Benefit of Parental Training for Infant Resuscitation in Low- and Middle-Income Countries

Graduates from neonatal intensive care units (NICUs) face a risk of sudden death at home after being discharged, but many of these incidents could be avoided if parents are equipped to recognize warning signs and perform immediate resuscitation.

This study aimed to evaluate the feasibility of training parents of high-risk neonates in low- and middle-income countries (LMICs) to effectively conduct infant resuscitation. Additionally, it measured parental anxiety and their perceived need for resuscitation one month post-discharge.

The present prospective study included parents of infants born before 34 weeks of gestation, weighing less than 1500 grams, or with neurological issues at discharge, who were trained in basic newborn resuscitation. This training utilized a modified approach with a low-fidelity mannequin and self-inflating bag, led by a trained neonatal fellow. Parents were evaluated through a post-training assessment, with a passing score set at 75% and completion of four essential steps. If they did not pass, retraining was provided. One month after discharge, parental anxiety was measured using the General Anxiety Disorder 7 (GAD-7) scale, along with documentation of any need for resuscitation.

The study showed the following findings:

• The researchers trained 91 parents of high-risk newborns in resuscitation from June 2020 to July 2021.
• The average gestational age of the neonates was 30 weeks, with an average birth weight of 1315 grams. 
• Eighty percent of parents passed the assessment on their first attempt, while 18% passed on the second attempt.
• The average training time per parent was 22 minutes.
• One month after discharge, only one mother reported mild anxiety, and resuscitation skills were successfully employed for one infant.

To summarize, training parents of high-risk neonates in LMICs to perform effective cardiopulmonary resuscitation using low-fidelity simulators can be achieved without increasing parental anxiety levels.

Source: Nalina A, Shashidhar A, Bhatia A, Bisanalli S, Suman Rao PN. Feasibility of Implementing Resuscitation Training for Parents of At-risk Infants at Discharge (FIRST AID). Indian Pediatr. 2025 Jan 15;62(1):21-26. doi: 10.1007/s13312-025-3352-z. PMID: 39754426.