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Cot deaths fall shows battle to save babies can be won
NHS bosses have unveiled a landmark blueprint to reduce health inequalities in Yorkshire and the divide is at its most stark in infant deaths. Health Correspondent Mike Waites reports in the last of a week-long series of articles on the plans.
THE death rate for babies has fallen in the past 15 years following the success of the "back to sleep" campaign which has dramatically reduced cot deaths by up to 50 per cent.
But there are still more deaths in Yorkshire than the national average which sees five babies in every 1,000 die before the age of one. In Yorkshire it is closer to six in every 1,000 – equivalent to about 42 additional lives.
Deaths are more common in deprived communities. Rates range from 7.7 per 1,000 in Bradford and seven per 1,000 in Kirklees to just 2.8 per 1,000 in Hambleton in North Yorkshire.
A baby boy born in the Heavy Woollen district around Dewsbury and Batley is three times more likely to die before his first birthday than one born in Ryedale in North Yorkshire.
Doctors believe there are a number of factors which help explain the death toll.
Liz Kernohan, a consultant in public health in Bradford where in-depth research into higher-than-average infant deaths is being carried out, said each was a tragedy.
The key lay in understanding the risks and in action to try to reduce them.
She said there were a number of complex factors which contributed to deaths during a child's first 12 months but these differed from area to area.
Mortality rates are at their lowest in parts of North Yorkshire where fewer women smoke during pregnancy, more mothers breast feed and mothers are less likely to be obese and more likely to eat better diets during pregnancy. There are also fewer teenage mothers.
Dr Kernohan said about a third of the difference between the best and the worst areas in Yorkshire was accounted for by lifestyle factors such as smoking during pregnancy – a habit an estimated 12,000 women fail to give up – and young mothers under 18 whose lives tended to be more chaotic.
A further 30 per cent of the difference was due to obesity, amid emerging evidence that women with weight problems, who are likely to eat foods which lack nutrition, have a direct impact on the later health of their children.
The remaining differences were more complex but included improved pre-conception planning to ensure mothers were in the best possible shape for pregnancy, reducing maternal and infant infections, and more breastfeeding.
A report in Bradford last year found there had been 21 infant deaths from severe infection including meningitis and septicemia over an eight-year period but two-thirds could have been avoided through breastfeeding, early management of illnesses, and immunisation.
Dr Kernohan said there was no simple strategy for reducing deaths and in many cases it would be a question of better public education to cut the risks rather than better standards of healthcare with measures involving many different agencies.
Long-term actions included improving infant nutrition, reducing poverty and better housing conditions.
"What we need to do on a local basis is to understand these issues in order to address them seriously," she said.
National guidance on the issue will be published in the spring.
Case study: The girl who survived being struck down twice
LINDA and Paul Bateman consider themselves lucky.
Their daughter Natalie was twice struck down with meningitis in the first three months of her life, but she survived.
Five years on and she is like any other youngster, enjoying school and riding her bike.
But her family who live in Scholes, Leeds, will never forget the day they came so close to losing her.
"She was our first child, she was so precious to us," said her mother, Linda.
"Then one morning she woke up screaming. Being new parents you don't know if you're over-reacting but I could tell something wasn't right."
Natalie was just three weeks old and her mother noticed she was not breathing normally.
"She sounded like she was groaning so I called the doctor and he came straight out. He knew straight away what it was, although he didn't tell us, and he gave her a life-saving penicillin injection."
Natalie was taken to hospital where doctors immediately carried out tests, which revealed she had contracted meningococcal B.
Her condition rapidly deteriorated and she was transferred to intensive care at St James's Hospital.
"It was awful," says Linda, a civil servant. "It was the worst time of our lives. I asked a doctor if she would live and she told me, 'I don't know'."
Thankfully, the quick thinking of the family doctor saved Natalie's life.
"If he hadn't given her that injection she probably wouldn't be alive today."
After spending two weeks in hospital she returned home. But a couple of months later the deadly virus returned.
"Her eyes started rolling back and I knew something wasn't right so I took her straight to hospital."
Doctors diagnosed meningitis and although it was not as severe as the first bout, it meant that Natalie spent her first Christmas in hospital.
She has since made a full recovery.
Linda wants other parents to be aware: "The important thing is to look out for symptoms like cold hands and feet, mottled skin and painful limbs. And if you're not sure, ring your doctor."
Meningitis Research Foundation runs a free 24 hour helpline on 080 8800 3344.
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Weather for Yorkshire
Saturday 26 May 2012
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