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

For new mothers struggling with breastfeeding, artificial intelligence can offer something doctors often cannot: an answer at 2 am.

But a new report is raising concerns about what happens when those instant responses replace professional medical advice.

A national survey commissioned by Orlando Health found that 51% of women aged 18 to 44 would first turn to an AI chatbot, social media platform or search engine if they had an urgent breastfeeding question.

Only 29% said they would first contact a doctor or lactation consultant, while 21% would turn to family or friends.

The findings highlight a growing challenge as new parents increasingly use AI to navigate pregnancy, caring for their infants and breastfeeding.

Is AI Advice Always Reliable?

AI can quickly explain clinical terms, suggest possible causes for a problem and provide general breastfeeding information. But it cannot examine whether the baby is actually getting enough milk.

“There are certain questions that can't be answered by AI,” said Erynne Bowers, M.D., a pediatrician with Orlando Health Physician Associates.

Bowers said roughly one-third of mothers who come to her with breastfeeding concerns have already received inaccurate advice from AI. Some of the misinformation involves recommendations about how much milk a baby should consume or how frequently the baby should be fed. The expert says that's where generic advice from AI can become misleading and dangerous.

Also read: Could Light-Controlled Nanobots Revolutionise Breast Cancer Treatment? Indian Researchers Explore The Possibility

Feeding Pattern Is Different For Every Baby

A baby's nutritional needs depend on several factors, including age, birth weight, growth trajectory, medical history and feeding efficiency.

Doctors also examine the baby's weight gain, hydration, urine and stool patterns, alertness and developmental progress. They may observe the baby's latch, tongue movement and coordination between sucking, swallowing and breathing. These assessments cannot be done by an AI chatbot.

A baby may spend a long time at the breast but transfer very little milk. Another may feed for a shorter period but feed efficiently. A generic feeding schedule therefore cannot explain the entire problem.

Also read: Breastfeeding Can Help Reduce Mothers' Risk of Type 2 Diabetes, Breast Cancer and More

How Incorrect Advice Can Create A Cycle?

Experts warn that telling a mother to feed less frequently, for example, could potentially reduce the baby's calorie intake while also lowering breast stimulation.

The report also describes the experience of Florida mother Emily Hunziker, whose newborn son began losing weight despite her efforts to breastfeed exclusively.

She worked with a pediatrician and lactation specialist, used a combination of pumping, bottle-feeding and supplemental formula while continuing to support her breastfeeding goals. Her son is now thriving and growing up well.

Also read: Breastfeeding Vs Mixed Feeding: Which Is Right For Your Baby? Experts Explain

Should New Mothers Stop Using AI For Breastfeeding Advice?

It does not mean that new mothers should completely stop using AI. AI can be useful for understanding medical terminology, preparing questions for a doctor or finding reliable resources. But it should not become the final decision-maker when an infant's nutrition or growth is at stake.

Warning signs like poor weight gain, unusual sleepiness, dehydration, persistent vomiting, breathing difficulties, severe pain or a sudden drop in feeding require medical assessment from a doctor rather than an automated generic advice.

Relying excessively on an AI chatbot for answers may delay seeking a physician's help which could, in turn, delay clinical examination and treatment.

Excessive consumption of cow’s milk has been linked to severe iron deficiency in young children. A Queensland specialist has also warned that in the past two years, three toddlers died after developing extreme iron-deficiency anaemia.

According to ABC News, the children were drinking more than 1 litre of cow’s milk a day.

Queensland Children’s Hospital haematologist Dr Sally Campbell said the toddlers were otherwise healthy but developed severe anaemia before infections like viral illnesses took a toll on their health.

“They were drinking more than one litre of cow’s milk per day. This resulted in them developing extreme iron deficiency anaemia and sadly, dying,” Campbell said.

She explained that severe anaemia leaves children with too few red blood cells to deliver enough oxygen to vital organs. A seemingly routine viral infection can therefore become severe and even fatal.

“One small virus can unfortunately be life-threatening when you’ve got a chronic anaemic state,” Campbell said.

Why Can Excessive Cow Milk Consumption Cause Iron Deficiency?

Also read: Should Children Take Protein Powders? A Dietitian’s Perspective

Consuming large quantities of milk can reduce a child’s appetite for iron-rich foods like meat, legumes and iron-fortified foods.

Dairy can also interfere with iron absorption. In growing children, whose iron requirements are high, this can gradually push iron reserves to a dangerous low level.

Research from the ORIGINS Project, a large longitudinal birth cohort following around 10,000 Western Australian children, has found widespread low iron levels among young children.

Researchers from The Kids Research Institute Australia, Edith Cowan University, Curtin University and The University of Western Australia published their findings in the Journal of Paediatrics and Child Health in 2025.

Using the World Health Organization’s ferritin threshold, the researchers found iron deficiency in 15% of one-year-olds and 20% of three-year-olds.

Professor Desiree Silva, co-director of ORIGINS and Professor of Paediatrics at The University of Western Australia, has described the problem as a “hidden health crisis”.

She said iron is essential for immunity, oxygen transport and healthy development, while low iron can contribute to tiredness, lethargy, poor sleep and difficulty in feeding.

Also read: Study Links Excessive Screen Time To Poorer Body Image in Teens With Skin Conditions

How Much Cow’s Milk Is Too Much?

Queensland health guidance recommends no cow’s milk as a drink before 12 months. From one to five years, children should have no more than about 500 ml, or two cups, a day.

Importantly, this does not mean parents need to eliminate milk from a toddler’s diet. The concern arises when excessive intake of milk replaces a balanced and nutritious diet.

Campbell said the problem is preventable and urged parents to adopt better dietary habits for toddlers.

Parents must also look for signs of low iron levels in their children. Symptoms like persistent tiredness, poor appetite, development concerns or unusual changes in behaviour should not be simply dismissed as fussy eating or a toddler phase. Severe iron deficiency can develop quietly, making early assessment and treatment important.

Eye specialists worldwide are raising the alarm, as myopia, or nearsightedness, is on the rise among children at a rate that is making eye doctors and pediatricians reconsider how they assess young patients.

What used to be a mild inconvenience that could be corrected with a pair of glasses is now being treated as a long-term health concern. High myopia in childhood is associated with an increased risk of serious eye conditions later in life, including retinal detachment, glaucoma and myopic macular degeneration. This is not just an anecdotal change.

Public health professionals say the development is likely due to a variety of causes, including more time spent on screens, less time outdoors, and more strenuous academics, which most online work is entangled with. The good news is that myopia can be controlled if it is discovered early.

Optometrists have an expanding toolbox of options, including customized contact lenses, Ayurvedic eye drops, and more time spent outdoors, that can help to delay its advancement in children. The trick is to catch it early. Seven warning flags to look out for as a parent

1. Squinting To See Distant Objects

Because myopia often develops gradually, many parents don't realize their child is struggling to see clearly until a school vision screening flags it or until the child is already several dioptres into nearsightedness.

A child who consistently squints to read the whiteboard, to watch TV from across the room, or to notice a buddy coming towards them is usually making an instinctive attempt to make a murky image clearer. Squinting alters the shape of the eye's opening for a brief period, which can help bring things that are far away into marginally better focus — but it's a signal, not a solution.

2. Sitting Too Close To TV Or Screens

A child who always sits inches from the screen, holds tablets or books very near to their face, or asks for a front-row seat at school may be compensating for trouble seeing things far away.

Also read: El Salvador Becomes First Country In Central America To Eliminate Trachoma: WHO

3. Regular Headaches Or Eye Strain

Children who have difficulty focusing on things that are far away have eyes to work harder all day. This added stress may manifest as frequent headaches, especially after school, screen time, or reading.

4. Poor Performance In School or Attention

Kids don’t usually say, “I can’t see the board. Instead, a sudden dip in grades, difficulties reproducing notes or seeming distracted and uninterested in class can be an ignored symptom of undetected vision problems.

5. Holding Books Or Devices Unusually Close

Similar to sitting close to screens, a child who holds a book, tablet, or phone very near their face may be doing so instinctively to bring text into focus.

6. Rubbing Eyes Frequently Or Excessive Blinking

While rubbing eyes and blinking can have many causes, when paired with other signs on this list, they can indicate visual fatigue from the eyes constantly trying to compensate for blur.

Also read: Tadalafil: Common Male-Potency Drug May Raise Glaucoma Risk In Men, Finds Study

7. Complaints That Things "Look Fuzzy" From A Distance

Sometimes the sign is simply the child telling you directly — that the street signs look blurry, that they can't see the ball until it's close, or that faces "look fuzzy" from across the room.

These direct complaints are often the clearest signs that your child is experiencing visibility issues. While rubbing eyes and blinking can have many causes, when paired with other signs on this list, they can indicate visual fatigue from the eyes constantly trying to compensate for blur.

Why Early Detection Matters

Pediatric eye specialists usually advocate regular vision examinations beginning in early childhood and continuing through the school years, as this is the age when myopia most typically first develops and progresses the fastest — between 6 and 12 years of age. If any of the following indicators are noticed, parents are recommended to schedule a full eye exam with an optometrist or eye specialist rather than waiting for the next standard school screening.

Common lifestyle adjustments include more unstructured outdoor time, regular breaks during near-work tasks (following the general “20-20-20” guideline of looking at something 20 feet away for 20 seconds every 20 minutes), and proper lighting for reading and homework, alongside professional treatment options.

By Dr Mandeep Singh Basu, Ayurvedic Eye Specialist, Dr Basu Eye Care Centre