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

Childhood weight gain is often noticed only when a child steps on a weighing scale. But the factors influencing a child’s weight can begin much earlier, hidden in everyday habits such as sleep, screen time, meals and physical activity. With busy family schedules and increasing screen use, healthy routines can sometimes take a back seat.

Supporting healthy habits from an early age is more useful than focusing only on a child’s weight or appearance. At the same time, regular growth monitoring helps pediatricians identify children who may need additional support. Not every child who looks chubby has obesity, and children’s body shapes naturally change as they grow.

Sleep and weight

Sleep is an important part of a child’s growth and development. Children who do not get enough sleep may experience changes in appetite, mood and energy levels. A tired child may also be less interested in physical activity and more likely to spend time sitting or snacking.

A consistent bedtime routine can therefore be an important part of maintaining healthy habits. Keeping screens away before bedtime, maintaining regular sleeping hours and creating a calm sleep environment can help children develop better sleep patterns.

Also read: After Lindsay Clancy Trial, Massachusetts Pushes Stronger Postpartum Mental Health Screening

The screen-time connection

Screens have become part of children’s everyday lives, whether for schoolwork, entertainment or communication. However, excessive recreational screen time can reduce the time children spend running, playing and being physically active.

Screens can also encourage mindless eating. Children watching television or playing games may snack without paying attention to hunger or fullness. Sugary drinks, packaged snacks and frequent eating in front of screens can gradually become habits.

Parents can begin with simple changes, such as keeping meals and snacks screen-free and encouraging children to take regular breaks from sitting.

Also read: 22-Year-Old Frozen Embryo Produced A Healthy Baby: Does An Embryo Have An Expiry Date?

Daily routines matter

Healthy weight management in childhood is not about strict dieting. It is about creating a balanced routine. Regular meals, nutritious snacks, adequate sleep and daily movement can help children develop healthy habits without making them feel that food or their body is a problem.

Children should be encouraged to eat a variety of foods, including vegetables, fruits, whole grains, pulses, dairy or suitable alternatives, eggs and other sources of protein. Simple, home-cooked family meals can form the foundation of a healthy diet. Highly processed foods and sugary drinks do not need to disappear completely, but they should not become everyday staples.

Physical activity should also feel like play rather than punishment. Cycling, dancing, outdoor games, swimming, walking or simply playing with friends can help children stay active while having fun.

Parents do not need to change everything overnight. Small, consistent steps can make a difference. Set predictable meal and sleep timings, create screen-free family meals, encourage outdoor play and avoid using food as a reward or punishment.

Most importantly, avoid making children feel ashamed about their weight. Focus on health, strength, energy and healthy habits rather than appearance.

Better sleep, healthy screen habits, nutritious food and regular movement can help children build a healthier relationship with their bodies and food. When parents create healthy routines for the whole family, children are more likely to adopt them naturally and carry those habits into adulthood.

Massachusetts is moving to strengthen postpartum mental-health care after the controversial trial of Lindsay Clancy increased focus on gaps in treating serious mental-health conditions during and after pregnancy.

Governor Maura Healey has proposed $2 million to expand voluntary nurse home visits to families with newborns, along with $250,000 to strengthen a state program that helps healthcare providers identify and treat mental-health and substance-abuse problems during pregnancy and after birth.

The state's Department of Public Health will also update regulations governing perinatal mental-health screening to identify a broader range of conditions, including mood and anxiety disorders and postpartum psychosis.

Massachusetts Expands Postpartum Mental Health Screening

The current Massachusetts law already requires postpartum depression or major depressive disorder screening for eligible postnatal individuals receiving care from primary-care providers, obstetricians, midwives and pediatricians.

But mental health problems after pregnancy can extend beyond depression.

The state's updated approach is expected to give healthcare providers more opportunities to ask about a patient's mental health during and after pregnancy, including during visits with an obstetrician, primary-care doctor or pediatrician.

Healey said, “Becoming a mother is a profound life change, and every parent deserves support — not just during pregnancy, but in the months that follow.”

She added, “Postpartum depression, anxiety and other maternal mental health conditions are real medical conditions, and no mother should feel ashamed to ask for help or feel like she has to navigate this journey alone.”

The changes are particularly relevant because there is currently no validated screening tool specifically for postpartum psychosis. Massachusetts health guidance says diagnosis depends on a healthcare provider assessing the person's symptoms.

Also read: The Postpartum Nutrition Gap: Why New Mothers Often Neglect Their Own Health After Delivery

More About The New Programme

The proposed $2 million investment would expand the state's Welcome Family programme so that all families with newborns can be offered a voluntary nurse home visit.

Massachusetts has around 68,000 births a year, while the programme currently reaches about 3,000 families annually. During a visit, a nurse can assess the health of the mother and baby, answer questions about feeding and sleep, and connect families with additional support.

The state also plans to invest $250,000 in the Massachusetts Child Psychiatry Access Program for Moms, which supports healthcare providers treating maternal mental health and substance-use conditions.

The additional funding could also help track postpartum psychosis data and improve education for healthcare professionals, mothers and families about warning signs.

Also read: Paris Jackson Undergoes ‘Painful’ ECT for Depression: Can Electroconvulsive Therapy Reduce Suicide Risk?

Early Detection Is Key

Perinatal mental-health conditions can affect people during pregnancy and after childbirth. Depression and anxiety are more common, while postpartum psychosis is rare but requires urgent medical attention.

Massachusetts' move aims to ensure that mental-health concerns are not identified only during a dedicated postpartum visit, but also when new parents interact with other parts of the healthcare system.

The measures follow the trial of Lindsay Clancy, whose attorneys argued that she experienced postpartum psychosis when she killed her three children in 2023. Prosecutors disputed the defence's argument, and the jury ultimately failed to reach a unanimous verdict, resulting in a mistrial.

Healey said the bigger goal is to make conversations about maternal mental health more routine. She said, “To every mom who has struggled with her mental health before, during or after pregnancy, I want you to know we see you — I see you.”

A 54-year-old woman in Greece recently gave birth to a healthy baby girl using an embryo that had been frozen for more than two decades. The case has marked a milestone in IVF, raising an intriguiging question: does a frozen embryo eventually have an expiry date?

Cristina Rapti-Tzelepi and her husband, Constantinos Raptis, welcomed their daughter Georgia in Athens on September 9.

The embryo was originally cryopreserved in March 2004 and was transferred in December 2025. The baby weighed 3.49 kg at birth.

The couple decided to use one of their remaining embryos after their 21-year-old son, Giorgos, died in a road accident in October 2025. Their son had also been born following IVF using an embryo from the same original treatment.

The case is remarkable as the embryo remained frozen for more than two decades. But scientifically, that does not mean the embryo continued ageing for 22 years.

Does A Frozen Embryo Actually Age?

A frozen embryo does not age in the way a an actual human person does. During cryopreservation, embryos are stored at extremely low temperatures, generally around -196°C in liquid nitrogen. At this temperature, biological processes that drive cellular ageing effectively stop.

The key is maintaining stable cryostorage conditions. The American Society for Reproductive Medicine says cryopreserved embryos must be maintained under stringent conditions, with IVF laboratories monitoring liquid-nitrogen levels and storage systems.

So, an embryo frozen in 2004 does not biologically become a 22-year-old embryo. Its chronological storage time increases, but its cells are preserved in the state they were in when frozen.

Also read: Emma Barnett Reveals She Had A Hysterectomy After Endometriosis Battle: What To Know About Adenomyosis

Long Storage Of Embryo & Healthy Pregnancy

A recent systematic review and meta-analysis published in Human Reproduction Open examined 23 studies involving more than 250,000 embryo-transfer cycles.

Researchers found that embryos stored for longer than five years appeared slightly less likely to survive thawing, with some reductions in pregnancy and live-birth rates.

However, the outcomes stopped worsening after around two years of storage, with no further deterioration as storage continued for much longer periods.

Longer storage was also not associated with increased risks of premature birth, high birth weight, or birth defects.

Earlier research has similarly found no dose-response relationship between the duration of embryo cryostorage and pregnancy outcomes.

Also read: Explained: What Is Posthumous Reproduction?

Does An Embryo Have An Expiry Date?

Scientifically, there is no established biological expiry date for a properly cryopreserved embryo. The bigger concerns are the quality of the embryo before freezing, the freezing and thawing technique, laboratory conditions, and whether the embryo survives thawing.

There are also factors like biological limits and legal limits that affect IVF. In Greece, women currently have a legal age limit of 54 for completing IVF procedures.

Rapti-Tzelepi had only a limited window in which to obtain approval and undergo treatment. Her case is therefore not proof that every embryo can remain viable indefinitely. But it provides another striking example of how modern cryopreservation can preserve reproductive potential for decades.