New hope for sick newborns

Researchers believe they may have devised a safe and cheap treatment to reduce brain damage experienced by some newborns during birth.

Melbourne researchers believe they may have devised a treatment to reduce the brain damage experienced by some newborns.

Melbourne researchers believe they may have devised a safe and cheap combination treatment to reduce the brain damage experienced by some newborns during birth.

About four million babies a year globally – including 40 Victorian infants – suffer birth asphyxia, where they are born pale and lifeless after being starved of oxygen as they make their way into the world.

While standard treatment involves hypothermia, cooling these babies by three degrees to reduce brain metabolism and promote cell healing, half of these newborns will still die or suffer serious lifelong disabilities such as cerebral palsy or developmental disabilities.

In the experiment that culminates 10 years of research, scientists from the Hudson Institute of Medical Research and Monash University found that adding intravenous melatonin – the cheap and safe sleep hormone – to hypothermia reduced brain damage and seizures, and improved physical movement in newborn animals better than either treatment in isolation.

The findings, published in the Journal of Pineal Research, mean the team can now test the simple antioxidant and anti-inflammatory treatment in Victorian newborns as part of a world-first trial.

It’s hoped the research will improve outcomes for newborns.

Lead researcher Suzanne Miller said that while many studies had tested each treatment individually, this was the first evidence to show the boosted effect of the combination therapy.

“When a baby has a very bad asphyxic event at birth, and then it comes into an environment where there is lots of oxygen, that is overwhelming for them and can cause an ­increase in oxygen-free radicals,” Professor Miller said.

“The first thing to do was prove that melatonin could dull that production of oxygen-free radicals. We really had to take it in a stepwise approach. We showed very convincingly in this paper that if you treat with cooling, and if you give melatonin on top of it, it’s much more effective than either of those treatments ­separately.”.

Study co-author and ­Monash Children’s Hospital neonatologist Atul Malhotra said improving the effectiveness of cooling treatments by adding intravenous melatonin given within the first few hours of birth, had the potential to change the lives of these vulnerable newborns.

“If you have a major drop in your blood flow to the brain, your brain dies,” Associate Professor Malhotra said. “There is no way I can ­revive it, so there will always be the odd baby who won’t make it.

“But if 50 per cent have bad outcomes currently, hopefully we can bring it down to perhaps 25 per cent and we can keep trying to improve it.

“We are cautiously optimistic that it’s going to be effective and we have hope that it will definitely decrease the burden of disease and outcomes.”