36 per cent newborn deaths worldwide are caused by infections

Simple Tetanus immunisation can save 1 million newborn deaths

“Almost 40 per cent deaths of children under five years of age occur in the newborn period worldwide,” Instructor Research Dr Samana Ali, informed general physicians at a Continued Medical Education (CME) seminar on “Caring for the New Born” at Aga Khan University.

Three-quarters of all neonatal deaths (3 million) occur within first week of life, and at least one million babies die within 24 hours of birth. Infection is one of the major causes of newborn deaths across the world especially in developing countries. It accounts for total 36 per cent of all neonatal deaths. Pneumonia/sepsis contributes 26 per cent, tetanus seven per cent and diarrhoea three per cent of all infection related deaths.

“Most of these infection-related deaths could be prevented if all mothers and their babies had access to simple preventive measures and treatments,” stressed Dr Ali. Tetanus toxoid immunisation is one of the most cost-effective health interventions. Two doses of this vaccine given to mothers, can prevent one million deaths of newborn babies occurring because of Tetanus.

Consultant paediatricians and neonatalogists shared their professional views with general practitioners at the seminar. Consultant Neonatalogist Dr Syed Rehan Ali explained, “Jaundice in new born babies is a sign, not a diagnosis. It is important as it may be a sign of another disorder.” All babies develop elevated serum bilirubin (SBR) levels, to a greater or lesser degree, in the first week of life. “Jaundice is serious when it starts during the first 24 hours of life, lasts longer than two weeks, occurs with other danger signs,” he said.

Consultant Paediatrician Dr Muhammed Sohail Salat said “There is no alternative to breast milk, but in case of insufficient breast milk, infant formula is prescribed. Babies should be fed preferably in the delivery room within an hour after birth.

“Babies born at completion of nine months of pregnancy usually tolerate feed well. First time mothers usually face problems like frequent vomiting as well as apprehension about feeding which leads to decreased milk production. Sometimes breast engorgement and cracked nipple lead to decrease feeding,” said Dr Salat.

Dr Salat discussed anomalies that cause feeding problems including premature, low birth weight babies, intrauterine growth retardation, infection in newborn, asphyxia, cleft lip/palate, cardiac and neuromuscular disorders. These conditions may delay full feeding achievement in these babies leading to longer stay in hospital.

Preterm babies born are more prone to have feeding problems as compared to term babies because of failure to achieve normal sucking, swallowing and coordination reflex. These babies are fed by cup/spoon/dropper or orogastrics tube passed into stomach. Their parents are taught about these manoeuvres while their stay in nursery.

Discussing common newborn skin disorders, Consultant Neonatalogist Dr Maqbool Qadir said, “Most of the skin conditions encountered in immediate newborn period are benign conditions, requiring no treatment. Only a handful of conditions require treatment.”

Senior Instructor Research Dr Khalil Ahmed elaborated on the topic of low birth weight and said, “Low birth weight is a leading cause of morbidity and mortality in newborns along with sepsis and birth asphyxia.” Dr Ahmed expressed hope that by raising awareness among general practitioners, neonatal mortality rate will be reduced to a significant extent.

AKU regularly organises CME seminars and workshops for referring physicians. These programmes are design ed to provide a current and practical update on the management of medical problems faced by primary care physicians and specialists.