While most babies are born safely, complications around the time of birth can lead to some not receiving enough oxygen and being exposed to infection. This tragically increases the likelihood of the baby dying or developing a brain injury, which can lead to severe disabilities in childhood such as cerebral palsy (CP) and learning, memory and language problems.

Lack of oxygen around birth affects 1-3 babies per 1000 live births in Western Europe, North America and Australia. In low-to-middle-income countries (LMIC), it affects babies 10 times more frequently.

Current treatment in high-resource settings is therapeutic hypothermia, which involves a newborn’s temperature being reduced by 3 degrees to 33°- 34°C for three days in an effort to slow down and/or prevent processes that cause brain damage. The baby is cooled with a special mattress while receiving intensive care support. However, even with cooling treatment, sadly 20% of affected newborns develop cerebral palsy and more than half have learning and memory problems in childhood.

For babies exposed to both infection and a lack of oxygen, the current cooling treatment is not as effective and the need for special equipment makes it less affordable in developing countries with more limited resources.

Melatonin, a naturally occurring hormone that has both anti-inflammatory and brain-protective properties, could be a realistic alternative. It has a low risk of side effects, no cold storage requirements and is easily administered. This makes it ideal for use promptly after birth in lower-resource settings and during transport. Wellbeing of Women researcher Professor Nikki Robertson, from University College London, and her team will evaluate the safety and effectiveness of melatonin for protecting babies’ brains. If Professor Robertson and her team find that melatonin helps newborn babies who lacked oxygen and were exposed to infection at birth, it could be used as an alternative or in addition to current treatments, helping to protect babies everywhere. The next step would be to move to clinical trials in babies in high-resource settings, with melatonin as an additional therapy to cooling or melatonin alone in LMIC.