Authorities are urgently trying to track down babies missing from the nation's health system - sparking fears about the wellbeing of potentially hundreds of at-risk Kiwi children.
While health officials don't know the extent to which babies are missing from the health database, an Auckland District Health Board report reveals 102 babies previously lost were found in the three months to December 2020.
There are fears that unaccounted children could be missing vital health appointments and vaccination deadlines, putting them at serious risk.
Health Minister Andrew Little is alarmed at the revelations.
"It's really bad," he told the Herald.
"We've got to stop it and the best way to do it is to upgrade our IT systems ... if they are not connected with the health system then they fall through the cracks."
The 102 Auckland babies have now been linked with GPs or outreach programmes for immunisation follow up. Meanwhile, the investigation into other missing babies continues.
The Herald can reveal a service called Uri Ririki - Child Health Connection Centre (UR-CHCC) was established in November 2019 to investigate which babies were missing their first Well Child checks.
Health experts spoken to by the Herald were horrified by the number of missing babies and suggested concealed pregnancies due to abuse or incest could be a contributing factor.
However, Auckland DHB said the problem was largely to do with children being born overseas and not getting an NHI (National Health Index) number when they entered New Zealand.
Without an NHI number a child misses out on immunisations, Well Child checks - including testing hearing, heart, sight, hip joints and general wellbeing - and access to a GP or hospital.
The Health Minister said the situation was concerning because it meant there wasn't an accurate record being kept of those missing babies' healthcare.
"If records are missing then we can't get an accurate medical picture for those young children and we need that because of the vaccination programme," Little said.
He said the failure would be addressed by the new health reforms, announced last week.
UR-CHCC continues to work with the National Immunisation Register (NIR) and a regional Child Health Information Platform (NCHIP) to identify any children who may not yet have had their immunisation, Well Child Tamariki Ora or other routine appointments.
The Herald asked Auckland DHB for the total number of babies the service had so far identified but was not given a clear answer.
Instead, a DHB spokeswoman said that in the three months to December 2020, 78 infants were identified on NCHIP who were not on the NIR in Auckland and Waitematā DHBs.
A further 24 babies were identified as already being on the NIR but required contact details to be updated.
Te Rōpu Poa - Te Hau Ora Ō Ngāpuhi chief executive - said it was shocking that in a modern society there were still gaps in the system.
"Imagine if those babies have disabilities or special needs and we don't know about it, the disadvantage that goes with lack of monitoring. How does that happen?" Poa said.
"It means they can't be monitored to ensure they are safe, well, healthy and have access to all the healthcare services available."
Poa shared tragic stories of young women who didn't want to disclose a pregnancy because they had been abused or it was a result of incest.
Maybe that was how they'd slipped through the cracks, she said.
"Imagine having a baby and no one knowing about it, and then your recovery. It's very scary because you could have an unwell mum with mental health issues and a very unwell baby. I've just never heard of it before."
Tish Taihia, clinical midwife manager at Nga Hau Mangere, said concealed pregnancies were still happening, especially in Pasifika communities.
In order to avoid getting signed on to the NHR a mum would have to give birth at home without professional health support.
It was a midwife's responsibility to ensure babies were signed up to the NHR, Taihia said.
In 2018, the Herald reported hospital workers occasionally helping women give birth who'd had no antenatal care. A Northland DHB report that year noted that three women had presented in labour "unbooked" with no antenatal care, and this seemed to be more common.
Debbie Holdsworth, funding director for Auckland and Waitematā DHBs, said Uri Ririki service was delivering "real and tangible results" by ensuring tamariki in the region received important health checks and immunisations to support their health, growth and development.
"The first 1000 days of a child's life are critically important for shaping lifetime development. Staying connected with whānau helps us to ensure that we're offering all the health services that infants and children are entitled to," Holdsworth said.