Helping Babies Breathe reaches 400,000 health care providers in 77 countries
A global program initiated by the American Academy of Pediatrics (AAP) called Helping Babies Breathe has led to a significant decrease in newborn deaths in multiple countries, including Tanzania, where newborn mortality has plummeted by 47 percent over two years.
Now this life-saving neonatal resuscitation training program has been updated to reflect new scientific evidence and supporting guidelines. Since the initial launch of Helping Babies Breathe in 2010, more than 400,000 providers in 77 countries have been trained in the newborn resuscitation techniques, and the materials have been translated into 26 languages.
"This is literally becoming a movement," said Beena Kamath-Rayne, MD, MPH, FAAP, a master trainer and member of the Helping Babies Breathe planning group for the AAP who also worked in rural Ecuador as a young doctor. "This training program has been instrumental in guiding birth attendants through the most important steps of resuscitation that will help a baby to breathe within the critical golden minute of life."
Helping Babies Breathe provides basic instruction on newborn resuscitation, such as drying and rubbing the baby for tactile stimulation, clearing the airway and using bag and mask ventilation methods to help a nonresponsive baby to breathe.
The new, updated curriculum provides a way to transition to the next steps in care. It aims to reduce the newborn mortality rate to 7 per 1,000 live births or fewer by 2035, which is a World Health Organization goal. In 2013, 2.8 million babies worldwide died within the first month of life and 2.6 million babies were stillborn.
"The first 28 days of a child's life remain the most risky, with neonatal mortality rates improving more slowly than overall childhood mortality," said AAP President Benard Dreyer, MD, FAAP. "We really have to focus on the newborn if we're going to meet our goals for preventable child deaths."
Key scientific updates to the Helping Babies Breathe program discuss the hazards of prolonged suctioning, and the importance of delaying cord clamping so that ventilation can be established before cutting the cord. The curriculum provides instructions how to assess the chest movement to boost effectiveness of bag mask ventilation, and what steps to take when ventilation is ineffective.
New quality improvement exercises, as well as guidance for master trainers and educators at Helping Babies Breathe facilities on how to involve local health leaders, are now included. New equipment reprocessing and cleaning instructions have also been added.
Helping Babies Breathe is the first program in the broader suite of evidence-based educational programs known as Helping Babies Survive, which aims to reduce neonatal mortality in the 75 Sustainable Development Goal countries. The programs address three major causes of newborn death: asphyxia, infections and preterm or low-birthweight complications. The AAP developed Helping Babies Breathe in collaboration with the World Health Organization, with support from the U.S. Agency for International Development (USAID); Save the Children; Latter-day Saint Charities; Laerdal Global Health; Johnson & Johnson; and a number of other global health organizations.
Dr. Kamath-Rayne remembers how it felt when working in Ecuador to rely solely on basic resuscitation skills to save a baby's life.
"I didn't have a ventilator. I didn't have people who were skilled to help me if the baby needed advanced resuscitation. I had to do the resuscitation," she said. "Realizing that I was the person who had to care for this baby and do the right things because there was no other help nearby is one real reason I recognize the importance of being involved in Helping Babies Breathe."
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