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Joy Marini, MS, PA-C Headshot

The Global Challenge of Saving Newborn Lives

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There are moments in all of our lives that take our breath away -- moments that are either so stunning or emotionally moving that time seems to stand still.

Some of mine include watching the fog roll across the autumn trees in the Great Smokey Mountains, and stargazing from a small beach away from the city lights, amazed that there are so many. There is also the birth of each of my children -- how the sound of their first breaths erased everything in the room for me and suddenly an entire world of possibilities was captured in one boisterous cry.

But not every mother gets to have that breathtaking moment, because not every baby takes a first breath.

Birth asphyxia, or difficulty breathing at birth, is not an unusual or rare occurrence -- it affects one out of every 10 newborns globally. Interventions can be as simple as warming a baby and rubbing its back or feet to stimulate it to breathe. In some countries this happens so quickly and automatically that the mother may be unaware that there was ever a moment of concern. But in many other areas of the world training for these basic skills has not been available, and health care workers don't know that they can follow simple steps to revive a newborn. Without a lifesaving intervention, one in 10 of these babies will die and countless others will suffer long-term health consequences.

In 2004, the Chinese Ministry of Health approached Johnson & Johnson with some ideas for saving the lives of babies and mothers in China, particularly in more rural areas. Among the issues was the high rate mortality from birth asphyxia. Having worked with the American Academy of Pediatrics' Neonatal Resuscitation Program, we recognized that a similar training program might be a solution for China. With about 13MM infants born in 2004 in China, there was potential to have an impact on millions of lives.

Saving one newborn from birth asphyxia is straightforward: teach a midwife the necessary skills and make sure the baby is born in a facility where the midwife can help. Our goal, however, was to have at least one person trained at every birth taking place at a facility in China. This meant training thousands of doctors, nurses and midwives. Taking on a challenge this huge required... well, baby steps. With a five-year plan created jointly by partners, expertise in country-wide implementation from the Chinese Ministry of Health, technical expertise from the American Academy of Pediatrics (AAP) and several Chinese health care organizations, as well as strategic thought partnership and support from Johnson & Johnson, we created Freedom of Breath, Fountain of Life, the Chinese Neonatal Resuscitation Training Program.

To date, the program has saved more than 90,000 infants in China. Our five-year plan in China became a 10-year plan. And the success of this program has inspired Johnson & Johnson to join with partners to address birth asphyxia in India, Vietnam, Pakistan, Malawi, Uganda, Tanzania, South Africa and more. These programs are not all just like the China program; our work is guided by considerations like local resources and needs. For example, in some countries we focus on very low-resource areas and use a simplified training called Helping Babies Breathe, also created by the AAP. We also partner with different organizations in different countries to ensure that the programs we are helping to develop are sustainable and effective.

I have met some of the children whose lives were saved as infants as a result of our training in China. Alongside her beautiful, energetic toddler, one mother told me, "I hope that my baby grows to do something meaningful like the doctors and nurses who saved him." It is moments like those that motivate me to continue this work. Every mother should have the moment with her newborn that takes her breath away, and every baby deserves that joyful first breath of life.