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Wed 16 October 2019
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In their series exploring the deaths that go unnoticed, Natalie Bloomer and Samir Jeraj examine why infant mortality rates in England and Wales are on the rise.


Every week, Liz Morley fills baby baskets with nappies, clothes and toiletries for new parents who are unable to afford such essential items. Her organisation in Bolton, Baby Basics, has seen a significant increase in demand over the past year. 

“In 2018, we gave out 178 baskets to parents in need,” Morley says. “We have handed out 205 baskets so far this year already.” She says the reasons for the increase are varied, but believes that the introduction of the Universal Credit benefit and the growing trust that midwives have in her group are key factors. “[The midwives] don’t need to go and buy these things out of their own pocket now, as they might have in the past,” she says.

The organisation also provides mothers with labour bags so that they have a clean nightie, slippers and other items when they go into hospital to have the baby. “The goods we provide are the difference between mums having essential items and not, and babies having a safe space to sleep or not.”

Baby Basics previously helped a family of four who were all sleeping on one double mattress on the floor and has heard of several people using baby baths as beds as they are cheaper than cribs. 

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Poverty such as this during pregnancy and in the early days of a baby’s life can have a devastating impact. Infants are more than twice as likely to die if they are born into a poor family rather than a wealthy one. And the situation is getting worse. Figures by the Office for National Statistics (ONS) show that infant mortality rates in England and Wales have increased for the past three years, with the rates highest in the most deprived areas. 

In Manchester alone, the infant mortality rate has soared by 40% in the past decade. In an attempt to halt the rise, the local authority has introduced a new strategy to tackle the problem. Speaking earlier this year, Manchester’s director of population health and wellbeing, David Regan, said that the council’s plan would “focus on ensuring the best specialist knowledge is being applied to provide high quality and safe services, plus improving access to health advice and information”.

In nearby Wigan, the local health trust recently ran a scheme handing out baby boxes to new mothers in a bid to reduce the number of sudden unexpected infant deaths. The boxes, which contain items such as blankets and clothing, also provide a safe place for a baby to sleep.

Kathryn Ashton, a midwife feeding coordinator in the area, says that, because new mothers had to attend local centres to receive the boxes, it allowed health workers to reach more women earlier in their pregnancy. “We know the north west has high rates of infant mortality and we see more health issues in more deprived areas,” she says. “We wanted to reach these women before their baby was born.”

The healthcare think tank the Nuffield Trust says that poor maternal health, social inequality, smoking rates, obesity and a variation in the quality of antenatal care are all issues that affect the rate of infant deaths. “Previous improvements in smoking rates among pregnant women have slowed down and there are also more obese women attending antenatal appointments,” Nuffield Trust research analyst, Jessica Morris, says. 

“These could both be tackled with effective public health interventions. Our research shows that variation in the quality of care during and after childbirth, as well as wider social inequalities, are also all playing their part in why these figures are not going in the right direction. The fact remains that infant mortality rates in the most deprived areas of England remain much higher than those in the least deprived.”

In response to the release of the ONS figures earlier this year, the Royal College of Paediatrics and Child Health said that the rise was “extremely worrying”. Its president, Russell Viner, said that social inequalities are a major factor in causing infant deaths. “To address the UK’s dismal infant mortality rates, it is paramount that the Government take immediate steps to tackle social inequality and improve maternal and early years care,” he said. 

“Reducing maternal deprivation and providing properly funded supportive services to help women during pregnancy and early motherhood would begin to reverse these sobering statistics.”  

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