In 2016, 2.5 million babies died, almost 1 million of them during the first 24 hours after birth (WHO).
That sounds – overwhelming. Over 2 million parents are grieving the loss of a child in a year. Perhaps you’re reading this, and that number includes you – that was one or more of your babies. The numbers are staggering and leave most of us feeling helpless. How do we save that many babies, even if we just make that number smaller?
Because one child’s life saved matters to everyone.
While the statistics can be a lot to comprehend, the solutions are actually quite simple and affordable in most of these cases. Which is both a bit of a relief – there are solutions! – and also tends to make many of us angry to hear – because there are solutions.
Yet 2.5 million babies died anyway.
Recently I sat down with some infant, maternal and nutrition health experts from World Vision to ask them what we, in developed nations, can do to help bring this infant mortality rate down worldwide. In 2014, I had the honor of joining a World Vision Advocacy group to see their work in Zimbabwe with maternal and infant health, since Zimbabwe is one of the leaders in infant and under the age of 5 years mortality. World Vision works closely alongside communities in developing countries to help them make changes from the ground up in areas they may be struggling or need additional education in. Some countries most strong moves in their maternal and infant mortality rates have come because of World Vision’s helping to establish new standards and train locals to care for pregnant women and infants in a different way that may have been the norm prior.
Kathryn Reider, senior nutrition advisor with World Vision US, spoke on how initiation of breastfeeding is critical and yet in many countries, sadly overlooked. When I asked her what barriers were presented for this, she explained, “A lot of it would be around cultural barriers and that in some places you’ll find that feeding of colostrum, which is the first milk, is not seen as beneficial. But the very little amounts of colostrum that an infant gets in the first day is highly beneficial, so working in that space is particularly important for World Vision. Trauma and post-partum depression can both be significant. Post-partum depression is probably an area that doesn’t receive as much focus in less developed contexts. Not that it doesn’t happen, but it’s not an area where I think the expertise is as strong in addressing.”
Another issue we discussed is the healthy timing and spacing of pregnancies. When I traveled with World Vision to Zimbabwe, I talked with a couple of mothers who had lost children, and one of them said that after having a full-term stillbirth, she had come home and her community and family encouraged her to get pregnant as quickly as possible again and put it behind her. Not only did she not have time to grieve, but her body didn’t even have time to heal. I wondered how World Vision began to address this issue, something that I know many women in the US face as well – the push to move on.
Lisa Bos, World Vision Advocacy, explained that in an ideal situation, this is addressed right away and through follow-up generally with a community health volunteer or community health worker. The message of waiting at least 6 months is essential – from the emotional perspective, but the body needs time to recover, too. “We do try to make sure that the husband or male partner is also involved because so many of these issues tend to be cultural. Making sure that the male partner is involved in those conversations is extremely important. We’re also trying to involve faith leaders more. Sometimes that message about timing and spacing is better received if it’s coming from a pastor.”
I found this last bit particularly interesting as we don’t tend to rely on pastors for that kind of education/information here, but in other countries, those leaders are the backbone of the communities.
Alfonso Rosales, Maternal and Child Health Senior Advisor for World Vision US, talked to me about something near to my heart – premature babies. Since two of my three sons died at 20 weeks and lived for a short time, I wanted to know what happens when a child is born prematurely in a country where the nearest hospital might be a day’s walk or more.
He told me that prematurity is one of the leading causes of death among children. World Vision provides education on the use of Kangaroo Mother Care – specifically designed to take care of babies who do not have access to an incubator. This uses the body heat of the mother, skin-to-skin contact, to prevent hypothermia of a premature baby. “But,” he states, “skin to skin contact is not enough. We need to feed the baby. Premature babies who are not able to suck are not able to breastfeed. So these mothers need to know how to feed the baby with breastmilk with some sort of tools like a spoon or a syringe until the baby is able to breastfeed.”
I also learned one of the most critical issues for a newborn’s survival is the health status of the mother. Alfonso mentioned that when they talk about prematurity they also talk about low birth weight, which is that baby who is chronically malnourished when he or she is born – has a direct correlation with the nutritional status of the mother. So if the mother is malnourished, the chances that her newborn is going to be malnourished are higher, and then the likelihood of infant mortality is higher as well.
Many of these women deliver in their homes, and if they don’t have appropriate knowledge on how to manage a clean delivery then their child will be more vulnerable to infection.
Lisa agrees, telling us, “In many countries — especially when I’ve been in Africa — some women are delivering at a very basic health facility that may not have incubators, there may or may not be a doctor on staff. Such a resource-limited environment is the biggest impact on how premature of a baby could survive in some of these lower resource environments.”
I’ll be honest – at this point in the conversation, it was all I could do not to cry. I know what it feels like to deliver babies prematurely and helplessly watch as they die. I can only imagine doing that in your home, many as a teenager, desperately trying to keep your baby warm and clean while spoon feeding it.
The trauma that must leave on these women and their families is almost incomprehensible to me.
I was told about a New Mother and Baby Kit World Vision offers for purchase – with supplies so very basic that it tugs at your heart a bit:
- soap/chlorhexidine to clean the umbilical cord
- silver nitrate for the eyes
- clean towels
- a blanket for the baby – one of the leading causes of death among newborns is hypothermia
- clean clothes, so the baby is in a clean place
- working to ensure clean water
Lisa also shared that from an advocacy perspective, they’re making progress on under-five child survival; where they are not making progress is with newborns. And that’s impacted by the mother’s health and those first 1,000 days of life.
If we are frank, there will always be infant mortality. As hard as that is to accept. However, we – especially those of us who deeply know how losing a child feels – can make a difference to so many. We can be the change for a mother somewhere who may have a chance to raise her child, or just have the tools to provide a warm, clean spot to spend a few precious moments with her baby who won’t survive.
Here’s how we can help:
- Donate a New Mother and Baby Kit, and provide a new mother with the information and essential supplies she needs.
- Sponsor a child, and be part of a child’s life while contributing to World Vision’s community-level interventions.
- Use your voice, and be an advocate for the needs of mothers and infants.
- Learn more about the World Vision Health work information.
Learn about great investments being made by the US government, like USAID’s Helping Babies Breathe public/private partnership that focuses on newborn resuscitation.
Thank you to Lisa, Alfonso, Kathryn, Matthew, and World Vision for their work and their time in sharing with Still Standing about these crucial initiatives around the world for mothers and babies.
Main image ©2018 World Vision/photo by Jon Warren