Shall we talk about the causes of infant mortality?

Today we are going to talk about a somewhat sensitive, but very important topic. That is, the loss of little babies, that is, within the first year of birth, leaving us. This is what doctors and researchers call `(Infant Mortality)`. When you hear this word, you may think of statistics, but in reality, behind this lies an unbearable sadness, a disappointment in a family.

What is Infant Mortality? Do we understand it exactly?

Simply put, `Infant Mortality` refers to the death of a baby within 12 months of birth, that is, before the age of one year. There is another word called `(Neonatal mortality)`. It refers to the death of a baby within the first 28 days of birth. Although these words are used for statistics and research, in real life this is a very painful experience. It is like a piece of yourself has been lost, and you cannot imagine how to move forward.

But why are we talking about this? Because, things like this shouldn't happen. Every baby has the right to start life healthy and celebrate not only their first and second birthdays, but many more. But, how many things are there that affect the health of babies and their families?

Social determinants of health, which affect our health, are often related to this. Imagine, if you don't get even the basics like nutrition and prenatal care during pregnancy, it becomes difficult to expect a healthy baby. Researchers and doctors are always trying to remove such barriers and create an environment where everyone can have a healthy pregnancy and give birth to healthy babies.

What are the reasons why little ones get separated from us?

According to statistics currently in the world, especially in countries like America, there are several main causes of infant mortality:

• Congenital abnormalities (or birth defects): These are various physical or genetic problems that occur while a baby is developing in the womb. Some are minor, while others can be life-threatening.
• Preterm birth and low birth weight: Babies born before the due date, that is, before 37 weeks, may experience various complications because their organs are not fully developed. Also, babies weighing less than 2500 grams at birth are at higher risk.
• Sudden Infant Death Syndrome (SIDS): This is a very sad condition. It is when a healthy baby suddenly dies, usually while sleeping, for no apparent reason.
• Unexpected accidents: These include car accidents, falls, drowning, and suffocation. Since babies are very vulnerable, it is essential to take good care of them.
• Pregnancy complications: Conditions that occur in the mother during pregnancy, such as high blood pressure, diabetes, and infections, can also affect the baby.

Causes that specifically affect newborns

The main causes affecting newborns, that is, babies within the first 28 days, include:

• Bacterial sepsis: This is a serious infection.
• Respiratory distress syndrome: This condition can occur, especially in premature babies, because their lungs are not fully developed.
• Congenital heart disease: Problems with the structure or function of the heart that are present at birth .
• Hemorrhage: Excessive bleeding within the brain or elsewhere.

What caused infant deaths in the past? What is the situation now?

Compared to the current causes, in the past, that is, in the late 1800s, the main cause of infant deaths was infectious diseases . Imagine, how many little lives would have been lost to diseases like diarrhea, whooping cough, measles, pneumonia, and tuberculosis at that time?

However, this situation changed a lot over time. Public health measures such as clean water, pasteurization of milk (a method of killing germs in milk), and vaccinations made it possible to protect babies from these infectious diseases.

In the early 1900s, infectious diseases accounted for more than 60% of infant deaths. But by the late 1990s, that number had dropped to 2%. What a huge improvement, isn't it?

What is this IMR (Infant Mortality Rate)? What can we learn from it?

You may have heard the term `IMR`. `IMR` stands for `Infant Mortality Rate`. Simply put, this is the number of babies who die before the age of one year out of every 1,000 live births. It does not include stillbirths or miscarriages.

Researchers use this `IMR` value to study how infant mortality occurs among different population groups (e.g., within a country, region, race, income level). This allows them to understand many things:

• Identify which people and which areas need more resources and support for a healthy pregnancy and childbirth.
• This not only provides insights into infant mortality, but also into the overall health of a society or group of people. Because many of the factors that affect infant mortality (such as access to health services and resources) affect everyone in that group.
• Using this data, we can create policies and make necessary changes for healthy pregnancies and healthy babies.

A little insight into the situation in the world and our region

Even in a developed country like the United States, the `IMR` in 2022 was 5.6 per 1,000 live births. Also, among some ethnic groups in that country (e.g. African Americans), this rate is about twice the national average. This shows how much disparity there is even within a country.

This `IMR` value varies greatly among different countries in the world. For example:

• Some of the countries with the highest `IMR` are: Sierra Leone, Central African Republic, Nigeria, Somalia. Some of these countries have more than 70 infant deaths per 1000 births.
• Some of the countries with the lowest `IMR` are: Japan, Singapore, Norway, Slovenia. These countries have a very low rate of 2 infant deaths per 1000 births.

This clearly shows how much the chances of a baby celebrating their first birthday can vary depending on where they are born and the resources they have (especially health services). In Sri Lanka, we are ahead of many developing countries in this regard. Our free health care, especially the maternal and child clinic system, is a great strength in this. But we have a lot to do to improve this situation further.

What can we do to prevent these infant deaths?

Unfortunately, not all infant deaths can be prevented. There are some causes that cannot be controlled, even with the best technology and the best doctors. But we know that the care you receive during pregnancy and after the baby is born can make a big difference.

A global problem is that not everyone has access to the same health services and resources. Researchers and policymakers are constantly trying to solve this problem. The goal is for everyone to have unhindered access to the resources they need to protect their own health and that of their children.

On a personal level, there are several things you can do to ensure a healthy pregnancy and a healthy baby:

• Taking care of your health before you get pregnant: If you have any chronic medical conditions (e.g. diabetes, high blood pressure), see a doctor and get them under control before you get pregnant.
• Attending antenatal clinics as scheduled: Attend every clinic exactly as your doctor/midwife tells you. This will ensure that you and your baby's health is regularly monitored.
• Following your doctor's advice: Follow your doctor's advice carefully about what you should do (e.g., nutritious food, prescribed vitamins) and what you should not do (e.g., smoking, alcohol) during pregnancy.
• Creating a safe sleeping environment for your baby: This is very important to prevent SIDS. Do not put your baby to sleep face down, put your baby on his back on a firm mattress. Do not place toys or blankets in the sleeping area.
• Using a car seat for your baby's safety when traveling in a car: Use a properly installed car seat that fits your baby on every trip.

Doctors examine the baby immediately after it is born in the hospital. This allows them to quickly identify any health problems and begin the necessary treatment.

Finally, the most important thing to keep in mind (Take-Home Message)

We know this is not an easy topic to talk about or think about. As you read this, you may feel scared, anxious, or overwhelmed, especially if you have experienced something similar. Perhaps you are searching for reasons for this. Or, if you are someone who has come to learn more about this, you may feel like you need to do something about it.

Whatever your personal story, it's important to know this: Health experts, researchers, and governments around the world are working hard every day to reduce these infant deaths and give every baby a healthy start in life.

Because no family should have to go through the unbearable pain of losing a baby. The more we learn about this, the more we discover new things with scientific advances, the more we can help our families and create an environment where every little one can be welcomed into this world with love.

` Infant mortality, Infant mortality, Health, Pregnancy care, SIDS, Birth defects, Low birth weight, Maternal health, Child health