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

A 16-year-old mother in Peru delivered a baby who was in placenta that attached to her liver.

This is a rare milestone as the baby has been safely delivering from an abdominal ectopic pregnancy in which the placenta was attached to the mother’s liver.

The case involved 19 year old Valeria Vela, whose pregnancy continued to 40 weeks and resulted in the birth of a healthy baby girl. Health authorities in Peru say this is the first documented case of its kind in the country and only the fourth reported worldwide in which both mother and baby survived.

Understanding the Rarity of Ectopic Pregnancies

Ectopic pregnancies occur when a fertilized egg implants outside the uterus. In most situations, they develop in the fallopian tubes.

Around 96 percent of ectopic pregnancies happen there and only a very small number occur in the abdominal cavity. These pregnancies cannot safely continue because the organs where the egg may attach are not designed to support a growing fetus. In this case, the egg implanted directly on the liver, which meant the fetus relied on the liver’s arteries for blood supply. This created a situation that demanded extremely careful monitoring, as even small shifts in blood flow could have been dangerous.

The Challenges Doctors Faced

For doctors, the biggest challenge was the placenta. Removing a placenta that has attached itself to the liver can cause severe bleeding that can quickly turn fatal. Peru’s Health Minister Luis Quiroz Avilés explained that any attempt to detach it without preparation could have caused life threatening hemorrhage in the mother.

To manage this, the medical team used a technique that closes the arteries feeding the placenta by blocking their blood flow. This approach helped prevent massive bleeding during surgery and gave both mother and baby a chance at survival.

Another extraordinary aspect of this case was that the pregnancy reached 40 full weeks. Previous live abdominal ectopic pregnancies that resulted in birth reached only up to 36 weeks. Doctors followed Valeria closely through her pregnancy and relied on advanced imaging and interventional radiology techniques to keep the situation stable. According to local reports, the clinical management required constant coordination among specialists from obstetrics, radiology, surgery and intensive care.

A Baby Born Against All Odds

The baby, named Aylin, was born on November 30 and weighed 7.9 pounds. Officials revealed the case only after both mother and child were safely discharged from the hospital. Valeria is now in stable condition and recovering well, while Aylin is reported to be healthy.

Why This Does Not Change Standard Care

Although the case has been described as a medical milestone, specialists emphasize that such pregnancies are exceptionally rare. Most ectopic pregnancies cannot continue and trying to carry them comes with severe risks that include hemorrhage, organ damage and even death. For this reason, early diagnosis and timely intervention remain the safest and most widely recommended approach. This case highlights what is medically possible under very specific circumstances, but it does not change established guidelines for managing ectopic pregnancies.

Do you feel like your attention span has gone down? Thanks to multiple social media platforms and its shorter duration content, we find ourselves losing attention and cannot keep up with anything that goes a little bit over a minute. This has not just affected us, but children are now being diagnosed with attention deficit hyperactivity disorder (ADHD) more.

A latest peer-reviewed study by Karolinska Institutet, which monitored more than 8,300 US-based children from age of 10 to 14 noted that social media use has lead to increased inattention symptoms.

The researchers of the aforementioned institute in Sweden, along with the Oregon Health & Science University in the US found that children spent an average of 2.3 hours a day watching television or online videos, 1.4 hours on social media and 1.5 hours playing video games.

The study found no connection between ADHD-related behaviors, such as distractibility, and activities like playing video games or watching TV and YouTube. However, long-term social media use was linked to rising inattention symptoms in children. ADHD is a neurodevelopmental condition marked by impulsiveness, trouble focusing and frequently forgetting everyday tasks.

. According to the researchers, “We identified an association between social media use and increased inattention symptoms, interpreted here as a likely causal effect.” They noted that while the impact on each child may be small, widespread behavioral shifts could have a meaningful effect at the population level. The study also suggested that growing social media use may be contributing to the rise in ADHD diagnoses.

Why Social Media May Disrupt Focus

Torkel Klingberg, a professor of cognitive neuroscience at the Karolinska Institute, said the findings pointed specifically to social media as a factor affecting children’s ability to concentrate. He explained that platforms bombard users with constant notifications and messages, and even the anticipation of receiving one can interrupt mental focus. “This affects the ability to stay focused and could explain the association,” he said.

The research also showed that socioeconomic background and genetic risk for ADHD did not change the observed link, suggesting that the distraction-rich environment of social media itself may be responsible. Klingberg added that increasing social media use could partly explain the rise in ADHD diagnoses among children, which grew from 9.5 percent in 2003–07 to 11.3 percent in 2020–22, based on data from the U.S. National Survey of Children’s Health.

Early Social Media Exposure Raises Concerns

The authors stressed that the study does not imply all children who use social media will develop concentration problems. However, they pointed out that many children begin using these platforms well before age 13, the minimum age for apps such as Instagram and TikTok. The report called for stronger age verification measures and clearer guidance from tech companies.

How Much Time Children Spend Online

The study tracked a gradual rise in social media use, from around 30 minutes a day at age nine to about two and a half hours by age 13. The children were enrolled at ages nine and ten between 2016 and 2018. The full findings will appear in the journal Pediatrics Open Science.

Samson Nivins, a postdoctoral researcher at the Karolinska Institute and one of the study’s authors, said the team hopes the results will help parents and policymakers make more informed decisions about healthy digital habits that support children’s cognitive development.

As winter settles in and children move between school, outdoor play, and indoor gatherings, coughs and colds often become unavoidable companions. While many coughs resolve on their own, doctors warn that a cough that lingers for weeks is not something parents should overlook. At the same time, the cold season naturally weakens a child’s defenses, making it important for families to follow simple steps to improve immunity.

When a Cough Lasts Too Long

According to Dr Nishant Bansal, Consultant Pediatrician and Neonatologist at Motherhood Hospitals, Noida, parents must stay alert when a cough stretches beyond the usual duration. He explains, “A cough that lasts for weeks should never be ignored. While many are caused by mild infections, persistent or recurring coughs can point to allergies, asthma, or an underlying health issue.”

Many children are catching respiratory infections during weather changes or after starting school. As temperatures drop, coughs tend to worsen. What may look like a harmless lingering cold could actually be linked to an allergy, asthma, sinusitis, whooping cough, or even exposure to pollutants and smoke.

Dr Bansal adds, “If a child’s cough becomes worse at night, during exercise, or after exposure to dust or pets, it may be triggered by asthma or allergies. These symptoms should be reported to a doctor without delay.” Children exposed to polluted air or cigarette smoke are especially prone to constant coughing and wheezing.

Ignoring these symptoms can interfere with sleep, appetite, growth, and energy levels. Some infections, such as whooping cough or sinusitis, require prompt treatment to prevent complications. That is why early identification of the cause is essential.

Managing and Preventing Persistent Coughs

Parents often try repeated home remedies such as honey, steam, or warm fluids, but these may not be enough. “If the cough lasts more than two to three weeks, it should be evaluated instead of being managed with only home remedies,” says Dr Bansal.

Indoor air quality plays a major role. Avoid smoking around children, improve ventilation, and use an air purifier if possible. Keeping children well hydrated with warm soups, milk, or water can soothe the throat and loosen mucus. Over the counter cough syrups should be avoided unless a doctor prescribes them.

Warning signs such as wheezing, breathing difficulty, coughing fits, or fever need immediate medical care. Timely guidance helps the child breathe better, recover faster, and avoid long term complications.

Why Winter Increases Illnesses in Children

Children are naturally more vulnerable during colder months. They often face sore throats, colds, coughs, and viral infections that spread easily when people gather indoors. Dr Atul Palwe, Consultant Pediatrician and Neonatologist at Motherhood Hospital, Lullanagar, Pune, explains, “Viruses spread more easily in winter, especially when children stay in closed spaces for long hours.”

Strengthening immunity is key to helping children stay healthy throughout the season.

Simple Ways to Boost a Child’s Immunity

Focus on a Nutritious Diet

“A strong immune system begins with a balanced diet,” says Dr Palwe. He recommends plenty of fruits, vegetables, whole grains, legumes, nuts, and seeds. Foods rich in vitamin C such as oranges, guavas, and amla, along with zinc and iron rich foods, help build resistance.

Maintain Hydration

Children tend to drink less water in winter, but staying hydrated helps the body remove toxins. Warm soups and milk are comforting alternatives.

Encourage Regular Activity

Indoor games, yoga, and outdoor play on pleasant days improve blood circulation and strengthen immunity.

Ensure Adequate Sleep

“Children under ten need about ten to twelve hours of sleep every night to keep their immunity strong,” says Dr Palwe.

Teach Hygiene Habits

Handwashing before meals, after play, and covering the mouth while coughing reduces the spread of infections.

Dress Them Warmly

Layering helps protect children from cold winds while still allowing movement.

Get Enough Vitamin D

Limited sunlight in winter can affect vitamin D levels. Dr Palwe suggests encouraging morning outdoor play or discussing supplements with a doctor if needed.