Infant mortality down in U.S., but this surprising change could make babies even safer

Over the last decade, the infant mortality rate in the United States has dropped considerably. Data from the U.S. Centers for Disease Control and Prevention showed that the number of newborns who died before age 1 dropped 15% between 2005 and 2014. But new research shows that the odds of a newborn dying in their first year of life, including full-time babies, are far higher in the United States than many other developed countries.

Luckily there are steps parents, doctors and lawmakers can take to ensure our little ones will live long, healthy and happy lives.

According to a new study published in PLOS Medicine, the U.S. infant mortality rate for babies born full-term were 50% to 200% higher than other affluent nations including Austria, Denmark, Finland, Norway, Sweden and Switzerland. In particular, researchers studied more than 10 million full-term infants born in the United States between 2010 and 2012 and discovered that, out of every 5,000 full-term births, 11 newborns died before 1 year old. More than 7,000 babies born between 37 and 42 weeks gestation die in the United States each year, the study showed.

So what’s behind the high infant mortality rate? There are two main causes, according to study co-author Neha Bairoliya of the Harvard Center for Population and Development study: Congenital malformations, which accounted for 31% of newborn deaths during the study, and high risk of sudden unexpected deaths in infancy (SUID), which represented 43% of cases.

“While we do not have data on actual sleeping arrangements from our study, other data sources suggest that a substantial number of babies continue to sleep on their tummy,” Bairoliya tells Reuters. “We also found a shockingly large number of babies dying from suffocation, which suggests that parents either use covers that are not safe, or let children sleep in their own beds.”

(While many parents find co-sleeping works best for them, according to the American Academy of Pediatrics, “infants should sleep in the same bedroom as their parents – but on a separate surface, such as a crib or bassinet, and never on a couch, armchair or soft surface”.)

Though not involved in the study, Michael Gradisar, a psychology researcher at Flinders University in Adelaide, Australia, says its findings illuminate key differences between the United States and Europe when it comes to maternal and infant health. Particularly, Gradisar tells Reuters, different approaches to infant sleep and parental leave between the two continents may influence survival rates among newborns.

“Once a baby is born in the U.S., the odds of that baby dying in its first year from poor sleeping arrangements (sleeping position, co-sleeping) is higher than the best European countries, especially in Scandinavia,” he says. “There are also clear links between paid parental leave, which is higher in Scandinavian countries, and lower infant mortality risk in the first year of life.”

So how can we lower the infant mortality rate in the United States?

Enact a federal paid parental leave law

There are clear links between paid parental leave and a lower infant mortality rate. Studies show paid leave has significant health benefits for parents and their babies that ensure survival: Reduced postpartum depression rates, encourage breastfeeding, and increase the number of infant checkups and vaccinations.

But the United States is the only country, out of 41 developed nations, that doesn’t have a federal paid leave law of any kind. On the other hand, Sweden, one of the nations with a low infant mortality rate, comparatively, offers new parents 480 days of paid leave at 80% of their normal salary.

Increase access to affordable prenatal and neonatal care

Although medical advances have made prenatal and neonatal care more accessible, there is still a large number of women and infants who are not receiving these services. Many mothers, particularly mothers of color, face significant barriers to accessing adequate healthcare for themselves and their children: Lack of insurance, lack of affordable care, unreliable transportation, and financial insecurity, among others. And research shows that babies of mothers who receive late to no prenatal care are five times more likely to die.

Improve training around risk factors

It’s not only the accessibility of care that affects infant mortality rates—it’s also the quality of that care. Research shows that the leading causes of neonatal death include infections, complications during pregnancy and childbirth and congenital abnormalities. But all of these conditions are preventable or can be diagnosed and treated early with better healthcare.

That’s where improved training comes in: A ProPublica investigation published last year found that many postpartum nurses had poor knowledge of the warning signs associated with pregnancy- and childbirth-related complications. By improving training and education, nurses will be better able to educate parents.

Have better support systems for new parents

Parenthood may be rewarding, but it’s also incredibly stressful. There are so many challenges that new mothers face while trying to handle their new responsibilities. Research shows that, without adequate support and services available to parents, the risk for infant mortality is heightened, particularly among underserved populations. Support for new parents could be anything from creating free or affordable activity groups to offering to act as a night babysitter for a few weeks to a few months.

The infant mortality rate is high in the United States compared to other developed countries, but it doesn’t have to be. There are solutions that, when implemented, can have a tremendous influence on a baby’s survival.

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