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 couples plan a pregnancy, conversations usually revolve around ovulation, sperm count, and the health of the uterus. What often goes unnoticed is a small butterfly-shaped gland in the neck that quietly influences all of this: the thyroid. According to Dr Swati Rai, Consultant Gynecologist and Laparoscopic Surgeon at Motherhood Hospitals, Noida, checking thyroid health before trying to conceive is not optional. It is essential.

Why thyroid testing matters before pregnancy

The thyroid controls many vital processes in the body, including metabolism, energy levels, and hormone balance. Even a mild thyroid imbalance can interfere with fertility, yet many couples are unaware of this connection. Dr Rai explains that untreated thyroid problems can make it harder to conceive and may also affect the ability to sustain a pregnancy. This is why both partners, especially women, should undergo thyroid testing before planning a baby.

In many cases, couples spend months focusing on reproductive organs while the real issue lies elsewhere. A poorly functioning thyroid can quietly disrupt the body’s reproductive rhythm without obvious warning signs.

The thyroid and menstrual health

Thyroid hormones play a key role in regulating menstrual cycles and ovulation. When thyroid levels are low, a condition known as hypothyroidism, periods may become irregular or infrequent. Ovulation can be delayed, and eggs may not mature properly. On the other hand, hyperthyroidism, where hormone levels are too high, can cause unpredictable cycles, making it difficult to time conception.

These disruptions often lead to confusion and frustration, especially when routine fertility tests appear normal. As Dr Rai points out, thyroid imbalance is frequently the missing link in unexplained fertility issues.

How thyroid health affects the womb

The thyroid does not just influence ovulation. It also affects the womb itself. Healthy thyroid hormone levels support the growth of a thick, healthy uterine lining that is needed for implantation. If hormone levels are slightly off, the lining may not be able to support a fertilized egg, increasing the risk of early miscarriage.

Thyroid imbalance can also reduce progesterone levels after ovulation. Progesterone is crucial for sustaining pregnancy, and low levels may lead to difficulty maintaining it even after conception. Additionally, some women have thyroid antibodies despite having normal hormone levels. These antibodies can cause inflammation that interferes with implantation and early pregnancy development.

Symptoms that are easy to miss

Many women experience fatigue, unexplained weight gain or loss, hair fall, or mood changes but do not associate these symptoms with fertility problems. Factors such as stress, poor diet, iodine deficiency, and low iron levels can further disrupt thyroid function. Without testing, these issues often go undetected.

Taking the right steps early

Dr Rai advises women to undergo a complete thyroid evaluation before pregnancy, not just a basic TSH test. Early detection and treatment can significantly improve fertility outcomes and support a healthier pregnancy.

She also recommends following a balanced diet rich in iodine, iron, selenium, and protein, managing stress through yoga or meditation, and reporting symptoms like irregular periods or persistent fatigue to a doctor without delay. If pregnancy does not occur despite normal reports, seeking medical advice early is crucial.

Prioritizing thyroid health is a simple but powerful step. Addressing it in time can make the journey to pregnancy smoother, safer, and far less stressful for couples hoping to conceive.

Too much about Danish parenting is already out in the discussion, but there is something new, yet again. The rulebook to Danish parent, and its first rule is: Children Always Make Sense.

The New Danish Parenting or NDP is based on a concept which relies on the Internal Family System or IFS, an attachment theory that in Denmark is called the New Child View. This is a shift from the old ways of parenting, to a new method, which follows equality, integrity, authenticity, and accountability.

The new child view is based on the work of Danish Family Therapist Jesper Juul, Family-lab, and Blackbird Institute.

Danish Parenting: Why Is It Important?

The Old paradigm of parenting was based on fear, control, abuse of power and inequality between the parent and child. Even though parents know how children behave, the old way is ingrained into our brains so much, that it is hard to follow through in practice. The new method thus compels parents to be with their own wounded parts or the inner child. This is when it becomes even more important to be with the actual child the parent is taking care of.

Also Read: What Is Denmark's 'Cry It Out' Method Of Putting Babies to Sleep?

Danish Parenting: Why Is It Unique?

At the foundation of New Danish Parenting is attachment. It is through the attachment of oneself from within can one take care of the actual child. The new way encourages to form a sense of safety, security and attachment between the self and parts of our inner children.

The system this bases focuses on healing modality. The focus lies on feeling safe, being the parent our child wants us to be. The new method has this New Danish Parenting, the first rule is: Children Always Make Sense. Let's talk a bit about that before moving on to the other rules.

Danish Parenting Rule No. 1: Children Always Make Sense

As human beings, we live on a spectrum between integrity and cooperation. Integrity means being true to what we feel on the inside and expressing it honestly on the outside. Cooperation, on the other hand, is about fitting in, belonging, and maintaining relationships with caregivers, family, and society. Both are essential for healthy living, but the balance between them can easily tip.

We are born deeply connected to our integrity. As babies, we cry when we are hungry, uncomfortable, or scared. We turn toward connection when we need it and turn away when we’ve had enough. This isn’t weakness. It’s competence. Babies instinctively know how to communicate their needs and boundaries.

The bond between a baby and caregiver is a two-way relationship. When a baby makes a sound or facial expression and a caregiver responds with a similar one, both are engaging, learning, and growing. These small moments shape the brain and nervous system of both child and adult, building connection and trust.

As we grow, we naturally adapt to our environment. This helps us survive, belong, and feel loved. We learn to share, wait, cooperate, and consider others. In supportive environments, children learn how to be themselves while staying connected to others.

But no environment is perfect. This is where over-cooperation begins. Over-cooperation happens when children learn that certain feelings, needs, or boundaries are not acceptable. A child may hide sadness behind a smile, ignore discomfort during unwanted touch, or eat past fullness because stopping isn’t allowed.

What often looks like “bad behavior” is actually a child struggling. Children are not being difficult; they are having a difficult time. Their behavior always has meaning and usually comes from a place of self-protection.

When adults meet children with curiosity instead of punishment, children feel seen and safe. This helps them understand themselves better and slowly return to a healthier balance between integrity and cooperation.

Meghan Trainor, an American singer-songwriter and television personality opened up about her third child through surrogacy. In an interview with PEOPLE she said, :"It wasn’t our first choice, but we had endless conversations with our doctors on this journey, and this was the safest way for us to be able to continue growing our family. We are forever grateful for that option."

Trainor, 32, and her husband Daryl Sabara, 33, welcomed their daughter Mikey Moon via surrogate on January 18, and are also parents to their sons Riley,4, and Barry, 2.

What Did Meghan Trainor Say About Surrogacy?

"Our surrogate is one of the most selfless, strong and loving people I’ve ever met. We felt so connected throughout the entire journey, and I’ll always be grateful for the care and love she showed our daughter. She gave us the greatest gift of our lives. She graciously answered our many check-in texts to make sure she was doing okay."

Meghan also said that she wants people to know that surrogacy is just another beautiful way to build a family. "It is not something to whisper about or judge. It is rooted in trust, science, love, and teamwork. Every family's journey looks different, and all of theme are extremely valid."

Read: Your Child’s 2026 Vaccine Checklist: What to Take, When, And Why It Matters, According To Doctor

Why Did Meghan Trainor Choose To Have A Child Through Surrogacy?

Trainor wrote Dear Future Mama, a pregnancy and parenting book in 2023, where she talked about her struggles during her first two pregnancies. She mentioned how traumatic was it for her after Riley's birth, when she also faced post-traumatic stress disorder, when her son was rushed to the NICU. At the same time, Trainor was being treated on the surgery table. "Usually when you're being sewn up for 45 minutes, you're like, 'Look at my gorgeous baby. We did it. This is everything.' But I was laying there alone."

She said in that very moment she was so drugged that she called her mother and cried. She had to learn how traumatic that was for her. She also told PEOPLE that she had reached a "breaking point" and struggled with her mental and physical health after Barry's birth. In an essay for Today.com, she wrote: "I was alone with Barry and he would not stop crying and then I was crying. I was having a panic attack and I was just over-exhausted, but I felt like I was dying. I felt if I stood up, I would pass out. I didn’t feel safe holding the baby and at the same time I felt like my body was giving up on me."

With the past medical reasons, especially the impact on her mentally, and other complication, after medical consultations, Trainor chose to go for surrogacy.

Also Read: Parents Are Now Preferring Girls Over Boys; What Led To This Shift?

What Is Surrogacy?

As per Yale Medicine, surrogate mothers are impregnated through the use of in vitro fertilization or IVF. In this process, doctors create an embryo by fertilizing eggs from the intended mother or an egg donor with sperm from the intended father or a sperm donor. Since the surrogate mother does not provide the egg, she is not genetically related to the child.

Emre Seli, MD, a reproductive endocrinologist and infertility specialist tells Yale Medicine, “Gestational surrogacy is a great option for people who really want to be parents but have faced long odds."