Novel program is saving newborns' lives in developing countries

A program that teaches health care workers in developing countries basic techniques to resuscitate babies immediately after birth is saving lives, according to a study to be presented Tuesday, May 3, at the Pediatric Academic Societies (PAS) annual meeting in Denver.

Called Helping Babies Breathe, the program focuses on simple techniques such as rubbing the baby dry, keeping the baby warm and suctioning the baby's mouth, all within the first minute of life called "The Golden Minute." If the baby does not start breathing at this time, the provider has been taught to initiate face mask ventilation to "help the baby breathe." The program is designed to be implemented in settings where oxygen, chest compression, intubation and medications are not feasible or available.

Approximately 1 million newborns in the developing world die each year due to birth asphyxia, which is the failure to initiate or sustain spontaneous breathing at birth. "We postulated that many of these deaths are easily preventable if basic resuscitation interventions are undertaken soon after birth," said study co-author Jeffrey M. Perlman, MD, FAAP.

Helping Babies Breathe was piloted in Tanzania by the Ministry of Health in September 2009. Nurse midwives as well as physicians, assistant medical officers, and medical and nursing students were taught the steps to take immediately after birth to evaluate babies and stimulate breathing. Educational materials are culturally sensitive and include pictures. Birth attendants also have access to basic equipment, including realistic newborn simulators, boilable bag-mask ventilation devices and boilable bulb suction devices.

Four hospitals collected data for three months before and three to four months after the program was implemented. Results showed that the mortality rate dropped 50 percent after program implementation from 13.4 deaths per 1,000 births to 6.3 deaths per 1,000 births.

"This is terribly exciting because if these findings are sustained, then this represents for the first time a reversal of birth asphyxia-related mortality," said Dr. Perlman, professor of pediatrics at Weill Cornell Medical College and division chief of newborn medicine at New York Presbyterian Hospital, New York City.

In addition, Helping Babies Breathe could help developing countries meet United Nations Millennium Developmental Goal 4 targets, which call for reducing mortality among children under 5 by two-thirds from 1990 to 2015.

"Currently, none of the countries in Sub-Saharan Africa is close to meeting the goals," Dr. Perlman said.

Helping Babies Breathe is an initiative of the American Academy of Pediatrics and other global health partners. The curriculum was developed with input from the World Health Organization.