Health Quality & Safety Commission | Lives saved but more action needed to prevent infant and child deaths
The Child and Youth Mortality Review Committee (CYMRC) estimates nearly 3000 lives have been saved in the past 20 years because of efforts to prevent sudden unexpected death in infants (SUDI).
A dramatic reduction in SUDI deaths has reduced the annual death toll from 200 to 60, which CYMRC attributes to a highly successful ‘back to sleep’ campaign.
The Chair of CYMRC, Dr Nick Baker, says those numbers, added up over two decades, represent a significant number of people still alive who might otherwise have died.
He is heartened by that and by the latest figures from Statistics New Zealand which show infant deaths and the infant mortality rate were at record lows in 2012. The full Statistics New Zealand media release is available at http://www.stats.govt.nz/browse_for_stats/population/births/BirthsAndDeaths_MRYeDec12.aspx.
However, he says the CYMRC’s latest special report, released today, shows more needs to be done to keep the most vulnerable members of New Zealand’s communities safe from harm. The report, Unintentional suffocation, foreign body inhalation and strangulation, is available on our website.
“There has been some fantastic work happening within communities and with health professionals and others in recent years, and this is having a positive impact on infant death rates,” he says. “At the same time, it’s clear that too many babies and young children are continuing to die from preventable harm, so the challenge to us all is to really take on board messages about the best ways to keep our children safe.”
The CYMRC report says death from traumatic asphyxia caused by suffocation is one of the three leading causes of unintentional injury deaths in New Zealand. The report looks at three main types of death: suffocation in the place of sleep, inhalation of food or foreign bodies, and external pressure on the neck or face.
Dr Baker says the report provides a tragic reminder of just how dangerous everyday objects such as curtain cords, ropes, pillows and mattresses can be.
“Things can change in an instant where babies and children are concerned,” he says. “It is not uncommon for deaths to occur when young ones are in unfamiliar surroundings, less actively supervised than usual, busy with other activities, or in the presence of intoxicated or distracted caregivers. This reinforces the importance of good routines and safety measures around children to ensure they are safe.”
The report says 50 of the 79 deaths it looked at arose from unintentional suffocation in bed, underlining the need to provide babies and young children with safe places to sleep.
“We were especially concerned to see that the rate of death in Maori and Pacific infants is significantly higher than for European infants,” says Dr Baker. “We’re not sure exactly why this is, although differences in the rate of smoking during pregnancy may be a factor. We know that infants exposed to cigarette smoke in pregnancy tend to be smaller and are more prone to suffocation.”
He says there are some very practical things people can do to help prevent SUDI, including putting babies to sleep on their backs, make sure their rooms are smokefree and not too hot, giving them plenty of room to breathe, and providing a sober caregiver.
The CYMRC report makes a number of recommendations which Dr Baker says support current government initiatives to improve support for vulnerable children, enhance smoking cessation programmes, put in place better systems to engage across the health system, increase the availability of safe sleeping spaces, encourage policies and staff training in district health boards (DHBs), and place greater emphasis on the safety of cots and bassinettes.
The CYMRC, which operates under the umbrella of the Health Quality & Safety Commission, reviews deaths of children and young people aged 28 days to 24 years, and provides advice on how to prevent further deaths.
Last year the Commission wrote to all DHBs asking them to prioritise the prevention of SUDI. In the report just released, CYMRC says it will convene a meeting of key agencies in product safety with a view to improving the flow of information about deaths and injuries, supporting enforcement of mandatory safety standards for cots and bassinettes, and providing cot safety information to both retailers and purchasers. It is also calling for better coordination across a range of government and other agencies and the inclusion of SUDI prevention messages in antenatal courses and other child injury prevention initiatives.
Dr Baker says information collected for the CYMRC report has already been used to influence new Ministry of Health choking guidelines, and is contributing to the development of training resources and safe-sleep programmes around New Zealand.
“Each number in this report represents a tragic loss for families and whanau around New Zealand, and we hope that our investigations of infant and child mortality, and our support for actions which aim to keep children safe, will help to prevent further deaths of these types,” he says.