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

“My child is a picky eater; he hardly eats anything, so should I start giving him a protein shake?” As a pediatric dietitian, I hear this question most often from parents. Be it on the attractive shelves of a supermarket or a post on social media, you will find products that promise your child will be taller, stronger, sharper, and no wonder why parents might feel the fear of missing out!!

But here’s the reassuring truth: No, most healthy children don’t need protein powders/ protein biscuits.

Before talking about this “trendy” supplement, it is important to understand why protein is important and what its functions are.

Why Is Protein Important?

Protein is called the building blocks, and rightly so cause it helps build muscles, stronger bones, good skin, hormones, enzymes, and antibodies. Meaning, for good immune function, for growth and development, or be it for tissue repair, we all need protein.

However, protein is just a block of this big puzzle; we equally need good carbs and good fats along with it. In fact, good carbs, if included in balanced quantities, help protein do its job; we dietitians call it the “protein-sparing action”.

So The Question Arises: Are Children Getting Enough Protein?

Interestingly, Yes. Many of the parents assume that their child is getting less protein cause they are skipping/ refusing or eating small portions, but in reality including small portions even plays a big impact, as child requires less protein than adults and some of the rich protein sources like curd, milk, paneer, eggs, dals, lentils, soya products, lean meat, fatty fishes, nuts & dry fruits do provide good amount of protein.

Let’s take a 5-year-old for an example; A glass of milk along with nuts in the morning, a bowl of thick dal in lunch, and a serving of paneer/ curd in a regular dinner easily meet their daily requirements without any supplements.

Do Protein Powders Make The Children Taller?

No, the child drinking protein powder will not decide the baby’s height. It is influenced by several factors like genetics, overall nutrition, good sleep, regular physical activity, etc. So no direct evidence is found that suggests drinking protein powder only will help children gain height.

So What About The Child Who’s Into Sports?

Most of the time, they also DON’T need the protein powder.

Physically active children usually need more energy overall—not just more protein. A balanced diet with nutritious high-protein meals and snacks is enough for the majority of young athletes. Milk after practice, peanut butter on whole-grain bread, boiled eggs, yogurt with fruit and seeds, or homemade sprouts chaat are all excellent recovery foods.

Then Who Needs Protein Powders?

Children who have been clinically diagnosed with vitamin and mineral deficiencies, or have had some chronic illnesses or surgeries, or have some inborn errors of metabolism will need protein powder.

Are There Any Downsides To Protein Powders?

Many commercial products marketed for children contain added sugars, flavourings, or ingredients that may not be necessary. Some provide far more protein than a child actually needs, along with high sodium and trans fats. Perhaps the biggest concern is that supplements can create a false sense of security. Parents may feel they've "covered nutrition" with a scoop of powder while the child continues to miss out on the benefits of a balanced diet.

Whole foods offer much more than protein. A bowl of dal provides fiber and minerals. Eggs contain choline, which produces acetylcholine- a neurotransmitter necessary for brain development. Dairy products contribute calcium and vitamin B12. Nuts and seeds provide healthy fats like omega-3 and antioxidants. These nutrients work together in ways that a supplement simply cannot mimic.

What Can The Parents Do Instead?

• Include protein in all three major meals: include curd, paneer, 1 bowl of thick dal, a piece of chicken or egg, add flaxseed chutney as a side.
• Do not panic if the child is eating less on some days; it's okay for the appetite to fluctuate according to their moods.
• Make protein familiar and fun- make besan cheelas with different chutneys, make roti pizzas with paneer and cheese on top, make paneer paratha.
• Involve them in cooking; this reduces the chances of picky eating as they feel included in the process.
• Eat together as a family.

In conclusion, always remember that more isn’t always better; as far as the children’s requirements are concerned, they can definitely be fulfilled by adding good, mindful protein options in day-to-day meals. As parents, it's natural to want the very best for your child. The good news is that the best nutrition doesn't usually come from a jar—it comes from a colourful plate, shared family meals, and healthy eating habits built over time.

But remember the simple rule: natural food first, supplements only when they are medically needed.

(By Payoshini Kulkarni, Nutritionist at Cloudnine Group of Hospitals, Pune)

On Wednesday, the Integrated Health & Wellbeing (IHW) Council on Wednesday released a national white paper urging significant policy reforms to tackle one of India's most overlooked public health challenges: infertility.

The policy includes insurance coverage for fertility treatment, public financing through government health schemes, and fertility benefits at the workplace.

The recommendations were disclosed at the 7th India IVF Summit & Awards 2026, held on World IVF Day, where the IHW Council also launched Mission Fertility 2.1, a national initiative aimed at making fertility care more affordable, accessible and equitable.

The white paper, 'Beyond the Burden of Infertility in India: Towards Reproductive Equity through Mission Fertility 2.1', argues that infertility should be recognised as a core reproductive health issue.

Developed in partnership with IIHMR Delhi, the report draws on evidence from the World Health Organization (WHO), National Family Health Survey-5 (NFHS-5), the Indian Council of Medical Research (ICMR) and other published research.

The proposal comes at a time when India's total fertility rate has fallen below the replacement level of 2.1. This has renewed conversations around reproductive health, declining birth rates and support for couples who wish to conceive but are battling infertility.

Five Key Reforms Proposed To Tackle Infertility

The white paper outlines five recommendations to improve access to fertility care:

1. Recognise infertility as an essential reproductive health condition.
2. Expand public awareness through ASHA workers, schools and workplaces, while giving greater attention to male infertility.
3. Reform private insurance by reducing waiting periods and improving coverage for fertility treatment.
4. Modernise reimbursement under government health programmes like CGHS and ESIC, and strengthen public financing through public-private partnerships.
5. Encourage employers to include fertility benefits within workplace wellness programmes.

The report also recommends creating a Fertility Benefit Package under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) for economically vulnerable families.

It cites public financing initiatives in Goa, Sikkim and West Bengal as examples of how government-supported fertility care can improve access.

Also read: Delhi HC Allows HPV Vaccine Drive To Continue Due To No 'Immediate Safety Risk'

'Fertility Care Should Not Be A Privilege'

Releasing the white paper, Smt. Baby Rani Maurya, Cabinet Minister for Women Welfare, Child Development and Nutrition, Government of Uttar Pradesh, joined fertility specialists, policymakers, researchers and industry representatives at the summit.

Experts at the summit said advances in clinical fertility technology have not been matched by public awareness, leading many couples to seek medical help only after delays.

Dr Sunita Tandulwadkar, President of the Indian Society for Assisted Reproduction (ISAR), said, "Today is much more than a celebration of a scientific achievement. It is a celebration of hope. India is no longer merely following global advances in IVF. India is helping create them. IVF is not about laboratories or incubators. It is about families waiting to hear a heartbeat, and every patient deserves compassion and the very best science we can offer."

Shivani Sharma, Chief Operating Officer, Bharat Serums and Vaccines (BSV), said stigma continues to delay diagnosis and treatment.

She said, "The gap between what medical science can offer and what many couples can actually access remains one of the biggest challenges before us. Awareness has not progressed at the same pace as science. Fertility conversations remain surrounded by silence and stigma, and by the time couples seek help, valuable time has often been lost."

Meanwhile, Dr Hrishikesh Pai, Founder and Managing Director of Bloom IVF Group and Immediate Past President of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), stressed that expanding access should be the next priority for India's fertility sector.

He said, "India has grown from ten IVF centres in the early days to nearly five thousand today, and the next phase of this journey has to be about access, which rests on four pillars: awareness, availability, affordability and assurance of ethical, quality outcomes."

For decades, fertility has largely been viewed as a woman's responsibility. From tracking menstrual cycles and undergoing repeated tests to managing treatments, much of the focus has traditionally fallen on women.

However, medical science tells a different story. Male factors contribute to nearly 40–50% of infertility cases, making it clear that fertility is a shared journey that deserves equal participation from both partners.

Despite this, many men hesitate to discuss fertility or undergo evaluation due to stigma, misconceptions, or the belief that infertility is a woman's problem. This delay can postpone diagnosis and treatment, adding unnecessary emotional stress to couples who are already navigating a difficult path.

Reasons Behind Male Infertility

Environmental exposures and certain medical conditions may also affect sperm health. The encouraging news is that many of these causes are treatable or manageable when identified early.

A fertility assessment is not only straightforward but also essential. A simple semen analysis often provides valuable information about male reproductive health and can help guide the next steps in treatment.

When both partners are evaluated together from the beginning, the process becomes more efficient, avoiding unnecessary investigations and ensuring that the right treatment plan is developed sooner.

Also read: From Hope To Parenthood: How IVF And Embryology Are Changing The Fertility Journey For Couples

Importance Of Fertility Treatment

Equally important is the emotional role men play throughout fertility treatment. IVF can be physically demanding for women, but the emotional burden is shared by both partners. Feelings of anxiety, disappointment, hope, and uncertainty are common. Open conversations, shared decision-making, and emotional support can strengthen relationships and help couples cope better with the ups and downs of treatment.

World IVF Day serves as an important reminder that infertility is not about assigning blame—it is a medical condition that affects couples together. Breaking the silence around male fertility is essential to reducing stigma and encouraging earlier intervention.

When men become active participants rather than silent spectators, they help create a more supportive, compassionate, and successful fertility journey. Fertility care is most effective when both partners stand side by side, facing the challenge together with understanding, empathy, and shared responsibility.

By Dr Tejas Gundewar, Fertility Consultant, Ruby Hall Clinic, Pune