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

When a child struggles with mental health issues, parents may tend to find themselves dealing with more than concern about their child's well-being.

Judgement from people around them, including relatives, friends, neighbours and other parents can add guilt and shame to an already challenging experience. Some families may even withdraw socially to avoid uncomfortable questions.

A recent study promoted by News-Medical found that parents may feel judged when they feel they are not able to live up to the definition of a "good parent." The researchers interviewed 24 parents whose children had mental health challenges.

The belief that a child's behavioural difficulties reflect poor parenting makes it harder for families to seek help. Parents may be told to discipline their child more strictly or change their parenting style, even when the child needs special care.

“Stigma often hurts parents as much as the condition hurts the child,” says Dr. Anupam Madaan, Attending Consultant Psychiatrist at Fortis, Jalandhar told HealthandMe.

But parents do not have to navigate this on their own. Understanding mental health conditions, seeking timely treatment and creating a supportive home environment can help children cope with their challenges without carrying the burden of stigma.

Why Do Parents Feel Judged?

Also read: GLP-1 Drugs May Offer Mental Health Benefits, Reduce Schizophrenia Relapses: Lancet Study

"Mental health problems are still widely misunderstood," Dr. Shiv Prasad, MD Psychiatry, Professor and Head of the Department of Psychiatry at Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital told HealthandMe.

Many people assume that a child's emotional or behavioural difficulties result from poor parenting, a lack of discipline or an inadequate upbringing.

He said, "There is also a lack of awareness about mental health conditions. While people are generally more comfortable discussing physical illnesses, they may hesitate to talk about depression, anxiety, ADHD, or other mental health concerns. As a result, parents may feel ashamed, isolated, or afraid of what others will say. Many also worry about their child’s future and how society will treat them."

In India, where family reputation and social expectations often matter, parents may worry about being blamed by relatives, neighbours or their child's school. This can lead to guilt and hesitation in seeking professional help.

“Children's mental health conditions come from a mix of genetics, brain development, stress and life events. Ordinary parenting choices do not cause them,” Dr. Madaan explains.

He speaks about the National Mental Health Survey, which reported a prevalence of about 7.3% among adolescents aged 13 to 17 across 12 states. A 2026 review of studies in India also identified stigma as a major barrier to adolescents seeking mental health care.

How Can Parents Protect Their Child From Stigma?

Also read: Attention Deficit May Be The Wrong Way To Understand ADHD, Says US Psychiatrist

Parents cannot control what others say, but they can decide how they respond and what their child hears at home.

Dr. Prasad advises parents to focus on their child's needs instead of worrying about how the family is perceived. Seeking professional help should be treated as a responsible step, not a source of shame.

He said, "Speak openly with your child, reassure them that their condition is not their fault, and never label or compare them with others. Set clear boundaries with people who make insensitive comments, and share personal information only with those you trust. Seek professional help when needed and maintain a supportive home environment."

The language used at home matters, too. If children repeatedly hear that they are a problem, a burden or a source of embarrassment, they may begin to believe it themselves.

Instead, parents should reassure them that they are loved and valued, and that their mental health difficulties do not define who they are.

Dr. Madaan recommends explaining the condition early and making it clear that the child is not at fault. This can help prevent internalised stigma, in which children begin to see their illness as a personal weakness. He said, "They may then be less likely to hide their symptoms or avoid seeking help."

Parents should also decide carefully who needs to know about the diagnosis. Dr. Madaan recommends informing the child's class teacher and family doctor early so they can provide appropriate support. He said, "Relatives who are told should respect the child's privacy and avoid discussing the diagnosis in front of the child or at social gatherings."

Recognising When A Child Needs Professional Help

Also read: Self-Diagnosis Could Go Wrong: Are We Overusing The Words Anxiety, Trauma and ADHD?

Stigma can delay treatment, making it important for parents to recognise changes in their child's behaviour and emotional well-being.

Dr. Madaan advises seeking an assessment when certain symptoms show.

He said, "Sadness lasting beyond two weeks, a sudden drop in school performance, withdrawal from friends, or changes in sleep and appetite call for a visit to a child psychiatrist."

A child psychiatrist may use screening tools like the Strengths and Difficulties Questionnaire for children or the PHQ-A for teenagers.

Parents should also follow the recommended treatment plan, attend therapy sessions and give prescribed medication as directed. They should consult the psychiatrist before stopping medication, even if the child appears to be doing better.

If The Child Is Being Bullied

For a child already dealing with mental health challenges, bullying can add another layer of psychological toll. Home should be a place where they feel heard, believed and protected.

“Parents should encourage open conversations and listen without immediately questioning, blaming, or dismissing the child’s experience,” says Dr. Prasad.

Responses such as “Why don’t you just ignore them?” or “You must have done something to provoke them” can leave children feeling that they have to manage the problem alone.

Instead, parents can say, “I am glad you told me. This is not your fault, and we will work through it together.”

If bullying occurs at school, parents should document incidents and speak to teachers or school authorities. Threats, physical harm and online harassment should be addressed promptly.

Parents can also encourage healthy friendships and activities that help children recognise their strengths. If bullying begins affecting their sleep, mood, school attendance or self-esteem, professional help could be necessary.

Parents Need Support Too

Also read: GLP-1 Drugs May Offer Mental Health Benefits, Reduce Schizophrenia Relapses: Lancet Study

Caring for a child with mental health challenges can leave parents exhausted. The pressure to manage treatment, family responsibilities and other people's opinions can take a toll on their own mental and emotional well-being.

Dr. Madaan said, "Caregiver burnout, a state of exhaustion that can bring low mood and anxiety, is common. Regular meals with fruit, vegetables and protein, seven hours of sleep and a daily walk keep energy steady. A parent support group or a counsellor offers a safe place to talk."

Talking to a counsellor, joining a parent-support group or confiding in family members can also provide a space to talk without fear of judgement. Experts say that parents do not need to manage every aspect of their child's care alone. Looking after their own well-being can help them remain better equipped to support their child.

For Dr. Prasad, tackling stigma begins with changing how families and communities talk about mental health.

“We should avoid labelling children as ‘abnormal,’ ‘weak,’ or ‘problematic.’ Instead, we should recognise that every child has different needs and may require different kinds of support,” he says.

Oscar-winning actress Hilary Swank has announced that she is expecting her third child with her husband Philip Schneider, at the age of 52.

Swank was 48 when she gave birth to twins, daughter Aya and son Ohm, in April 2023.

Sharing a video on Instagram of her husband and their 3-year-old twins dancing in the dark with neon glow sticks taped to their clothes, Swank wrote, “A lot of people have been asking what project I’m doing next; this one releases in December.”

The video also revealed Swank’s growing belly, with a tiny baby shape outlined in glow sticks.

Hilary Swank’s Journey To Motherhood

Read: RSV Warning: Welsh Mum Urges Pregnant Women To Get Vaccine After Baby Nearly Dies

Swank and entrepreneur Philip Schneider married in August 2018 after dating for a year and a half. They welcomed their twins in April 2023, when the actress was 48.

“It wasn't easy. But boy (and girl!) was it worth it,” Swank wrote on Instagram at the time, alongside a photo of herself holding the newborns.

Swank has also spoken about embracing the physical and personal changes that come with motherhood.

“For me, it’s not about bouncing back to our pre-baby bodies but rather bouncing forward into our new bodies and selves,” she told Women’s Health last year.

What To Know About Pregnancy After 50

Also read: High BP in Pregnancy Linked to 42,000 Maternal Deaths, 500,000+ Stillbirths, Newborn Deaths: WHO

Pregnancy at age 35 or older is medically referred to as “advanced maternal age,” according to the American College of Obstetricians and Gynecologists.

Women who become pregnant later in life face increased risks of complications, including gestational diabetes, preeclampsia, miscarriage and preterm birth.

As maternal age increases, doctors may recommend closer monitoring during pregnancy. This can include screening for chromosomal abnormalities, additional ultrasounds and more frequent prenatal visits and testing as the pregnancy progresses.

“Pregnancy in the 50s is possible, but it requires careful medical supervision. With advancing maternal age, the risks of miscarriage, chromosomal abnormalities, gestational diabetes, high blood pressure, preeclampsia, preterm birth and stillbirth increase,” Dr. Tripti Raheja, Director of Obstetrics and Gynaecology at CK Birla Hospital, Delhi, told HealthandMe.

Dr Prampreet Kaur Ghuman, Senior Consultant- Obestriction and Gynecologist at Cloudnine Group of Hospitals, Mohali added late motherhood requires careful consideration of both maternal and foetal health.

“By this age, most women have reached menopause, making natural conception extremely unlikely”.

She noted most pregnancies achieved at this stage often involve assisted reproductive technology (ART), using donor eggs from younger women or embryos frozen earlier in life. “While younger donor eggs can significantly reduce the risk of age-related chromosomal abnormalities, they do not reverse the ageing of the mother’s body,” she told HealthandMe.

Planning A Pregnancy After 50

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The experts advised women planning a pregnancy to consult an obstetrician and fertility specialist for a preconception assessment. This should include an evaluation of existing health conditions and available fertility options.

"For women contemplating pregnancy later in life, planning should begin with a detailed evaluation of cardiovascular health, blood pressure, blood sugar, existing medical conditions and overall fitness for pregnancy," Dr Prampreet said.

It is equally important to discuss the potential risks, the likelihood of complications and the demands of parenting over the long term.

Taking folic acid as advised, maintaining a balanced diet, exercising appropriately, avoiding alcohol and tobacco, and reviewing medications with a doctor are important steps.

Once pregnant, early prenatal care, recommended genetic screening and regular medical monitoring can help identify complications and support better outcomes.

A Welsh mother whose newborn daughter nearly died after contracting respiratory syncytial virus (RSV) is urging pregnant women to get vaccinated to protect their babies.

Jo Goldsmith said she was told to “prepare for the worst” after her daughter Phoebe contracted RSV just five days after birth, the BBC reported. Phoebe, now four, developed breathing difficulties and was admitted to a hospital’s high-dependency unit.

Goldsmith said the vaccine was not available when she was pregnant but that she “definitely would have had it.”

“I wouldn't want any family to go through what we went through,” she said.

RSV vaccinations for pregnant women were introduced in Wales in September 2024.

“She was five days old, she had quite a lot of congestion... and we noticed quite quickly that she seemed to be breathing very fast and was struggling,” Goldsmith said.

What Is RSV?

Also read: Flu Vaccine: Why October Is A Good Time To Get Your Family Vaccinated

Respiratory syncytial virus (RSV) is a common respiratory virus that typically causes cold-like symptoms. However, it can lead to serious illness, including bronchiolitis and pneumonia, particularly in infants, older adults and people with weakened immune systems.

Almost every child contracts RSV by the age of two. The virus can cause severe illness in infants, with up to three in every 100 infected infants requiring hospitalization.

Maternal vaccination with RSVpreF (Abrysvo) helps protect newborns against RSV during their first months of life. However, uptake has remained relatively low in the US and Europe since the vaccine was introduced in 2023, according to a study published last week in The Lancet Regional Health – Europe.

In the UK, the RSV vaccine is routinely offered to pregnant women from 28 weeks of pregnancy to help protect their babies. It is also offered to eligible older adults, including everyone aged 75 and over. Older adults generally need only one dose, while women are advised to receive the vaccine during every pregnancy.

Maternal RSV vaccination allows protective antibodies to pass from the mother to the baby before birth. More than 30 countries have introduced maternal RSV vaccination, either as a stand-alone intervention or alongside other preventive measures, such as infant immunization.

How Does RSV Spread?

RSV spreads through respiratory secretions, including saliva and mucus, and through contact with contaminated surfaces. In the US, infections typically occur from late fall to early spring, although seasonal patterns vary by region.

What Are The Symptoms Of RSV?

Read More: XFG Variant In Spain: COVID-19 Cases Rise Amid Respiratory Infection Surge

RSV symptoms usually appear four to six days after exposure. Early signs often resemble a common cold and include:

• Runny nose and sneezing
• Cough
• Decreased appetite
• Irritability and tiredness in infants

Babies may also develop rapid or labored breathing. In some cases, the infection spreads to the lower respiratory tract, causing bronchiolitis or pneumonia.

Parents should seek urgent medical attention if a baby has difficulty breathing, shows signs of dehydration or becomes unusually unresponsive. Severe breathing difficulties require emergency care.