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Baby Steps

Fewer babies are dying in Shelby County than in years past.



Around nine out of every 1,000 babies born in Shelby County died before his or her first birthday in 2011.

While that number may sound high, the 9.6 rate for 2011, the most recent data available, is significantly lower than the 14.6 deaths per 1,000 births in 2003, when the Shelby County rate was at its highest point in years.

Historically, Shelby County has suffered from one of the highest infant mortality rates in the country, sometimes earning a comparison with the rates of developing countries.

But for the first time in years, Shelby County's rate is in the single digits, which seems to be part of a national trend in declining infant mortality rates. In April, The New York Times reported that the national rate fell by 12 percent from 2005 to 2011 with the most striking improvements occurring in Southern states.

"In Memphis, we have a high infant mortality rate, not because we don't know how to take care of babies but because we have too many newborns born premature or with low birthweight," said Dr. Ramasubbareddy Dhanireddy, medical director of the Sheldon B. Korones Newborn Center at the Regional Medical Center at Memphis (MED).

Dhanireddy said multiple efforts at the MED have contributed to the decline in the county's rate: neonatal intensive care, keeping babies warm at birth, encouraging more new mothers to breastfeed, and teaching new moms to lay babies on their backs to sleep to prevent Sudden Infant Death Syndrome.

Dr. Giancarlo Mari, medical director of the High Risk Obstetrics Center at the MED, said his efforts are focused on reducing congenital abnormalities in low birthweight babies, which is one of the main causes for death in those babies.

"If we look at patients with diabetes, we know they have a risk of having a baby with a congenital abnormality of four to 10 times higher than the general population," Mari said. "But if we can take care of that diabetic patient before conception, guess what? The number of congenital abnormalities will be the same as the general population."

Since any baby who dies before its first birthday factors into the infant mortality rate, the work to keep babies alive extends beyond the delivery room.

The MED Foundation takes donations of baby accessories — clothes, diapers, pacifiers, etc. — through an Amazon wish list and donates them to new mothers in need.

"It's very stressful when you are delivering a baby at 26 weeks," said Tammy Ritchey, vice president of development and executive director at the MED Foundation. "If we can alleviate some of the pressure by making sure she has the appropriate clothes for the baby or the correct bottles, that's one less thing she has to worry about."

The BLUES Project run by the University of Tennessee Health Science Center focuses on giving new mothers social support and education on motherhood.

"A lot of the issues that prevent babies from getting to their first birthday are psycho-social issues, not just medical issues. A lot of the moms we see are having problems with domestic violence or financial things or they don't have housing," said Teresa Franklin, project manager for the BLUES Project.

BLUES Project staffers provide social support to new moms, such as accompanying them to doctor visits and even to the delivery room if they don't have anyone else to go with them. Since the BLUES Project began in 2002, Franklin said she's seen a decline in babies dying before their first birthday.

Dhanireddy cautions celebrating the reduced infant mortality rate: "Yes, it's a cause for celebration that we have made for the first time ever our infant mortality rate come down to less than 10 per 1,000 births, compared with up to 17 and 18 per 1,000 in the past. But we should not say that we have achieved the mortality rate that we should be achieving. We should at least get down to the national average of about six per 1,000."

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