PHOTO: Hygiene conditions for a newborn can be "very, very challenging", says Rachel Cummings. (Supplied: Save The Children/Hanna Adcock)
Nearly 50,000 babies will be born in the overcrowded Rohingya camps in Bangladesh this year when some will be the children of rape, and all of them will begin their lives in flimsy settlements where they are at risk of getting sick and suffering from malnutrition.
Health workers in the camps are scrambling to give the babies of 2018 a fighting chance at survival, but there are fears many will die before they reach five years of age.
In the four months since the Myanmar military started a brutal crackdown in response to Rohingya militants attacking army and police posts, the number of people who have fled to refugee camps across the border in Bangladesh has swelled by nearly 655,000.
There are now 870,000 Rohingyas living in the makeshift tent city, according to abc.net.au report.
Five per cent of them are pregnant women.
Rachel Cummings from Save the Children said most of the women will give birth in the tents or tarps that they now call home.
"The home setting is really very, very sick," she said.
"There's limited access to clean water, to running water, so the hygiene conditions for a newborn can be very, very challenging."
'No place for a child to be born'
Ms Cummings is in charge of Save the Children's health response to the Rohingya crisis, and maternal health is one of the biggest challenges in the refugee camp.
"This is no place for a child to be born," she said.
"From the very beginning they will battle odds stacked against them, living in an overcrowded environment where everyone is desperate for help."
In the conservative Muslim Rohingya community, women favour privacy in childbirth.
It is not uncommon for a woman to stay in the confines of home for 40 days after her child is born.
Older women often play the role of a midwife, and Save the Children is trying to equip them with basic hygiene kits so the risk of infection and disease is minimised.
There are health facilities at the sprawling camps, but getting to one can require a treacherous journey.
"Given the terrain and the distances involved, for the women to make the journey from the home to a health facility can be very, very challenging," Ms Cummings said.
"It's quite hilly and now the rains are coming it can be quite muddy.
"At night that's a very unsafe journey to take."
On January 22, Myanmar is due to begin accepting back Rohingya refugees under the terms of a repatriation agreement signed with Bangladesh last November.
Earlier this week, Myanmar officials said two reception centres built to process returning refugees were "almost ready".
The official line is that any Rohingya who fled after the August violence is welcome to come back.
But with tens of thousands of refugees citing rape, beatings and other atrocities at the hands of Myanmar's army, it is unclear whether any will be willing to return.