©Copyright 2010 AAP News

Volume 31 • Number 8August 2010www.aapnews.org

by Trisha Korioth • Staff Writer

Seizing the “golden minute” after birth can mean the differencebetween life and death for infants. A new program called HelpingBabies Breathe is setting out to improve birth rates in developingcountries, focusing on what happens during those first 60 secondsof life when a newborn is not breathing.

Every year, 940,000 die of intrapartum-related neonatal deaths,99% in developing countries without medical assistance, accordingto the World Health Organization (WHO). Helping Babies Breatheis working to change that statistic and achieve a WHO goal to reducechild mortality worldwide by two-thirds by 2015.

The program, which launched during the International Conferenceon Global Health June13 in Washington, D.C., is a collaboration ofthe Academy, the U.S. Agency for International Development, theSaving Newborn Lives initiative of Save the Children, and the EuniceKennedy Shriver National Institute of Child Health and Human Devel-opment (NICHD), with materials provided by Laerdal Medical AS.These organizations have committed to reducing the newborn mortalityrate across the globe by training birth attendants in developing countriesin the essential skills of newborn resuscitation.

“There’s a high level of enthusiasm because (Helping Babies Breathe)fills a gap in education and a gap in services provided to newborn babies,”said William Keenan, M.D., FAAP, co-chair of the Helping BabiesBreathe Global Implementation Task Force and AAP medical director,International Affairs.

Helping Babies Breathe trains birth attendants to use just a few simpletools and techniques to assess a newborn in the first golden minute of lifeto determine if the baby is breathing well or must be ventilated with a bagand mask. The aim of the program is to have at least one person skilledin neonatal resuscitation at the birth of every baby.

A durable, easy-to-use training simulator was developed by Laerdalto complement educational materials, and it will be provided at a verylow cost to developing countries.

Growth of a programSuccessful pilot testing was completed in Bangladesh, India, Kenya,

Pakistan and Tanzania. The next goal is to roll out the program to between15 and 20 countries globally, by using established links with a coreplanning 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 coreplanning 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 successfulNeonatal Resuscitation Program that has saved so many children aroundthe world. The AAP is continuing its great tradition in intervening in amajor problem that claims the lives of between 1 and 2 million infantsa year,” said AAP President Judith S. Palfrey, M.D., FAAP, who wasamong the 100 people from around the world who completed the MasterTrainer program in Washington, D.C.

The evidence-based curriculum is adaptable to clinical and training

AAP Abroad

Jeffrey M. Perlman, M.B., Ch.B., FAAP (left), Helping Babies BreatheGlobal Implementation Task Force member, and A. Udaya Thomas ofJhpiego – Innovating to Save Lives, Baltimore, observe as ArthurMunfungwa Ngoy, of St. Joseph Hospital, Dominican Republic of theCongo, applies a mask and delivers room air to the newborn simulatorduring the Master Trainer program in Washington, D.C.

Helping Babies Breathe

New global program to boost newbornsurvival rates

©Copyright 2010 AAP News

use wherever babies are born and is basedon the 2005 International Liaison Com-mittee on Resuscitation Consensus on Sci-ence and Treatment Recommendations.

“There is a major emphasis on scalingup the program to benefit as many peopleand support policy and program develop-ment on a lasting and sustainable basis,”said Steve Wall, M.D., FAAP, senior adviserof Saving Newborn Lives at Save the Chil-dren, which assisted in technical review ofthe educational materials.

Back to basicsWhat makes the teaching materials unique is their ease of use. Birth

attendants can follow a pictorial action plan algorithm step by step. Pre-vious programs were too complex and required a high level of advancedskills, Dr. Wall said.

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

Experts working in low resource countrieshave adapted the Neonatal ResuscitationProgram materials with varying levels ofsuccess, said Dr. Keenan. “We had theopportunity to take all of that expertise and(those) international experiences to makea program tailored to the resource limitedparts of the world,” he said.

Helping Babies Breathe will be one ofthe first well-monitored worldwide inter-ventions, according to Linda Wright, M.D.,

FAAP, deputy director, Center for Research for Mothers and Childrenand director, Global Network for Women’s and Children’s Health

Research at NICHD. NICHD is developing a framework to track out-comes and monitor quality of the program.

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

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

For more information about Helping Babies Breatheand to access materials and the pictorial algorithm, visitwww.helpingbabiesbreathe.org.

RESOURCE

Friends of the sectionKnow of a pediatrician living abroad who, for economic reasons, cannot

join the Academy as an AAP International member? The AAP Section on International Child Health (SOICH) has an opportunity

for those pediatricians living in countries classified as lower-middle andlow-income categories by the World Bank to connect and interact withSOICH members. Friends of the Section can participate in the AAP internationallistserv and receive the SOICH newsletter electronically.

For details, visit www.aap.org/sections/ich/default.cfm or e-mailalule@aap.org.

AccoladesHelping Babies Breathe was recognized as an “outstanding program

which has resulted in significant benefit to American society” and selectedfor the 2010 Award of Excellence from the ASAE and the Center for Asso-ciation Leadership.

ASAE and the Center for Association Leadership is a joint organizationfor association professionals.