Helping Babies Breathe AmandaHigginson,MD

November9,2016

Outline

• Theproblem• Asolu>on• Theevidence• Hands-on

*ThemajorityoftheseslidesarefromDr.CarlBose’spresenta>onatthe2015AAPNCE*

GlobalNeonatalHealth

Mostofthesedeathsarepreventable!

• 3.8neonataldeaths(3.2millions>llbirths)

• ~3xdeathsduetoHIV/AIDsandmalariacombined

• >400neonataldeathseachhour

Wheredomostneonataldeathsoccur?

Oestergaardetal.PLoSMed2011

WhatCausesNeonatalDeath?

WhatCausesNeonatalDeath?

Whatcanbedone?

Improvedresuscita?on

•  Pretermlabormanagement•  KMC•  Alternatefeedingtechniques

•  Cordcare•  Improvedhygiene•  ExclusivebreasHeeding

DHS 2006-2008. Service Provision Assessment: 2002-2010. MACRO International Inc

Access to newborn resuscitation is severely limited

The challenge

71

57

43

81

69

50

42

9 14 14

23

5 6 8

24 22

31

50

25

8

15

0

10

20

30

40

50

60

70

80

90

Egypt Ghana Kenya Namibia Rwanda Tanzania Uganda

Perc

enta

ge

% of all babies born in facilities

% of all babies born by staff trained in neonatal resuscitation

% of all babies born in facilities with newborn respiratory equipment

Asphyxia: Major cause of newborn death

Liu et al. Lancet , May 11, 2012

Preterm 35 %

Asphyxia 23 %

Congenital 9 %

Infections 27 %

Other 6 %

The challenge

TheHelpingBabiesSurvivePrograms:Educa?onalProgramstoImproveNeonatalOutcomes

2015 NRP® Current Issues Seminar

EDUCATIONALDESIGN

SIMPLE HANDSON CO-OPERATIVELEARNING

EDUCATIONALDESIGNPURPOSEFULDEVELOPMENTOFEDUCATIONALMODELS

BagandMaskVen>la>on Expressionbreastmilk Nasogastrictubefeeding

Spurs new medical device innovations

¾ Openable for cleaning ¾ Boilable for disinfection ¾ Reusable 100s of times ¾ Highly affordable ($ 3)

Reusable newborn suction device

¾ Better mask seal ¾ Fewer parts ¾ Easier to clean ¾ Lower cost

«Upright» resuscitator

HelpingBabiesBreathe(HBB)

Ac#onPlan

• Ac>onPlan• FacilitatorFlipChart• LearnerWorkbook

• NeonatalSimulator• BagandMask• Suc>onDevice

HelpingBabiesBreatheMaterials

ResultsfromtheField:Tanzania

ResultsfromtheField:Nepal

Pediatrics.2016;137(6):e20150117

Lotsofongoingresearch

Essen?alCareforEveryBaby(ECEB)

Ac#onPlan

• Ac>onPlan• FacilitatorFlipchart• ProviderGuide• ParentGuide

Essen?alCareforEveryBaby

Materials

Essen?alCarefor

EveryBaby

ParentGuide

Essen?alCareforSmallBabies(ECSB)

Ac#onPlan

• Ac>onPlan• FacilitatorFlipchart• ProviderGuide• ParentGuide

Essen?alCareforSmallBabies

Materials

ExpressionofBreastMilk

NasogastricTubeFeeding

Improvedresuscita?on

•  Cordcare•  Improvedhygiene•  ExclusivebreasHeeding

TheHelpingBabiesSurvivePrograms •  Pretermlabormanagement

•  KMC•  Alternatefeedingtechniques

MeetNeoNatalie

HelpingBabiesBreathe,ROC

THANKYOU!

Helpbabiesbreathiftheydonotcryatbirth.Provideessen#al

caretoallbabies.

Keepsmallbabieswellandhelpthemgrow.