Why do so many babies die on their first day?

~1 million babies die on the first day of life. Birth asphyxia, hypothermia, hypoglycaemia and early-onset sepsis all present within hours. Immediate newborn care — drying, warming, stimulating, breastfeeding within the first hour and resuscitation if needed — prevents the majority of these deaths at near-zero cost.

What is kangaroo mother care?

KMC is continuous skin-to-skin contact between a small/preterm newborn and a parent. WHO's 2022 guidelines recommend initiating immediately after birth — even for babies requiring medical care. Evidence shows KMC reduces neonatal mortality by 36%, hypothermia by 78% and promotes breastfeeding.

What are the three leading causes of neonatal death?

Preterm birth complications (~35%), birth asphyxia (~24%) and neonatal sepsis (~15%) account for approximately three quarters of all neonatal deaths. All three are addressable: KMC and antenatal corticosteroids for prematurity; neonatal resuscitation for asphyxia; clean delivery and antibiotics for sepsis.

What is the Every Newborn Action Plan?

ENAP, co-led by WHO and UNICEF, is the global roadmap to end preventable neonatal deaths and stillbirths by 2035. It sets coverage milestones for skilled birth attendance, 8+ antenatal contacts, postnatal care within 24 hours, KMC for small babies and neonatal resuscitation training.

What causes neonatal sepsis?

Early-onset neonatal sepsis (before 72 hours) is typically caused by GBS or E. coli acquired during delivery. Prevention includes intrapartum antibiotic prophylaxis for GBS-positive mothers, clean delivery practices and chlorhexidine cord care. Late-onset sepsis is often healthcare-acquired, requiring strict infection prevention in neonatal units.

What is birth asphyxia?

Birth asphyxia occurs when a newborn fails to establish breathing — causing oxygen deprivation and potential brain injury. Basic neonatal resuscitation (clearing airway, drying, stimulating, bag-and-mask ventilation) reverses most cases. Every birth attendant should be trained. Therapeutic hypothermia reduces brain injury in severe cases where NICU capability exists.

What is a stillbirth?

A stillbirth is fetal death at or after 28 weeks — approximately 1.9 million annually, 98% in LMICs. Largely preventable with quality antenatal care and skilled birth attendance but excluded from most global health statistics. Universal stillbirth registration is a prerequisite for investment in prevention.

How does prematurity affect survival?

Preterm babies — born before 37 weeks — are the most medically vulnerable newborns. Antenatal corticosteroids (given before preterm delivery) reduce neonatal respiratory distress syndrome mortality by ~34%. KMC dramatically improves survival even without NICU. Very preterm babies (<32 weeks) ideally require NICU care with surfactant and CPAP.

How does breastfeeding protect newborns?

Initiating breastfeeding within the first hour — providing colostrum with its concentrated antibodies — reduces neonatal mortality from infections by approximately 45%. Exclusive breastfeeding also protects against SIDS and supports gut maturation.

Why are stillbirths undercounted?

Stillbirths are excluded from most national vital statistics and SDG indicators. WHO estimates actual rates may be 2-3 times reported figures in some countries. Cultural taboos and administrative practices contribute. ENAP campaigns for universal registration as a public health prerequisite.

How does PHIG's accreditation work address newborn health?

PHIG's Accreditation Canada programme in Georgia includes standards for delivery room readiness, neonatal resuscitation competency, KMC implementation and postnatal care — directly improving the quality of newborn care in accredited Georgian hospitals.

How does GMJ News cover newborn health?

GMJ News tracks UNICEF IGME neonatal mortality data, WHO KMC guideline updates, ENAP milestones and neonatal sepsis, prematurity and stillbirth research — all relevant to PHIG's accreditation work and the Georgian Medical Journal's focus on maternal and child health.

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Newborn Health

Q: How does breastfeeding protect newborns?

Initiating breastfeeding within the first hour — providing colostrum with its concentrated antibodies — reduces neonatal mortality from infections by approximately 45%. Exclusive breastfeeding also protects against SIDS and supports gut maturation.

Q: Why are stillbirths undercounted?

Stillbirths are excluded from most national vital statistics and SDG indicators. WHO estimates actual rates may be 2-3 times reported figures in some countries. Cultural taboos and administrative practices contribute. ENAP campaigns for universal registration as a public health prerequisite.

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Newborns are the most vulnerable people on earth: approximately 2.3 million die in their first 28 days of life each year — now nearly half of all deaths in children under five — from conditions that are almost entirely preventable with known interventions (UNICEF 2023). The three leading killers — preterm birth complications, birth asphyxia and neonatal sepsis — share a common solution: skilled birth attendance, kangaroo mother care and immediate newborn care. The Every Newborn Action Plan (ENAP) targets ending preventable neonatal deaths by 2035.

Key messages

Most dangerous day

The first 28 days of life carry the highest mortality risk of any time in human existence. 2.3 million newborns die each year — 1 million on the very first day (UNICEF 2023).

47% of child deaths

Neonatal deaths account for 47% of all under-5 deaths globally — making newborn survival the frontier of child health progress.

Three killers, three solutions

Preterm birth, birth asphyxia and neonatal sepsis cause ~75% of neonatal deaths — all addressable with kangaroo mother care, immediate newborn care and clean delivery with antibiotics.

Kangaroo mother care — 36% mortality reduction

WHO's 2022 guidelines recommend initiating skin-to-skin kangaroo mother care immediately after birth for all small and preterm babies. Evidence shows 36% neonatal mortality reduction.

1.9M stillbirths invisible

1.9 million stillbirths occur annually — largely preventable with quality antenatal care and skilled birth attendance, yet almost entirely excluded from global health statistics and investment.

ENAP 2035 target

The Every Newborn Action Plan (ENAP), co-led by WHO and UNICEF, targets ending preventable neonatal deaths and stillbirths by 2035.

Key statistics

2.3M

neonatal deaths/year

UNICEF 2023

on first day of life

UNICEF

47%

of all under-5 deaths

UN IGME 2023

1.9M

stillbirths/year

WHO/UNICEF 2023

36%

mortality reduction with KMC

WHO 2022

2035

ENAP target year

WHO/UNICEF

Neonatal mortality rate (per 1,000 live births) globally 2000-2022 — UN IGME

Source: UN Inter-agency Group for Child Mortality Estimation. Substantial but insufficient progress toward ENAP targets.

Glossary of key terms

Neonatal period
WHOFirst 28 days of life — the highest-mortality period of human existence. Early neonatal (days 1-7) is most critical; the first 24 hours carries the greatest single-day risk.

Kangaroo mother care (KMC)
WHO 2022Skin-to-skin care of small/preterm newborns by a parent, initiated immediately after birth. WHO 2022 guidelines recommend early initiation even for babies requiring medical care. Reduces mortality by up to 36%.

Preterm birth
WHOBirth before 37 completed weeks — the leading cause of neonatal death globally. KMC substantially improves survival even at lower-resource facilities.

Birth asphyxia
WHOFailure to initiate breathing at birth causing hypoxic brain injury. Causes ~25% of neonatal deaths. Basic neonatal resuscitation (bag-and-mask ventilation) is the life-saving response.

Neonatal sepsis
WHOBloodstream infection in first 28 days — fatal without prompt antibiotics. Early-onset from GBS/E. coli during delivery; late-onset often healthcare-acquired.

Stillbirth
WHOFetal death at or after 28 weeks. ~1.9M annually, 98% in LMICs. Largely excluded from health statistics despite being mostly preventable.