Infant Mortality: Causes and Prevention

Infant Mortality Metrics - Counting Tiny Lives

• Infant Mortality Rate (IMR): Deaths of infants <1 year per 1000 live births annually.
  • $IMR = (\text{Number of infant deaths <1 year} / \text{Total live births in a year}) * \textbf{1000}$
• Neonatal Mortality Rate (NMR): Deaths of infants <28 days per 1000 live births.
• Perinatal Mortality Rate (PNMR): Stillbirths (≥28 weeks gestation) + early neonatal deaths (<7 days) per 1000 total births.

⭐ India's current IMR is approx. 28 per 1000 live births (latest SRS data).

Neonatal Mortality Causes - First Month Foes

Neonatal period = first 28 days of life. Key causes:

• Prematurity (<37 weeks) & Low Birth Weight (LBW <2.5kg)
• Birth Asphyxia & Hypoxia (intrapartum-related)
• Neonatal Infections:
  • Sepsis
  • Pneumonia
  • Meningitis
  • 📌 Remember: Infections like Sepsis, Pneumonia, Meningitis (SPM) are major threats.
• Congenital Anomalies (e.g., cardiac, neural tube defects)

Leading Causes in India (approx. %):

⭐ Prematurity and LBW are the leading causes of neonatal mortality in India.

Post-Neonatal Mortality Causes - Later Infant Threats

Key threats for infants aged 1-12 months:

• Infections: Major killers.
  • Diarrheal Diseases
    • Leads to dehydration; ORS is vital.
  • Acute Respiratory Infections (ARIs)
    • Pneumonia is a leading cause of death.
• Malnutrition:
  • Often coexists with and worsens infections; Protein-Energy Malnutrition (PEM) is significant.
• Accidents & Injuries:
  • Includes drowning, falls, burns, poisoning.
• Congenital Anomalies (Persistent):
  • Structural/functional defects from birth (e.g., cardiac).

⭐ Pneumonia and diarrhea are major killers in the post-neonatal period.

Infant Mortality Risk Factors - Underlying Dangers

• Maternal Factors:
  • Age extremes: <18 or >35 years
  • Low maternal education level
  • Maternal malnutrition (e.g., anemia, low BMI)
  • Inadequate or absent Antenatal Care (ANC)
• Socio-economic & Environmental Factors:
  • Poverty, overcrowding
  • Poor sanitation, unsafe water supply
  • Indoor/outdoor air pollution
• Healthcare Access & Quality:
  • Limited access to skilled birth attendants & emergency obstetric care
  • Poor quality of postnatal care

⭐ Lack of Antenatal Care (ANC) significantly increases risk of infant mortality.

Prevention Strategies - Shielding Our Future

A vital three-pronged approach: Antenatal, Intranatal, Postnatal care.

• Antenatal Care (ANC):
  • Early registration, min. 4 ANC visits.
  • Interventions: IFA, TT immunization, nutrition, danger sign awareness.
• Intranatal Care:
  • Institutional delivery with Skilled Birth Attendance (SBA).
  • 📌 '5 Cleans': Clean hands, surface, cord tie, blade, cord stump.
  • Safe delivery.
• Postnatal Care (PNC):
  • Essential Newborn Care (ENBC): Warmth, airway, cord care, Vit K.
  • Exclusive breastfeeding (6 months), full immunization.
  • Home-Based Newborn Care (HBNC) by ASHA. Key Initiatives: IMNCI, JSSK, RBSK.

⭐ IMNCI strategy: integrated management of common childhood illnesses to reduce mortality.

High‑Yield Points - ⚡ Biggest Takeaways

• IMR: Deaths of infants <1 year per 1000 live births; neonatal mortality (first 28 days) is its largest component.
• Top causes: Prematurity/LBW, birth asphyxia/trauma, neonatal sepsis/pneumonia, congenital anomalies, diarrhea.
• Key interventions: Quality ANC, skilled birth attendance, exclusive breastfeeding (first 6 months), full immunization.
• Kangaroo Mother Care (KMC) significantly improves survival in LBW infants.
• IMNCI strategy provides an integrated approach to child survival.
• National programs like JSSK aim to eliminate preventable infant deaths.