Infant Mortality
Infant mortality is defined as the number of infant deaths (one year of age or younger) per 1000 live births. Traditionally, the most common cause worldwide was dehydration from diarrhea. However, the spreading information about Oral Re-hydration Solution (a mixture of salts, sugar, and water) to mothers around the world has decreased the rate of children dying from dehydration. Currently, the most common cause is pneumonia. Other causes of infant mortality include: malnutrition, malaria, congenital malformation, infection and SIDS.
Infanticide, child abuse, child abandonment, and neglect also contribute to a lesser extent. Related statistical categories:
• Perinatal mortality only includes deaths between the foetal viability (22 weeks gestation) and the end of the 7th day after delivery.
• Neonatal mortality only includes deaths in the first 28 days of life.
• Postneonatal mortality only includes deaths after 28 days of life but before one year.
• Child mortality includes deaths within the first five years after birth.
Infant mortality rate (IMR) indicates the number of deaths of babies under one year of age per 1,000 live births. The rate in a given region, therefore, is the total number of newborns dying under one year of age divided by the total number of live births during the year, then all multiplied by 1,000. The infant mortality rate is also called the infant death rate (per 1,000 live births).
Historically, infant mortality claimed a considerable percentage of children born, but rates have significantly declined in the West in modern times. This has been mainly due to improvements in basic health care, though high-technology medical advances have also helped. Infant mortality rate is commonly included as a part of standard of living evaluations in economics.
The infant mortality rate for White Americans was 5.7 per 1000 births in 2003-05. For African Americans it was 13.6 per 1000, and for Hispanic Americans it was 5.6 per 1000. Overall, the infant mortality rate for the United States was 6.9 per 1000 in 2003-05.
Promising Strategies
Focus on modifying the behaviors, lifestyles, and conditions that affect birth outcomes, such as smoking, substance abuse, poor nutrition, lack of prenatal care, medical problems, and chronic illness. Public health agencies including CDC/ATSDR, health care providers, and communities of all ethnic groups must partner to improve the infant mortality rate in the United States. This joint approach should address the behaviors, lifestyles, and conditions that affect birth outcomes. Substantial investments have been made in consultation, research, and service delivery to reduce disparities in access to health care and health status. The plan to reduce infant mortality rates includes:
A network between health care experts and minority communities to encourage healthy behaviors by pregnant women and parents of infants.
Research that will determine the cause of SIDS, develop effective strategies to identify at-risk infants more precisely, and create effective interventions for high-risk infants.
What can Healthcare Providers do to Help Reduce Infant Mortality Rates?
Health care providers should advise their patients about factors that affect birth outcomes, such as maternal smoking, drug and alcohol abuse, poor nutrition, stress, insufficient prenatal care, chronic illness or other medical problems.
What can Communities and Individuals do to Help Reduce Infant Mortality Rates?
Communities can play an important role in this effort by encouraging pregnant women to seek prenatal care in the first trimester and educating communities, providers, pregnant women and family members on factors that effect infant mortality such as smoking, substance abuse, poor nutrition, lack of prenatal care, medical problems, chronic illness, and sudden infant death syndrome (SIDS). Parents and caregivers should become familiar with the risk factors and always place sleeping infants on their backs. Research has demonstrated that babies who slept on their stomachs or sides were at a higher risk for SIDS. A separate but proximate sleeping environment is recommended such as a separate crib in the parents’ bedroom.
What are the Risk Factors for SIDS?
1) Tummy (prone) or side sleeping
Infants who are put to sleep on their tummy or side are more likely to die from SIDS than infants who sleep on their backs.
2) Soft sleep surfaces
Sleeping on a waterbed, couch, sofa, or pillows, or sleeping with stuffed toys has been associated with an increased risk for SIDS.
3) Loose Bedding
Sleeping with pillows or loose bedding such as comforters, quilts, and blankets increases and infant’s risk for SIDS.
4) Overheating
Infants who overheat because they are overdressed, have too many blankets on, or are in a room that is too hot are at a higher risk of SIDS.
5) Smoking
Infants born to mothers who smoke during pregnancy are at increased risk of SIDS. Also infants exposed to smoke at home or at daycare are more likely to die from SIDS.
6) Bed sharing
Sharing a bed with anyone other than the parents or caregivers and with people who smoke or are under the influence of alcohol or drugs, increases an infant’s risk for SIDS. The safest place for an infant to sleep is in their own crib or other separate safe sleep surface next to the parent or caregiver’s bed.
7) Preterm and low birth weight infants
Infants born premature or low birth weight are more likely to die from SIDS.
Guidelines for the Death Scene Investigation of Sudden, Unexplained Infant Deaths (SUID) and the Investigation Reporting Form (SUIDRF)
Accurate, consistent cause-of-death data is needed to monitor national trends in infant deaths, evaluate prevention programs, and conduct research that will ultimately lead to a reduction in these deaths. In order to achieve this aim, CDC is working to improve the quality of data collected at infant death scene.
Infant death scene investigation training materials
Of equal importance to revising the SUIDIRF is the need for training investigators and death certifiers in how to consistently collect data at the death scene and translate the investigation findings into a cause-of-death on the death certificate.investigations and of data recorded on death certificates.
SIDS Research
CDC is investigating reasons for the disparities in SIDS rates between minorities and white infants. Additionally, CDC is examining the trends in SIDS and other SUID to determine the extent to which changes in reporting cause-of-death explain the continued decline in SIDS rates.
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