“The depth and breadth of this problem is hard to solve,” said Jennifer Bailer, co-lead of the Butler County Partnership to Reduce Infant Mortality, citing issues of poverty, unemployment and housing.
The Butler County partnership — formed last July — was one of nine urban communities to join the Ohio Equity Institute, formed by the Ohio Department of Health and CityMatCH, a national organization with expertise in maternal and child health, to improve overall birth outcomes and reduce racial and ethnic disparities in infant mortality.
Butler County had 43 infant deaths in 2013, and has lost a total of 216 infants since 2008, according to ODH.
The most common causes of infant deaths in Butler County are prematurity and sleep-related incidents, the local partnership determined through data analysis.
“Don’t sleep with your baby; it’s too much of a risk,” said Dr. Lisa Mannix, Butler County Coroner.
Mannix said she’s investigated nine infant deaths so far this year, with at least three being sleep related.
State legislation passed in June now requires coroners to submit to the Centers for Disease Control and Prevention a Sudden Unexplained Infant Death Investigation reporting form for each infant death investigated.
The eight-page report includes witness interviews, the infant’s medical and dietary histories, information on the mother’s pregnancy and details from the scene of the incident.
“The CDC is trying to gather more information. … In the hopes it will help us learn more and prevent future sleep-related deaths,” Mannix said.
Each of the nine communities within the Ohio Equity Institute have identified areas of focus to tailor their efforts for reducing infant deaths. The Journal-News reported in June the Butler County group identified a county-wide smoking cessation program; a Centering Pregnancy program; and safe-sleep education as the projects to implement over the next several years.
“As teams think of how they want their interventions to take shape, we are challenging them to aim for a population-level change … this is the only way we are going to move the needle on infant mortality,” said Monica Beltran, public health project coordinator at CityMatCH.
Centering pregnancy
The nonprofit Primary Health Solutions, operating three community health centers in Hamilton and Middletown, has plans to apply for a sizable grant to establish a local centering pregnancy program, once legislation is passed approving the funding sources.
Marc Bellisario, chief executive officer at Primary Health Solutions, said Senate Bill 279, poised to pass soon, will approve a pool of $1 million from the Governor’s Office of Health Transformation to four organizations over a three-year period.
The bill has several goals: to reduce low birth rates; reduce the preterm birth rate; increase breastfeeding rates; decrease smoking rates; and decrease the prenatal visit no-show rate, said Julie DiRossi-King, chief operating officer at Ohio Association of Community Health Centers, a trade organization representing 43 federally-qualified health centers.
“There’s so much room for improvement,” DiRossi-King said. “Ohio is the worst place for the birth of an African American baby.”
The bill was introduced in February and is currently sitting in the senate finance committee.
Smoking cessation
Bailer said there are five new smoking cessation programs that will start in January in Butler County, including Tobacco Treatment Specialist; Baby and Me Tobacco Free; NOT (Not on Tobacco) for high school-aged students; and the 5 A’s Intervention.
Larissa Loufman, co-lead for the smoking cessation group, said encouraging smoking cessation can reduce infant mortality due to the effects of tobacco leading to poor birth outcomes, including low birth weight, premature births and still births.
“Fortunately, smoking is one of the most preventable causes of infant mortality,” Loufman said. “If a woman decides to quit smoking before or during pregnancy, negative outcomes and risks can be reduced or eliminated.”
Safe sleep
Bailer said in the next month she and the coroner, Dr. Mannix, will reach out to first responders across Butler County, including emergency medical services and police and fire chiefs, to provide safe sleep education for passing out to families when they encounter an unsafe sleep environment.
Bailer said the safe sleep education emphasizes the importance of the ABC’s — the baby be put to sleep Alone; on their Back and in a Crib.
“Many have died because of co-sleeping arrangements where someone rolls over and suffocates the baby,” Bailer said.
Dr. Robert Lerer, a pediatrician and the Butler County Health Commissioner, said the biggest dangers to a baby after being born all relate to unsafe sleep environments, including sleeping with adults, having stuff inside the crib or sharing a sleeping space.
“Sleep issues kill more babies than any other single issue,” Lerer said. “We haven’t found a racial or socioeconomic thread; it crosses over cultural, racial and ethnic divides.”
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