Helping Babies Breathe
New global program to boost newborn survival rates

Growth of a program

Successful pilot testing was completed in Bangladesh, India, Kenya, Pakistan and Tanzania. The next goal is to roll out the program to between 15 and 20 countries globally, by using established links with a core planning team in each of the governments, ministries of health and other contacts in developing countries.

Master trainers designated in each country will train others, oversee data collection and act as a liaison between the country and the core planning team. New facilitators (birth attendants trained to train others) teach the program to other birth attendants in the community.

“Helping Babies Breathe is a natural outgrowth of the highly successful Neonatal Resuscitation Program that has saved so many children around the world. The AAP is continuing its great tradition in intervening in a major problem that claims the lives of between 1 and 2 million infants a year,” said AAP President Judith S. Palfrey, M.D., FAAP, who was among the 100 people from around the world who completed the Master Trainer program in Washington, D.C.

The evidence-based curriculum is adaptable to clinical and training use wherever babies are born and is based on the 2005 International Liaison Committee on Resuscitation Consensus on Science and Treatment Recommendations.

“There is a major emphasis on scaling up the program to benefit as many people and support policy and program development on a lasting and sustainable basis,” said Steve Wall, M.D., FAAP, senior adviser of Saving Newborn Lives at Save the Children, which assisted in technical review of the educational materials.

Back to basics

What makes the teaching materials unique is their ease of use. Birth attendants can follow a pictorial action plan algorithm step by step. Previous programs were too complex and required a high level of advanced skills, Dr. Wall said.

“Physicians attend very few deliveries and are not the major provider in low resource settings in countries where there’s high neonatal mortality,” he said.

Experts working in low resource countries have adapted the Neonatal Resuscitation Program materials with varying levels of success, said Dr. Keenan. “We had the opportunity to take all of that expertise and (those) international experiences to make a program tailored to the resource limited parts of the world,” he said.

Helping Babies Breathe will be one of the first well-monitored worldwide interventions, according to Linda Wright, M.D., FAAP, deputy director, Center for Research for Mothers and Children and director, Global Network for Women’s and Children’s Health Research at NICHD. NICHD is developing a framework to track outcomes and monitor quality of the program.

“It is very cutting edge because we are using new materials, we’re resuscitating with room air — which has increasingly gotten favorable reviews from neonatologists in the United States — and we’re primarily using stimulation first,” said Dr. Wright.

What’s being applied overseas also can help educators in the United States, said Dr. Wright. “We’ve taken a practice that’s worked and improved it more so by simplifying it. We should all be really proud as pediatricians that we have made this possible.”