Helping save newborns’ lives
Breathing programme may prevent birth asphyxia in developing world
Training midwives and other birth attendants to help babies start breathing immediately after birth if they need help may prevent stillbirths and newborn deaths in the developing world, according to two US studies.
So-called birth asphyxia – when babies are born not breathing – is one of the major causes of newborn death in regions with limited resources, said researchers whose work appeared in Pediatrics.
Reducing infant mortality in the developing world is one of the United Nations Millennium Development Goals – but progress has been slow, according to Jeffrey Perlman from Weill Cornell Medical College in New York, who helped implement the Helping Babies Breathe programme in Tanzania.
The programme, launched by the American Academy of Paediatrics, trains birth attendants to immediately dry and warm babies, and to start breathing for babies with a bag and mask if they do not breathe on their own within one minute.
“The majority of deliveries in resource-limited areas are done by the midwife, and the midwife wasn’t really taught how to deal with a baby once they were born,” Perlman said. Instead, he said, midwives tend to focus on the mother immediately after the birth.
“If you can just teach them, when the baby’s born, to immediately dry the baby off... that drying and a little bit of stimulating will probably get 90 to 93 per cent of babies breathing who weren’t breathing before,” added Perlman, who wrote a report that appeared in Pediatrics.
“That’s the most exciting part, that something very simple can save many, many lives.”
Perlman and his colleagues compared about 8,000 babies born at eight hospitals before birth assistants were trained in the breathing programme to almost ten times as many babies born afterwards.
Programme leaders initially taught the breathing techniques to 40 ‘master trainers’ from the eight hospitals over two days. Some then went to other hospitals and health centres in the area to teach midwives and other healthcare providers.
The researchers found that newborn deaths dropped from 13 per 1,000 babies to seven per 1,000 once Helping Babies Breathe was implemented. The rate of stillbirth fell from 19 per 1,000 babies to just over 14, per 1,000.
In a second study from Southern India, though, another set of researchers saw no change in newborn deaths after the same program was taught to almost 600 birth attendants.
But stillbirth rates fell from 30 per 1,000 babies to 23 per 1,000, Shivaprasad Goudar from Jawaharlal Nehru Medical College in Belgaum, Karnataka, and colleagues, found.
According to UN data, 32 babies die in India for every 1,000 live births and 26 per 1,000 die in Tanzania.
The Helping Babies Breathe programme is supported in part by the Laerdal Foundation for Acute Medicine. Laerdal Medical manufactures breathing simulators and other products related to the programme’s work.