1. The Silent Epidemic Uniting to Reduce Infant Mortality

2. Infant Mortality in Virginia

3. Significance of Infant Mortality World View

4. Infant Mortality: The Problem World Rank

6. Only ranks within the top 30 states for protecting the lives of infants Infant mortality rate ranked 18 th highest in the nation by the CDC in 2006 Infant mortality rate twice as high for African-Americans Infant Mortality: The Problem – Virginia

7. Infant Mortality: Comparative Deaths

8. Just the Beginning of the Uphill Climb 123 more babies lived in 2008

9. Healthy People 2010: 4.5 Total Infant Mortality Rates Per 1,000 Births in Virginia

10. Infant Mortality: 5 Year Death Rates by Race/Ethnicity

11. Infant Mortality Rates Per 1,000 Births By Race/Ethnicity 1998-2008

12. Cause of Death20072008 Disorders Related to Short Gestation and Low Birth Weight 194163 Congenital Malformations, Deformations, and Chromosomal Abnormalities 135130 SIDS8160 Maternal Complications of Pregnancy6348 Other Conditions in the Perinatal Period4224 Abnormal Clinical Findings2936 Complications of Placenta, Cord, and Membranes2624 Unintentional Injury (Accidents)25 Top Causes of Death

13. Infant Mortality by Age at Death

14. Infant Mortality: Maternal Age 2008

15. Infant Mortality by Education and Race/Ethnicity Less than 12 Years12 Years> 12 Years

16. Resident Infant Death Rates by Method of Payment and Race/Ethnicity MedicaidPrivate InsuranceSelf Pay

17. Infant Mortality: By Geography Infant Deaths 2008 VA residents by number of live births

18. Prematurity: The Rising Trend

19. Virginia Resident and Cesarean Births

20. Prematurity and Late Preterm Births 35 Weeks 39 Weeks

21. A premature infant less than 37 weeks sleeping prone is 85 times more likely to die of SIDS A premature infant lying on its side is 40 times more likely to die of SIDS Prematurity and SIDS

22. Prematurity: SIDS Rate and Sleep Position Rates of SIDS Deaths Babies Sleeping on their Backs

23. Engage Healthcare Providers Pregnant women and their families Community Groups Health Insurers Changing Attitudes

24. Accessible prenatal care Promote breastfeeding Education about preterm labor signs and symptoms Decrease smoking and exposure to second- hand smoke Interventions that May Reduce Prematurity/Infant Deaths

25. Assess for substance use and intervene Assess for domestic violence and intervene Reduce major stress levels Refer to community services Interventions That May Reduce Prematurity/Infant Deaths

26. Breastfeeding: The Benefits Lower rates of SIDS Fewer ear infections Fewer asthma/allergy cases Less obesity Less diabetes Fewer childhood leukemia cases Fewer infections in premature babies

27. Educate mothers before birth Provide support from family, friends, healthcare workers, employers, society Provide safe places to nurse and pump Promote Breastfeeding

28. Prematurity and Smoking Exposure to smoking is associated with 20% of all low birth weight babies 8% of preterm births SIDS

29. Prematurity: Smoking and Pregnancy Successful treatment of tobacco dependence 20% reduction in low- birth-weight babies 17% decrease in preterm births

30. Prematurity Birth Defects SIDS Infant Mortality: Causes

31. Good prenatal nutrition Maternal health behaviors/effects Planned pregnancy with early, quality prenatal care Prevention of preterm & low birth weight babies Infant Mortality: Solutions

32. Infant sleep position and environment Family/caretaker violence prevention & safe home Home visiting nurses Infant Mortality: Solutions

33. Saving Babies Initiative Save babies from dying in their first year of life Focus on results Targeting 10 localities with the highest number of infant deaths Collaborating with other stakeholders

34. Saving Babies Outcomes Determining women at high risk Increasing awareness of signs/symptoms of premature labor Promoting safe sleep education

35. Saving Babies Outcomes Improving coordination/ efforts of private and public providers Enhancing outcomes through folic acid promotion, insurance coverage and transportation to prenatal care

36. Communicate the facts Provide intervention tips Support the Commissioners Infant Mortality Workgroup Infant Mortality Reduction: Raise Awareness

37. Infant Mortality Reduction: Spread the Word Control Weight Dont Smoke Dont Drink Take Vitamins with Folic Acid Visit Your Dentist Breastfeed

38. Infant Mortality Reduction: Practice Safe Sleep Habits Baby should… Sleep alone Sleep on his/her back Sleep in a crib without soft toys, bumper pads or quilts

39. The Silent Epidemic Uniting to Reduce Infant Mortality

40. Optional Slides Follow

41. Healthy 2010 Goal: 4.5 Infant Mortality – Recent History

42. Prematurity*- the problem *Less than 37 weeks Healthy 2010 Goal: 7.6

43. Top 4 Causes of Infant Death, Virginia 1998-2008