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

At a time when artificial intelligence (AI) is playing an increasingly significant role in healthcare, fertility clinics are turning to AI to help analyze sperm. Surprised? It's already happening. Advanced AI-powered systems are helping assess sperm with greater accuracy and consistency, offering men seeking fatherhood a more reliable path through fertility evaluation and treatment, according to experts, today on Father's Day.

Infertility affects millions of people worldwide, with an estimated one in six individuals of reproductive age experiencing difficulty conceiving at some point in their lives. Male infertility contributes to up to half of all infertility cases, and around 1 per cent of men are diagnosed with azoospermia — a condition in which no sperm are detected in a semen sample.

However, some men may have extremely low sperm counts, with only a handful of sperm cells present and difficult to detect through conventional methods. Emerging AI-powered technologies are now helping specialists identify these rare sperm cells more accurately, offering new hope to men facing severe infertility and improving their chances of biological parenthood.

HealthandMe spoke to experts, who believe that AI is increasingly being used in fertility care to improve the precision, consistency and efficiency of sperm analysis.

AI Changing Traditional Sperm Analysis

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Traditionally, semen evaluation has relied on manual microscopy, where embryologists assess sperm count, motility, morphology and movement patterns under a microscope. Experts said this process can be influenced by observer skill and interpretation, leading to variations in results.

Dr. Neha Gupta, Additional Director, Obstetrics & Gynecology at Fortis Noida, told HealthandMe that "AI systems use image recognition and machine learning to assess sperm count, motility, morphology and movement patterns in real time, often providing more reliable results".

"Research shows that AI-assisted sperm analysis can lower human error, reduce differences between observers, and process large amounts of data much faster than traditional methods," she said.

According to Dr. Gupta, these advances help doctors make better decisions and improve the overall efficiency of fertility evaluations.

AI as a Support Tool, Not a Replacement

Also read: AI Cannot Replace Doctors, It Can Only Complement, Says Dr Santosh Sivaranjani

Dr. Gupta added that for patients, AI can mean faster reports, more dependable assessments and a smoother diagnostic process. AI also aids in embryo selection, treatment planning and predicting IVF outcomes, helping customize fertility care.

Dr. PGL Lalit Kumar, Head of Embryology and Scientific Director at Nova IVF Fertility, told HealthandMe that sperm analysis has long depended on the expertise of embryologists who evaluate sperm characteristics manually.

"AI is gradually shifting sperm assessment from a largely observational process to a more data-enriched one, which can help specialists identify subtle patterns and variations that may have previously been difficult to quantify," he said.

One of the major advantages of AI, according to Dr. Kumar, is its ability to analyze large numbers of sperm cells within a short period and detect subtle patterns that may not always be obvious during manual assessment.

However, he stressed that AI is not replacing specialists. Instead, it serves as an additional tool that supports embryologists' observations and helps them make more informed decisions.

He added that AI can bring greater consistency to assessments by reducing subjectivity and ensuring sperm evaluation is based on objective, measurable parameters.

Making Fertility Treatment More Consistent

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"For couples going through fertility treatment, a lot of these changes happen behind the scenes, but they can make the whole process feel smoother," Dr. Kumar said, noting that faster analysis, more consistent reporting and smarter sperm selection can help doctors adapt treatment plans more effectively.

He said that technology has helped bring greater consistency to laboratory processes, particularly in sperm and embryo evaluation.

The expert emphasized that fertility treatment is not driven by technology alone and that the experience of embryologists and clinicians remains central to every decision, with AI acting as a support system rather than a replacement for human expertise.

AI Adoption Growing in India

Dr. Kshitiz Murdia, CEO and Whole-Time Director of Indira IVF Hospital, told HealthandMe that AI is making sperm assessment more objective, consistent and data-driven.

From traditional semen analysis, where interpretation could vary between observers on manual microscopic examination, he said that "AI-powered systems can rapidly analyze thousands of sperm cells and assess parameters such as count, motility and morphology with a high degree of precision, helping reduce human variability".

According to Dr. Murdia, adoption of AI-enabled technologies in reproductive medicine is gradually increasing in India, particularly in advanced fertility laboratories.

However, Dr. Murdia stressed that AI should be viewed as an aid rather than a substitute for clinical expertise. Human judgement, patient history and comprehensive fertility evaluation remain central to treatment planning.

As oncologists, we often meet patients at some of the most difficult moments of their lives. Yet there are times where a patient's journey reminds of the extraordinary resilience that people can show while facing the challenges that cancer presents

I recently treated a 38-year-old woman whose story has stayed with me.

Having just welcomed her baby into the world, her demanding yet joyful routine revolved around feeding schedules and sleepless nights. It was during this period that she noticed a hard lump in her breast.

Breast Lumps Can Cause Aggressive Breast Cancer

A sonomammography revealed a suspicious BIRADS 4A lesion. A biopsy confirmed Triple-Negative Breast Cancer (TNBC), which is one of the more aggressive forms of breast cancer. It was classified as a Stage III disease after evaluation through PET-CT which showed involvement of the axillary lymph nodes. The tumor also had a high Ki-67 index, indicating that it was growing rapidly.

Facing Cancer While Caring for A Newborn

The untimely diagnosis found the mother facing difficult questions about cancer treatment, her future and her ability to care for her child. One of the immediate challenges was that she had to stop breastfeeding.

Under the guidance of her pediatrician, her baby was transitioned to bottle feeds. This can be an emotionally challenging process for mothers as the feeling of guilt tends to seep in when breastfeeding plans are disrupted by illness.

A Modern Treatment Approach

After detailed and prolonged discussions with the patient and her family, we initiated treatment with neoadjuvant immunotherapy using pembrolizumab in combination with chemotherapy. This approach has emerged as one of the more prominent advances in the treatment of high-risk Triple-Negative Breast Cancer, having significantly improved outcomes for many patients.

Motherhood is a physically and emotionally taxing experience but the patient showed incredible strength during her cancer therapy, driven by her child and the unwavering support of her family.

Following completion of neoadjuvant therapy, repeat PET-CT imaging showed a near-complete response. She subsequently underwent surgery, and the final pathology report revealed a pathological complete response, meaning no residual invasive cancer had been detected.

This was the desired outcome for the treating team as well as the patient. She later completed the remaining course of immunotherapy, bringing her total treatment duration to one year. Today, both mother and child are doing well.

Breast Cancer Can Occur During Pregnancy

This tremendous journey highlights an important message. The fact that breast cancer can occur during pregnancy and the postpartum period deserves wider attention. Any breast lump that persists or feels unusual should be evaluated by a healthcare professional, as early diagnosis remains one of the most important factors in achieving positive outcomes.

The process is reflective of the advances in cancer treatment that are changing the outlook for patients with aggressive cancers. These advances are done through the integration of immunotherapy into treatment protocols which is helping more patients achieve improved long-term outcomes. The mother’s story is a reminder that cancer and motherhood are not mutually exclusive journeys.

Her ability to navigate this path is due to her timely diagnosis, access to appropriate treatment, family support and personal resilience. What began as a frightening diagnosis soon after childbirth ultimately became a story of hope, courage and survival. This is a powerful reminder to every new mother who might discover an unusual breast lump, that listening to your body and seeking medical advice early can make all the difference.

Pregnancy should not be regarded as a physical journey since it is a very emotional and deeply transformative phase in any woman's life. As the body changes itself to support new life, expecting mothers usually experience pain in the back, fatigue, and breathing-related discomfort. When practised under proper medical guidance, prenatal yoga can be very safe and highly supportive throughout pregnancy.

Supports Better Flexibility and Body Balance

As pregnancy progresses, the center of gravity of the body is shifted by the growing uterus. This can even impact posture and overall movement of the body. Prenatal Yoga normally includes gentle stretches and a controlled level of movement, which helps to improve the flexibility and stability without even placing unnecessary strain on the mother's and baby's bodies.

Yoga helps in:

• Reducing pregnancy-related back pain: Pain in the lower back is one of the most common discomforts that is mainly experienced during pregnancy. Gentle Yoga also assists in strengthening the back and provides better support to the spine.

• Improving breathing and oxygen flow: Mindful breathing also assists expectant mothers in managing breathlessness and calming the nervous system. Breathing-related awareness can assist women in remaining composed during the birth of a child.

• Reducing stress and anxiety: Pregnancy also causes emotional problems due to changes in hormones and physical discomfort during the birth of a child. Prenatal yoga integrates movement, exercises related to breathing, and relaxation techniques, which help reduce stress and mental fatigue. A good, calm mother is more likely to experience emotional well-being throughout the journey of pregnancy.

• Promoting better sleep: Most of the pregnant women also struggle with sleep-related patterns, due to body aches, frequent urination, which may help women to feel more confident and well prepared for the birth of a child.

• Preparing the body for labor: Prenatal yoga also plays a good role in building strength and controlled breathing, which can support the body during labor. Gentle hip opening movements and all relaxation techniques also help women to feel more confident and well prepared for the birth of a child.

• Encourages mother-baby connection: Prenatal yoga also provides expecting mothers with dedicated time to connect well with their baby. All these practices can also enhance the existing bond between mother and child, making the journey of pregnancy feel more positive.