her condition to gastroenteritis, also known as a stomach bug.

"They [gave] her some fluids to stop the dehydration, and she seemed to like come around and seemed to feel better — the pain eased and then she took to small sips of water,” Natalie-Anne Rowlett, her mother told the BBC.

"The doctors said they thought it was gastroenteritis or a stomach bug going around. They had said they wanted to take her for a scan, but they didn't do it because she perked up."

What Happened To Felicity-Jo?

While Felicity-Jo returned to her normal activities, her health suddenly deteriorated weeks later. On March 15, the teen collapsed in extreme pain and was admitted to the ICU at Burnley General Teaching Hospital. Here, the surgeons discovered she had been born with congenital adhesions, or internal scar tissue.

The adhesions caused a total bowel obstruction, which was eventually followed by an infection and sepsis, her mom told the BBC.

“The main symptoms were abdominal pain and persistent vomiting. It’s frightening how quickly things progressed from what seemed like a typical upset stomach to a life-threatening situation," Rowlett was quoted as saying to PEOPLE.

After undergoing two emergency surgeries, including the removal of a portion of her bowel, Felicity-Jo was transferred to the pediatric intensive care unit at Royal Manchester Children's Hospital. She remained on life support for 14 days while battling the infection and subsequent blood clots.

"Sepsis develops so quickly, and I want others to be aware. I know she'll come through. She's a fighter," Rowlett said, according to the BBC.

How Is Felicity-Jo Now?

After being fitted with a stoma bag and diagnosed with two blood clots four weeks after the health scare, Felicity-Jo finally took her first steps in almost a month.

Felicity-Jo has “managed a smile,” which “melted” their hearts, wrote Rowlett on the GoFundMe page, which the family started to raise funds.

Rowlett confirmed that her daughter was being moved from the PICU to another ward in the hospital.

“She still has a long road of recovery, stoma care, and rehabilitation ahead, but moving to the ward is a giant leap forward,” Rowlett added.

Rowlett is now urging others to be aware of the symptoms of sepsis, telling them to "trust their guts" if something “doesn’t feel right,” the BBC reported.

Congenital Adhesions: How It Can Lead To Bowel Obstruction?

Abdominal adhesions are bands of scar tissue that form between the organs in the belly and pelvis. The scar tissue mainly forms between loops of the small intestine, but can also form between an organ and the wall of the abdominal cavity.

When the condition is present from birth, it is called congenital adhesion. Congenital bands arise from abnormal adhesions of folds in abdominal organs that form during the first eight weeks of pregnancy.

Adhesions are the most common cause of a small bowel obstruction — a medical emergency caused by complete or partial blockage in the intestines. With obstruction, food, liquid, air and waste can’t pass through the intestines and can cause:

• Severe abdominal pain.
• Cramping.
• Bloating.
• Nausea and vomiting.
• Abdominal distension (when your abdomen swells outward).
• Obstipation (being unable to pass gas or poop).

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.

Poshan Pakhwada 2026: Theme

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:

1. Maternal and Child Nutrition – Promoting optimal nutrition during pregnancy, exclusive breastfeeding, and age-appropriate complementary feeding.
2. Early Stimulation for Brain Development (0–3 years) – Encouraging responsive caregiving and early learning interactions.
3. Play-Based Education in Early Years (3–6 years) – Supporting holistic development and school readiness.
4. Role of Parents and Community in Minimizing Screen Time – Promoting healthy habits and active engagement.
5. Strengthening Anganwadi Centers through Community Participation – Enhancing infrastructure and service delivery through Jan Bhagidari and CSR.

Poshan Pakhwada 2026: Activities

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

What Is Poshan Abhiyaan

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:

• Prevent and reduce stunting in children (0- 6 years)
• Prevent and reduce under-nutrition (underweight prevalence) in children (0-6 years)
• Reduce the prevalence of anaemia among young Children(6-59 months)
• Reduce the prevalence of anaemia among Women and Adolescent Girls in the age group of 15-49 years
• Reduce Low Birth Weight (LBW).

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.

What to Do?

Tips For Parents:

• Embrace science over superstition.
• Trust your pediatrician and not any advice.
• Verify advice: Does it align with the guidelines of scientific bodies.
• Join lactation support groups.
• Be aware of red flags like fever, lethargy, poor feeding, and excessive irritability.
• Seek expert opinion when in doubt.
• Your baby's first 28 days are critical and determine their lifelong health, so get them right.