Professor John Wyatt, a consultant and researcher who specialises in the care of newborn babies at University College Hospital, London, explains why research is vital if we are to give more babies the best chance of a healthy start in life.

What’s the scale of the problem?

“There are about 670,000 births in the UK each year. A full term baby will arrive anywhere between 37 and 42 weeks and about 90 per cent of babies will arrive on time. But about eight per cent of babies come early and are what we call pre-term. That equates to about 50,000 premature births each year. Due to the advances of science over previous decades, most babies born pre-term between 33 and 37 weeks rarely have any problems. Babies born born before 33 weeks or seven months are defined as very preterm. There are about 10,000 babies born preterm each year, representing about one and a half per cent of all births.

“When starting out as a medical student, I was warned not to specialise in the care of the newborn. I was told that with advances in medicine, sooner or later neonatologists would be put out of business! Actually, the number of premature babies is increasing.

“But prematurity isn’t the only problem that faces newborns. Other babies have serious problems at birth such as severe infections or oxygen deprivation. In all about 15,000 babies require intensive care each year. Sadly, over 3,000 babies die within the first year of life despite the best possible care. This means that eight or nine babies will die today, in hospitals up and down the UK. Right now across the UK there will be eight or nine sets of parents grieving and coming to terms with the death of their child. These figures don’t include stillbirths which account for another 3,000 deaths per year and nor do they include those premature babies who survive, but will have serious disability to contend with for the rest of their lives. There is a huge problem here that needs attention.”

Has progress been made over the decades?

“Yes, certainly there has been tremendous progress. Care for the newborn started, as we know it, in the 1960s. Only about 15 per cent of babies delivered at 28 weeks or less, weighing around two pounds, survived in 1965 and sadly many of the survivors were disabled. By 1995 survival rates had increased to over 60 per cent, and are still increasing year on year. In our own specialised unit, survival rates for babies of this size are now at 80-85 per cent and the majority of survivors will develop without serious disability.

“No one thing has led to this improvement. There’s been a whole series of incremental advances bricks in the wall, if you like. Arguably, care of the newborn is one of the great success stories of modern medicine. This is one area where your chances of survival and of going home healthy have completely transformed over the last 30 years. Nearly all of that has been due to medical research, including that funded by Action Medical Research.”

So why the problem finding funding?

“You might think that for such an emotive and important area as care of the newborn, there would be massive funding available for research. But in reality, research into care of the newborn is a Cinderella area. Compare the money going into cancer research tens if not hundreds of times greater. So charities like Action Medical Research have played a vital role in developments seen over the past 30 years.

“It’s more difficult than you might think putting the case for research in this area, despite the fact that by making a positive impact at the very beginning of a baby’s life you are investing in their future. Even leaving aside the ethical case for investing in this research, the economic case is very strong. The cost of medical care for a profoundly disabled child in his or her lifetime may be as much as £3-5million. That’s without loss of earnings, and any compensation settlement there might be if negligence is proved. If we can save one baby from being damaged, we could fund our entire research programme for more than five years!”

How advanced is the UK in this area?

“In terms of innovation and ideas, the UK is still very close to the top of the league table, I’m proud to say. Sadly, in terms of funding we are pretty low down the table. In the US I understand from colleagues that the pass mark to get research funded has actually gone down, from A- to B+, due to the massive amounts of government and charitable funding available. Whereas in the UK, the reverse has happened the pass mark has been raised effectively from A+ to A+++. That’s the frustration I experience. Research proposals we know are both original and world beating often don’t get off the ground because there is simply no money to make it happen. There are so many things we don’t understand about care of the newborn, and so many reasons why we still need to do research to prevent death and disability. I give my wholehearted support to Touching Tiny Lives, and wish Action Medical Research all the very best with the campaign.”

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