Poverty casue of high infant mortality

David Montgomery

Wanganui's high rate of infant deaths between the ages of 28 days and one year can be attributed to poverty in our city, a paediatrician says.

The head of paediatrics at Wanganui Hospital, David Montgomery, said the Whanganui District Health Board (WDHB) provided education and support to parents regarding smoking, safe-sleeping, breast-feeding and mental health, but Sudden Unexpected Death of an Infant (SUDI) rates were still "unacceptably high".

WDHB reported 18 deaths of infants in the four years to 2012 - a rate of 4.03 for every 1000 live births - the highest in the country, according to a survey by the Child and Youth Mortality Review Committee (CYMRC).

The four-year block before that showed a rate of 3.54, with 16 deaths in the period between 2007-11.

"I think the essential point to make is that socioeconomic disadvantage appears to be causally linked to the risk of SUDI," said Dr Montgomery, who is also the chair of Wanganui's CYMRC.

"The reason we have high rates in Wanganui is that we have high rates of poverty."

In response to the rising death rate for Wanganui infants, mostly caused by SUDI, WDHB, Plunket, Whanganui Regional Health Network (WRNH) and the Teen Parents Reference Group would be applying for funds to purchase and distribute Pepi-Pods (safe portable baby beds) to parents of at-risk babies.

"The Whanganui community collaboration is aiming to distribute 300 Pepi-Pods a year for the first three years of the project," Dr Montgomery said.

The WDHB also planned to launch a social marketing campaign about the importance of safe sleeping.

"Each family who receives a Pepi-Pod will also receive a personalised message about safe sleeping, and they will have to agree to adopt the safe sleeping principles," Dr Montgomery said.

Pepi-Pods are not a replacement for a bassinet or cot which meets NZ safety standards, but are portable for when the baby is away from home. They can be placed in the parents' bed while still giving the baby its own safe sleeping space.

"Several coroners have noted that the messages about safe sleeping are not getting through," Dr Montgomery said. "We anticipate that making Pepi-Pods available to those who need them will make a difference for our babies."

Lead Maternity Carers (LMCs) and midwives provide information to all expectant mothers about safe sleeping, he said, and Wellchild providers such as Tamariki Ora and Plunket nurses reinforce the information on their first visits to families.

"As with all culture/behaviour changes around subjects such as road safety, smokefree and safe sleeping for infants, it takes time for messages to become the norm," Dr Montgomery said.

The number of deaths for Maori infants was also disproportionately high throughout the country, the CYMRC reported.

"Our collaborative efforts include working closely with Whakawhetu (the national SUDI prevention for Maori) who have been here training our workforce to help them relay the SUDI messages in a manner that's culturally appropriate for Maori."

If babies had a low birth weight, were exposed to smoke, or were placed in sleeping positions that would compromise their airways, they would fall into the SUDI risk category.

"It's all about doing everything possible to enhance a baby's ability to breathe well," he said. Dr Montgomery called for family and friends to support those with newborn babies and encourage the safe sleeping message.