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Make way for babies: Advocates seek to build on Mississippi's success

TUPELO -- Mississippi's record drop in infant mortality means 64 more toddlers are disrupting Thanksgiving celebrations today.

The state saw 64 fewer infant deaths from 2013 to 2014. When combined with an increase in the number of births in 2014, the infant morality rate dropped from 9.7 per 1,000 births in 2013 to 8.2 in 2014. That's a 15-percent drop between 2013 and 2014, and a 28 percent drop since 2005.

"It's the most promising news we've had in a while," said State Health Officer Dr. Mary Currier. "If we continue to go in this direction, we will be making a big difference."

Mississippi won't know how the improvement in infant mortality rates compares to the rest of the country until next year, but Currier expects Mississippi will remain among the worst in the nation.

Even as the March of Dimes recognized Mississippi's work with the Virginia Apgar Award for successfully lowering the preterm birth rate by 11 percent since 2009, the organization still ranks Mississippi as one of the states in most need of improvement.

"We still have a lot of work to do," Currier said.

Despite the drop in deaths, the state lost 319 babies in 2014.

Prematurity

Most infant deaths in Mississippi -- 137 in 2014 -- are among babies born before 28 weeks' gestation. Full term is 40 weeks. Most of them weighed less than 3.3 pounds.

"We still have the highest rate of prematurity in the country," said Dr. Charlene Collier, a University of Mississippi Medical Center obstetrician-gynecologist who leads the Mississippi Perinatal Quality Collaborative.

Tupelo maternal-fetal specialist Dr. Justin Brewer, who works with high-risk pregnancies from across North Mississippi, has seen improvement, especially with the support of the perinatal collaborative.

There's been widespread adoption of giving pregnant women who have a history of preterm labor supplemental progesterone, Brewer said.

Getting more moms in preterm labor transferred to the hospitals where there are high-level neonatal intensive care units has been helpful in improving outcomes.

"Babies and moms do better when they're delivered at the same center as the NICU," Brewer said, instead of transferring the babies after they're born.

Advocates remain tremendously concerned about the racial disparity between black and white babies in terms of prematurity and infant mortality. Black infants account for 42 percent of births, but 58 percent of deaths.

"This is where we can make a difference," Collier said.

Healthier moms

Much work has been done to open access to prenatal care, and it's been widely successful. The next step is helping moms-to-be address uncontrolled high blood pressure and diabetes, obesity and tobacco use.

"We need moms healthy before they get pregnant," Currier said.

Another key issue is helping moms space pregnancies so their bodies have time to recover, Collier said. It's very important that women have at least 18 months between the end of one pregnancy and the beginning of the next. Making long-acting, reversible birth control like implants and IUDs has strong strategy.

"They're 20 times more effective than the pill," Collier said. "They let parents choose when they have the next child."

Safe sleep environments

Creating safe sleep environments for infants has been a source of success and an area for improvement.

In 2014, 33 of the 53 Sudden Unexplained Infant Deaths were connected to an unsafe sleep environment. In 2013, 77 Mississippi babies were lost to sleep-related deaths.

"This is a number where we should be aiming for zero," Collier said.

New Albany physician Dr. Shane Scott, who is certified in pediatrics and internal medicine, said the practice of placing infants on their backs to prevent SIDS has been widely adopted. However, families are still struggling with recommendations against pillows, blankets, bumper pads and co-sleeping.

"I think families don't realize the potential danger," Scott said.

Allocations from the Legislature last year meant the health department could provide grant funding to the SIDS Alliance to provide cribs for families who need a safe place for their babies to sleep, Currier said.

Partnerships

Just as the successes have come from partnerships, helping more Mississippi infants survive the first year of life will require broad commitment.

"This can't be just a health department project," Currier said.

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