Neonatal resuscitators can reduce newborn deaths

The first breath a baby takes is the biggest and most important of her life. Lungs that were filled with fluid take in an initial gulp of air, inciting a startled cry of protest from the infant—and joyful exclamations from the parents.

But what happens when breathing doesn’t come naturally? About one in ten newborns struggle to start breathing, and more than a million die each year because they couldn’t catch their breath. Most of the deaths are in developing countries, where health centers and birth attendants often lack tools that can help when a baby’s first breath fails.

PATH is researching manual resuscitation devices to provide managers of public health programs with the information they need to invest in resuscitators and to identify the features that are most important in the developing world—manufacturers need this input to refine their product designs.

An information vacuum

For life-saving medical equipment, neonatal resuscitation devices are relatively simple. Some consist of a mask that covers the baby’s mouth and a tube for a health worker to blow into. Others have a mask attached to a bag that pumps air when squeezed.

Why are such uncomplicated but important devices so underused? Considering the newborn lives at stake, it defies logic—unless you are a program manager in a developing country with more health needs than you have resources to meet and with no data on which resuscitators are easiest to use, work best, and are the best value. Lack of information is an invisible but stubborn barrier.

A million more first breaths

Our initial research revealed that, while neonatal resuscitators can cost up to $300 each, there are many reusable resuscitators available for one-tenth the cost. We evaluated 13 of them in our laboratory with experienced users (a local midwife and neonatologist), compared them to international standards, and assessed how well they worked during simulated resuscitations.

We published our results in the form of a handy guide for program managers and other decision-makers (print the guide with pages arranged as a booklet or access a regular PDF). Most of the resuscitators in the guide are available for less than $30 each.

Now we will turn our attention to supply. To spur local economic development and encourage pricing that developing-country health systems can afford, we’ll assist medical equipment manufacturers in Africa and Asia with improving the distribution and marketing of high-quality, affordable resuscitators.

Each of these efforts is a step toward a million more first breaths.

Photo: Yancy Seamans.