Infant Mortality Rate: Is Your Baby At Risk?

Infant mortality is something that no one wants to talk about — but it’s a topic about which we should be informed. In this post, we’ll break it down what’s behind the infant mortality rate to help you feel empowered and aware. Here, you’ll discover:

• What is the infant mortality rate
• What you can do to prevent infant mortality
• How different races are affected
• What the USA is doing as a country to reduce this number

What Is the Infant Mortality Rate?

When you hear the term “infant mortality rate” it sounds like a statistic about babies that die during childbirth or shortly after. However, that’s not the full definition. Infant mortality refers to the death of any infant up to his or her first birthday.

In 2017, for example, the infant mortality rate in America was 5.8 deaths for every 1000 births, according to data from the Centers for Disease Control and Prevention (CDC). This was the equivalent to about 22,000 deaths for 2017.

Each country has its own infant mortality rate, and it’s important to watch the trends each year. Why? The infant mortality rate (similar to the maternal mortality rate) is an indicator of the country’s overall health.

Why Are Babies Dying?

Infant deaths are often discussed in relation to sudden infant death syndrome (or SIDS), but the reality is that SIDS is just one potential cause of death. The most common reasons why a baby may pass away unexpectedly include:

Birth defects

Not all birth defects are fatal. For instance, cleft palates are a type of birth defect that can be corrected with surgery. However, some birth defects cannot be treated. Neural tube defects are some of the most serious types of birth defects. (source) Anencephaly is a type of neural tube defect in which parts of the baby’s brain and skull haven’t formed. These birth defects are usually discovered in utero but some heart conditions may not be detected until after birth.

Maternal pregnancy complications

Maternal pregnancy complications that lead to premature birth can increase the risk of fetal death. Incompetent cervix, for instance, is a maternal pregnancy complication that can lead to premature birth. When the cervix dilates too early, it’s possible that an otherwise healthy baby is born before his or her organs are fully developed. (source)

Sudden infant death syndrome

According to the Illinois State Department of Health and the CDC, SIDS is the third leading cause of death in children under one year of age. (source, source)  SIDS is an unexplained death in babies who were otherwise healthy. Almost all of these deaths (90%) occur during the first six months of a baby’s life. (source) SIDS isn’t the same thing as a suffocation death, but that will be covered more below.

Injuries and accidents

This category includes babies that perished due to accidents. This includes car accidents, drownings, and accidental suffocation. Suffocation is sometimes associated with SIDS, but the reality is that these are different issues. Suffocation can occur because of what position the baby is in. Positional asphyxiation occurs when the baby’s airways are blocked, such as being slumped in a car seat. (source, source)

Unsafe sleeping arrangements can contribute to accidental suffocation. This includes baby sleeping with blankets, pillows, crib bumpers, sleeping in baby gear not intended for sleep (such as baby walkers or high chairs), sleeping on unsafe surfaces (such as couches), or near areas that a baby could get wedged (between a wall and a bed).

Infant Mortality Rate: Know Your Baby’s Risk Factors

It’s not easy to read about infant mortality, I know. It’s enough to make your mama heart hurt, but there is wisdom in learning about the risk factors so that you can do everything in your power to give your baby a healthy start in life. Certain risk factors for infant mortality include:

• Unmanaged underlying health conditions: Prenatal care and routine well baby checks can help spot the signs of underlying health conditions
• Practicing unsafe activities: Always practice safe car seat installation and usage. Practice safe co-sleeping. You can learn how to safely co-sleep in this post.
• Maternal factors that affect infant mortality:  pre-term birth, low birth weight, obesity, diabetes, hypertension, alcohol, tobacco, HIV, rural residence, race, and psychosocial stressors can all increase the risk of fetal demise and infant mortality. (source: Texas DOH)
• Short time between pregnancies: Studies show short time between pregnancies can increase the risk of low-birth weight, but this can be particularly risky for mamas who had C-sections as short intervals increase the risk of uterine rupture. (source)
• Intrauterine growth delay: Low birth weight is a contributing factor to death rate, and intrauterine growth delay severely affects a baby’s growth. (source)
• Race: Black babies are more at risk of infant death than any other race.

Infant Mortality Rate: Risk factors and Racial Disparities

For every 1000 live births, the infant death rate was broken down by: (source)

• Black (non-Hispanic) babies: 11.4
• American Indian babies: 9.4
• Native Hawaiian or other Pacific Islander: 7.4
• Hispanic: 5.0
• Caucasian: 4.9
• Asian: 3.6

To put this in perspective: Black babies have 2.3 times the infant mortality rate as Caucasians, and they are 3.8 times more likely to die from low birthweight complications than any other race.

Why? There are many factors at play here, but a few of the underlying reasons include institutional racism, not having access to good quality care, living in “materno-toxic” areas, poor access to nutrition/prenatal vitamins. Black mamas are more likely to have premature and low birth babies, and as we just discovered in the last section, low birth weight is a major risk factor for infant death.

So, what can we do about it? Let’s talk about prevention in the next section.

Can You Prevent It?

I know, mama. This is a tough article to get through, but I want you to feel empowered to reduce your baby’s odds as much as possible.

Here are eight things you can do:

1. Reduce your risk of developing birth defects: Take prenatal vitamins — they contain folic acid which helps prevent neural tube defects, eat healthy foods, avoid smoking and drinking alcohol while pregnant.
2. Reduce your risk of pre-term birth: It’s not always possible to prevent pre-term birth, but receiving routine prenatal care can help prevent pre-term birth. Sometimes, pre-term labor can be stopped if you receive medical care promptly. Oddly enough, taking care of your oral health can also help prevent pre-term birth. (source)
3. Reduce your risk of having a low birth weight baby: One of the best things you can do during your pregnancy is to follow a healthy, whole foods-based diet. If you’re not sure if you’re getting enough calories or the right nutrition, don’t hesitate to reach out to your provider. Cigarette smoke (and secondhand smoke) can also contribute to low birth weight. If you need help quitting, talk to your doctor. If loved ones smoke, have them go outside.
4. Start prenatal care as soon as you know you’re pregnant: Prenatal care is designed to help you and your baby stay healthy during pregnancy. Certain screenings and imaging can help detect potential problems early on — so you (or your baby) can get the treatment you need quickly. For example, if you demonstrate the signs of incompetent cervix, a procedure called a cerclage can help prevent preterm labor.
5. Prioritize your diet: Following a nutritious pregnancy diet has many benefits. For example, healthy eating can help prevent (or manage) conditions like gestational diabetes. Not to mention, eating a healthy diet can help keep your pregnancy weight gain in check. A healthy diet includes ample hydration too! Being dehydrated can trigger contractions so be sure to drink plenty of water each day.
6. Creating a safe infant sleep environment: This is one of the hottest topics, but the reality is that cribs and even co-sleeping can be unsafe if done incorrectly. To create a safe sleeping environment, your baby’s airways must be clear at all times. This means no pillows, blankets, or stuffed animals should be near your baby. Your baby should also sleep on a firm surface. Again, you can reference this article for safe sleeping tips.
7. Use the newborn screening to check for hidden conditions: Shortly after birth, your baby will receive a newborn screening used to detect a variety of conditions include congenital heart disease and PKU. (source)
8. Advocate for prenatal care, address your concerns, reach out for more support: If you’re ever concerned about something during your pregnancy or after your baby is born, don’t hesitate to speak up, mama! Reach out for support and keep reaching until you get the support you need. For Black mamas, there are more and more resources to help you advocate for yourself and your baby. Black Mothers United is an example of a program designed to offer support and resources to Black mamas at risk of having a low birth weight baby.

What is America Doing to Reduce the Infant Mortality Rate?

We just covered eight things that you can do to improve your baby’s odds, but it’s good to know that America as a whole is also working towards lowering our infant mortality rate. Here’s a peek at what we’re doing:

CDC

In 2015, preterm birth and low birth weight were responsible for about 17% of infant deaths in America, according to the CDC. To help reduce the number of deaths due to preterm birth and low birth weight, the CDC provides support to perinatal quality collaboratives (PQCs). These PQC’s are networks of teams (through one or multiple states) working to improve health outcomes for both babies and their mamas.

The CDC is also on a mission to prevent infant death due to injury. Their Injury Center created resources designed to help educate, inform, and empower patients and all child care givers. This includes child passenger restraint guidelines.

MCHEP Programs

The Maternal and Child Health Epidemiology Program (MCHEP) assigns epidemiologists the task of assessing and improving maternal and child health systems and protocols. This program also issued the State Infant Mortality (SIM) Toolkit which is designed to help pinpoint weak spots in the system to prevent future deaths.

PRAMs

The Pregnancy Risk Assessment Monitoring System (PRAMS) was established in 1987 to reduce infant morbidity and mortality through assessments. This program pinpoints weak spots or problem areas and then works to address them.

Grassroots programs

In addition to the bigger programs (like the CDC’s programs), there are several grassroots and local programs who are on a mission to improve mother and baby outcomes. The National Perinatal Task Force is a program component of Commonsense Childbirth, it’s designed to provide awareness, support, and training for birth professionals and community members alike who care about the persistent racial disparities which continue to plague our communities.

The National Perinatal Task Force is a virtual community. It’s a grassroots movement designed to help start perinatal safe spots, especially in materno-toxic areas (places that are not friendly to mama’s). The task force works to create real, tangible changes, especially in areas where racial disparities affect infant outcomes.

Other resources

After having another baby at 43, I was reminded how challenging the postpartum period can be! I feel so passionate about mamas and babies getting the support they need that I created an affordable Baby Care Course. Taught alongside a holistic pediatrician and midwife, this course will teach you everything you need to know so that baby and mama can THRIVE in the first year postpartum. You can check out our course here.

Going Forward

It can be scary to think about infant mortality, but the reality is when you are taking care of yourself during pregnancy, getting routine care, and following safety guidelines (like safe car seat installation), you’re doing your best to keep your little one safe. Empower yourself by learning what you can and trust that all is well.