“As the Tennessee Department of Health celebrates its 90th birthday this year, we also celebrate remarkable improvement in a critical and broad indicator of population health: our infant mortality rate,” said TDH Commissioner John Dreyzehner, MD, MPH, FACOEM. “When our department was established in 1923, almost 80 out of every 1,000 babies died before reaching their first birthday. Though we still have much work to do, 90 years later, in 2012, we have seen a nearly ten-fold decrease, such that 7.2 babies out of every 1,000 suffer such a fate.”
Although the rate of infant deaths is declining in Tennessee, statistics show the need for continued efforts to improve birth outcomes. The state’s infant mortality rate still exceeds the national rate, which was 6.05 deaths per live births in 2011.
Many factors contribute to a healthy birth and first year of life. Good health before a woman ever gets pregnant; early prenatal care; avoidance of tobacco and alcohol; high-quality care during labor and delivery; immunizations and other preventive care for the baby and safe practices for the infant such as riding in a car seat, not being exposed to tobacco and sleeping alone on their back in a crib all help create an environment of health for the child.
While there is not one single solution that will prevent all infant deaths, the Tennessee Department of Health has partnered with hospitals and community organizations to reduce the risks of infant deaths through the reduction of early elective deliveries and the promotion of safe sleep practices. In Tennessee, nearly one third of babies are born at 37 or 38 weeks gestation. In some of those cases, labor starts on its own and the babies generally turn out fine.
“Many doctors were taught a baby who makes it to at least 37 weeks during pregnancy was ready to enter the world, but we now know a baby’s brain grows by 50 percent during just the last five weeks of a pregnancy and an early delivery increases the risk of complications and even death for an infant,” said TDH Family Health and Wellness Director Michael D. Warren, MD, MPH, FAAP.
Some deliveries are induced for medical reasons, but in other cases, delivery is induced for the convenience of the doctor or mother, known as “elective” induction or delivery. TDH has partnered with the Tennessee Hospital Association, March of Dimes, the Tennessee Center for Patient Safety and the Tennessee Initiative for Perinatal Quality Care to reduce elective inductions and deliveries in Tennessee before 39 weeks gestation. This initiative targets expectant and prospective parents, health care providers and health care facilities to educate them that “Healthy Babies are Worth the Wait” and on the benefits of waiting until at least 39 weeks for delivery of babies. To date, 61 of 66 hospitals across the state have committed to “hard-stop” policies aimed at reducing early elective deliveries.
Another important partnership is one to reduce sleep-related infant deaths. One in five infant deaths in Tennessee is due to preventable causes such as suffocation or strangulation while sleeping. Health departments, hospitals, primary care providers and other partners are working to educate parents and caregivers about safe sleep using the Tennessee Department of Health’s educational materials. TDH promotes the American Academy of Pediatrics recommendations that infants should:
• Always be placed on their backs to sleep
• Sleep alone in a crib or bassinet, although the crib or bassinet can be in the same room as an adult caregiver
• Not have bumper pads, blankets, stuffed animals, toys or pets in their cribs
• Sleep on a firm crib mattress with the mattress covered only by a fitted sheet
While there are many factors involved in an infant not making it to his or her first birthday, these two initiatives are making strides to prevent some of these deaths.
Additional Information:
Learn more about the Healthy Babies are Worth the Wait initiative and what you can do to reduce premature births athttp://health.tn.gov/mch/healthybabies.shtml.
Learn more about the “ABCs of safe sleep” and how to order free educational materials at http://safesleep.tn.gov.
The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. For more information about TDH services and programs, visit http://health.state.tn.us/.
Source:
TN Dept. of Health
