Jan 22 (Reuters) – 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 U.S. 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 program in Tanzania.
The program, launched by the American Academy of Pediatrics,
trains birth attendants to immediately dry and warm babies, and
to start breathing for babies with a bag and mask if they don’t
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 told Reuters
Health. 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 percent 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 program to almost ten times as many babies born
afterward.
Program 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 centers in the area
to teach midwives and other health care 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 United Nations data, 32 babies die in India for
every 1,000 live births, and 26 per 1,000 die in Tanzania.
The Helping Babies Breathe program is supported in part by
the Laerdal Foundation for Acute Medicine. Laerdal Medical
manufactures breathing simulators and other products related to
the program’s work.
(Reporting by Elaine Lies)
