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

Staying hydrated during pregnancy is crucial, but not every beverage that quenches thirst is safe for a mom-to-be. From morning coffee to bedtime teas, the choices can get confusing. So, how do you know which drinks are actually good for you and your baby?

We spoke to Dr. Sushruta Mokadam, consultant obstetrician at Motherhood Hospital, Kharadi, Pune, who rated the most common beverages consumed during pregnancy — from best to worst — and explained what makes them safe or risky.

Water

She recommends drinking at least three litres of water daily. “If plain water feels boring, try adding slices of lemon, cucumber, or mint. Detox water can be a refreshing and healthy alternative,” she adds.

Milk

Milk is packed with calcium, protein, vitamin D, and iodine, all vital for the baby’s bone, tooth, and brain development. “Milk is one of the most wholesome drinks for expectant mothers, provided it’s pasteurized,” says Dr. Mokadam.

She advises choosing between low-fat or full-fat milk based on your dietary needs. For those who are lactose intolerant or prefer plant-based options, fortified almond or soy milk can be good substitutes — as long as they’re enriched with calcium and vitamin D.

Fresh Fruit Juices

Freshly squeezed juices provide a good dose of vitamins, minerals, and antioxidants. “Juices like orange, pomegranate, or apple can help boost your well-being,” explains Dr. Mokadam.

However, she cautions against overconsumption: “Juice lacks fiber and is high in natural sugars. One small glass a day is fine, but going overboard can lead to unnecessary calorie intake and affect blood sugar levels.”

Herbal Teas

Many pregnant women turn to herbal teas for relaxation or to ease nausea. “Mild herbal teas like ginger or chamomile in moderation can help with digestion or morning sickness,” says Dr. Mokadam.

But not all herbs are safe. “Avoid teas with licorice root, pennyroyal, or unknown herbal blends. Always check with your doctor before adding any herbal tea to your routine,” she advises.

Coffee and Black/Green Tea

Caffeine crosses the placenta and can affect the baby’s heart rate. “It’s best to limit caffeine to less than 200 mg per day,” warns Dr. Mokadam. That’s roughly one small cup of coffee or two cups of tea. Too much caffeine may increase the risk of miscarriage or low birth weight.

Soft Drinks, Energy Drinks, and Sugary Beverages

These are high in sugar, artificial additives, and caffeine, with no nutritional value. “They can increase the risk of gestational diabetes, excessive weight gain, or even affect fetal growth,” says Dr. Mokadam.

She advises cutting them out completely for better overall well-being.

Pregnancy is a time when woman need to be extra careful with what they consume. There are always endless recommendations, and thus sometimes it could be difficult to separate fact from fiction, especially when it comes to protein intake. While protein is essential for everyone, however, during pregnancy, it plays a critical role in maternal health and fetal development.

Why Does It Matter?

A recent study has shown that lead has been found in popular protein powder, and the highest found in whey protein powder, or the plant-based protein powders. This is concerning, as protein are essential during pregnant as they contribute directly to the growth and development of the baby.

Proteins are made up of amino acids- body's building blocks. These amino acids help build and repair muscle and create hormones and produce enzymes.

A study published in Advances in Nutrition highlights that pregnancy is an “exceptional stage of life defined by rapid growth and development.” From just weeks after conception, the body adjusts protein metabolism to support fetal growth. Most protein deposits occur in the third trimester, reinforcing the importance of consistent protein intake throughout pregnancy.

Read: High Levels Of Lead Found In Protein Powders And Shakes, Reveals Consumer Reports

How Much Protein Do You Need?

Recommended protein intake usually varies by country, for instance in Australia, the RDI for pregnant women s around 60 grams per day, whereas 46 grams for non-pregnant women.

Are Protein Powder Safe During Pregnancy?

Yes, they are safe, unless they contain lead and other contaminants, which must be checked by the list published by the Consumer Reports and your local physician, gynaecologist and nutritionist.

There are several plant-based proteins that have the highest lead content in them, they are:

• Whey protein: Derived from milk; contains all essential amino acids. Not ideal for lactose-intolerant individuals.
• Hemp protein: Plant-based, safe for vegetarians and vegans.
• Pea protein: Plant-based, rich in branched-chain amino acids (BCAAs).
• Rice protein: Vegan-friendly, made from brown rice.

What Is An Alternative?

The RDI could be achieved with a manageable and balanced diet that includes:

Complete proteins: Lean meats, fish, eggs, dairy

Combined plant proteins: Legumes with grains or nuts (e.g., peanut butter on whole-grain toast)

A diet rich in fruits, vegetables, whole grains, legumes, nuts, and moderate protein sources, whether plant-based or animal, supports both maternal and fetal health. Weight gain is expected during pregnancy, and incorporating protein helps ensure that gain is nutrient-dense. For individual guidance, consulting a GP or dietitian is recommended.

Other alternatives like protein bars, or homemade bars, which use dates, nut butter, and seeds could be a healthier option as they do not contain added sugar.

Scientists have found that kids' social media use might be slowing down their brain power. A new study says that spending time on these apps could be hurting how well a tween's mind develops. This research shows that the more time kids spend on platforms like Instagram or TikTok, the worse they might do on school-related tasks later on.

How Does Social Media Affect Our Health?

The researchers found that children aged 9 to 13 who used social media more often did worse on tests that measured skills like reading, memory, and language. They were tested on these abilities two years after the study began. The results were published in a major medical journal called the Journal of the American Medical Association.

The lead scientist, Dr. Jason Nagata, explained that even using social media for a short time each day was connected to poorer results on these brain-power tests. He suggested that the brains of young tweens might be extra sensitive to social media. This means parents need to be careful about when they let their kids start using these apps and how much time they spend on them.

How Did Social Media Affect Kid’s Academics?

To figure this out, the researchers looked at information from over 6,500 children across the country. These kids were all part of the Adolescent Brain Cognitive Development (ABCD) Study, which is the biggest study ever done in the U.S. to track how children's brains grow over time. They sorted the kids into groups based on their social media use:

• Over half (58%) of the kids barely used social media at all.
• More than a third (37%) were using social media for about one extra hour every day by the time they turned 13.
• A small group (6%) were using social media for up to three extra hours a day by age 13.

The children's brain power was measured using special tests created by the National Institutes of Health, which tested things like how well they remember information and understand language. The study found a clear, but small, drop in the test scores for kids who used social media.

• Kids who used social media for just one extra hour a day scored about 1 to 2 points lower on their memory and reading tests.
• Kids who used social media for up to three extra hours a day saw a bigger drop, scoring as much as 4 points lower.

Why Is Important To Restrict Your Child’s Social Media Usage?

Dr. Nagata explained that even though these differences seem small, they are very important because they were seen again and again across the children. Since reading and memory are the most important skills for learning, even these small dips in scores, when seen across thousands of kids, could be a problem for education as a whole.

The scientists think the problem is that social media is so fun and engaging that kids might choose to scroll instead of doing homework or reading. This time shift could be hurting their learning. The researchers stress that creating good screen habits early on can help protect a child’s learning and brain growth.

The results of this study support actions already being taken, such as schools trying to limit student phone use during the day. The findings also provide backing for bigger changes, like making the age limits for social media access even stricter than they are now.

However, the researchers want to be clear about one thing: because they were only watching the kids' behavior (it was an observational study), they can't say for sure that social media causes the lower test scores. They can only say that there is a clear association between the two.