Preparing for a lifetime toolkit

              Improving Infant Outcomes
Infant Mortality Data
What is infant mortality?
Infant mortality is defined as the death of a baby that is less than one year old. Infant deaths
are typically classified as neonatal or postneonatal. Neonatal deaths are those to infants who
die before 28 complete days of life; postneonatal deaths are defined as deaths to infants at
least 28 days but less than 365 days old.
How does Oklahoma compare to the rest of the United States regarding infant mortality rates?
One of the factors in considering a nation’s health status compared to other countries is its
infant mortality rate (IMR), which is the number of infant deaths per 1,000 live births.
The United States ranks 31st among the 34 industrialized countries in infant mortality.
Source: Organization for Economic Co-operation and Development (OECD). OECD Health Data 2010 - Version October 2010.
In 2007, Oklahoma ranked 46th in the United States with an IMR of 8.5. Oklahoma’s IMR
has consistently remained above the national rate since 1992. While some improvements have
been observed, the state’s IMR of 8.5 deaths per 1,000 live births for 2007 is no better than the
national average of 8.5 achieved over 15 years earlier.
How does Oklahoma compare to surrounding states?
Chart 1: National IMR Rankings
2007
National
Ranking
State IMR
– US Average 6.7
1 Washington 4.8
12 Colorado 6.1
13 New Mexico 6.2
14 Texas 6.2
40 Kansas 7.9
33 Missouri 7.4
46 Oklahoma 8.5
37 Arkansas 7.6
48 Louisiana 9.1
50 Mississippi 10.0
51 D.C. 13.1
Source: Xu JQ, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final date for 2007.
National vital statistics reports; vol 58 no 19. Hyattsville, Maryland: National Center for Health Statistics. 2010
What causes infant mortality?
The top three rankable causes of infant death in Oklahoma are:
• congenital malformations (medical condition present at birth)
• disorders related to short gestation (less than 37 weeks of completed pregnancy)
and low birth weight (less than five pounds, eight ounces)
• Sudden Infant Death Syndrome (SIDS)
NOTE: The leading cause of infant death for whites, American Indian/Alaska Natives, Asian/Pacific Islanders, and Hispanics is
“congenital malformations” while the leading cause of infant death for African Americans is “disorders due to short gestation
and low birth weight”.
Are there racial and ethnic disparities in IMR in Oklahoma?
Yes. The following shows IMR by race and ethnicity of the mother from 2003-2007.
Chart 2: Oklahoma IMR by Race, Ethnicity (2003-2007)
Statewide 8.1
Race/Ethnicity
White 7.1
African American 16.4
American Indian/Alaska Native 8.6
Asian/Pacific Islander 4.4
*Hispanic 7.1
What can I do to prevent infant mortality in Oklahoma?
There are many things that everyone can do to help ensure Oklahoma’s babies are safe and
healthy. Some are:
*Persons of Hispanic origin can be of any race and are mutually
exclusive from the other race categories
Source: Oklahoma State Department of Health, Center for Health
Statistics,Vital Records Division. OK2SHARE Online Database.
• Being healthy before and between
pregnancies greatly improves the chances
of having a healthy baby
• Having a full-term pregnancy (about
40 weeks) contributes to good birth
outcomes
• Breastfeeding offers a baby the best
nutrition for every stage of growth
• Getting tested and treated, if needed, for
sexually transmitted diseases promotes
a healthy pregnancy and birth
• Placing baby on his or her back to sleep
decreases the chances of Sudden Infant
Death Syndrome
• Avoiding exposure to secondhand smoke
contributes to strong and healthy babies
• Preventing injuries among infants will
keep them safe and secure
• Recognizing the signs and getting help
for postpartum depression can improve
health for both mother and baby
Preparing for a Lifetime, It’s Everyone’s Responsibility
http://iio.health.ok.gov
Maternal and Child Health Service - Oklahoma State Department of Health
1000 Northeast Tenth Street, Oklahoma City, OK 73117-1299
Phone 405-271-4480 Fax 405-271-2994
STOP BY, CALL
OR VISIT
OUR WEBSITE
AN EQUAL OPPORTUNITY EMPLOYER
This publication was issued by the Oklahoma State Department of Health, as authorized by Terry Cline, Ph.D., Commissioner of Health. 2,400 copies were printed as part of a set by Heritage Solutions in
May 2011 at a cost of $2,957.50. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Funding provided by the Title V Maternal and Child Health Block
Grant, Maternal and Child Health Bureau, Department of Health and Human Services.
Nursing Your Newborn
Strong & Healthy Begins
with Breastfeeding
Breastfeeding is Going Well When:*
• Your baby nurses 8 or more times in a
24-hour period (about every 2 to 3 hours)
• Your baby has at least 3 wet diapers a day during the first few days
and at least 6 wet diapers a day by the end of the first week
• Your baby has 3 or more yellow, loose bowel movements
a day by the end of the first week
• You can see your baby sucking and hear swallowing while nursing
• Your full breasts are softer after the baby nurses
• Your baby seems satisfied after nursing
Breastfeeding Benefits for Your Baby:
• Provides the best nutrition for your baby
• Contains the best nutrients that your baby needs for the first 6 months of life**
• Protects against illnesses such as ear and respiratory infections
• Decreases allergies
• Creates a special bond between you and your baby
• Supports brain development
• Lowers risks of obesity and diabetes
* These guidelines are for healthy term babies. For those with special needs or specific questions, please contact your healthcare
provider or call the Oklahoma Breastfeeding Hotline at 1-877-271-MILK (6455).
**The American Academy of Pediatrics recommends that all babies receive 400 IU of Vitamin D each day starting at birth.
After six months of age, your baby may have a need for fluoride. To check the fluoride level in your community’s water, view
My Water’s Fluoride at http://apps.cc.cdc.gov/MWF/Index.asp. Talk to your healthcare provider about the need for a vitamin
D or flouride supplement.
Adapted from “Nursing Your Newborn-Breastfed Babies are Healthier Babies” American Academy of Pediatrics New York Chapter 2
Nutrition Committee.
Tips for Successful Breastfeeding
• It’s best if your baby nurses within the first 1 to 2 hours after birth
• Skin-to-skin contact is good for your baby and can help increase your milk supply
• Nurse your baby every 2 to 3 hours
• Early and frequent breastfeeding will allow your milk supply to increase to meet your baby’s needs
• Do not give your baby water or formula unless directed by your healthcare provider
• Breastfeeding can take some work and practice to get you and your baby used to each other,
so give it some time
Breastfeeding Benefits for You
• Convenient
• Breastmilk is free
• Always readily available to feed your baby
• Helps you lose your pregnancy weight faster
• Helps your uterus return to its normal size faster
• Lowers your risk of breast and ovarian cancer
• May lower your risk of heart disease
Help is Available
• Your baby should be seen by a breastfeeding educated healthcare provider 2 to 5 days after
discharge and again at 2 to 3 weeks of age
• Your baby’s healthcare provider and your lactation consultant can provide help and support during
your breastfeeding experience
• Mothers and healthcare providers with breastfeeding questions can call the toll-free Oklahoma
Breastfeeding Hotline at 1-877-271-MILK (6455)
• For help and support, please call your local WIC Clinic or 1-888-655-2942
• For more information, visit the Oklahoma State Department of Health Breastfeeding Information
and Support Website: http://bis.health.ok.gov
Preparing for a Lifetime, It’s Everyone’s Responsibility
http://iio.health.ok.gov
Maternal and Child Health Service - Oklahoma State Department of Health
1000 Northeast Tenth Street, Oklahoma City, OK 73117-1299
Phone 405-271-4480 Fax 405-271-2994
STOP BY, CALL
OR VISIT
OUR WEBSITE
AN EQUAL OPPORTUNITY EMPLOYER
This publication was issued by the Oklahoma State Department of Health, as authorized by Terry Cline, Ph.D., Commissioner of Health. 4,000 copies were printed as part of a set by Heritage Solutions in
June 2010 at a cost of $10,500. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Funding provided by the Title V Maternal and Child Health Block
Grant, Maternal and Child Health Bureau, Department of Health and Human Services.
Pregnancy
and Infections
Vaginal infections have been linked with
pregnancy in the tubes (ectopic pregnancy),
preterm labor, babies born too early, and Pelvic
Inflammatory Disease (an infection in the uterus
and tubes) that can lead to problems getting
pregnant in the future. Babies born early have a
much higher chance of dying within the first year
of life. Since over 50 percent of pregnancies in
Oklahoma are not planned, it is important for
you to take steps to avoid getting an infection or,
if you have an infection, to get treated as soon
as possible.
If you are planning a pregnancy or are pregnant
and have ever had more than one sex partner or
have a partner that has had or currently has more
than one sex partner, please ask your healthcare
provider to test you early in your pregnancy.
Most likely your insurance will pay for testing.
If you change partners during your pregnancy
or suspect your partner has other partner(s),
please ask your healthcare provider to test again
during the pregnancy. The testing is simple
and often the infection is curable before delivery.
This will increase the chances for a healthy
pregnancy and a healthy baby.
Bacterial Vaginosis (BV): Vaginal infection is
common in sexually active women but is not
sexually transmitted. This infection is associated
with preterm labor, premature birth and uterine
infection if not treated. With this infection you
may notice an increase in vaginal discharge and a
fishy odor. More than half of all women with this
infection do not have any symptoms.
The following infections are sexually
transmitted and both you and your partner
need to be treated:
Chlamydia: Chlamydia is the most common
sexually transmitted infection. Both you and your
partner could have this infection and not know it.
You might have an increased discharge, pain with
sex or bleeding after sex. Untreated Chlamydia
infections in pregnant women can cause serious eye
and lung infections in babies after they are born.
Gonorrhea: Gonorrhea is the second most
commonly reported sexually transmitted infection.
This infection can cause the same symptoms
as Chlamydia or cause no symptoms at all. A
pregnant woman can transmit the infection to
her baby during delivery causing blindness, joint
infection or a life threatening blood infection.
Herpes: Genital Herpes is a sexually transmitted
infection that usually causes blisters in the genital
area and flu-like symptoms. The blisters or
“outbreaks” can come back at any time after the
first infection. A pregnant woman with blisters
during the last few weeks of pregnancy, can pass
the infection to her baby. Herpes infections can
cause death in newborns.
Human Immunodeficiency Virus (HIV): HIV
is the virus that causes AIDS. This virus may be
passed from one person to another through
infected blood, semen, vaginal secretions, or
breast milk. HIV can be sexually transmitted or
can be transmitted from mother to baby during
pregnancy. It is very important that you know your
HIV status. Every pregnant woman should receive
HIV testing early in her pregnancy and again
before delivery. A pregnant woman with HIV can
reduce the risk of transmitting HIV to her baby to
as low as 2 percent with proper care and treatment
from a physician. However, without treatment
the risk of transmission from you to your baby is
25 percent. As a pregnant mom making healthy
decisions for you and your unborn baby, knowing
your HIV status is vital.
Human Papillomavirus (HPV): HPV infection is
a sexually transmitted infection causing genital
warts and cervical cancer. This infection is caused
by a group of viruses with more than 100 different
strains or types. A baby exposed to one of these
viruses during delivery can develop warts in the
throat or voice box.
Syphilis: Syphilis is a sexually transmitted
infection, but many people infected with syphilis
do not have any symptoms for years. This
bacterium can cross the placenta and infect a baby
before it is born. An infected baby may be born
dead or may be born without signs of infection
but develop serious problems within a few weeks
(learning problems, seizures, or death).
Hepatitis B: Hepatitis B is a virus that attacks the
liver. All women should be tested for this virus
when they have their prenatal lab work done.
Most women who have Hepatitis B do not even
know they are sick. There are many ways you
can get Hepatitis B. You may have gotten it from
your mother when you were a baby. It can be
transmitted sexually or through blood or blood
products. It can also be transmitted if you use
intravenous drugs or “shoot up”.
If you have the virus, your baby will need to be
given the Hepatitis B vaccine at birth and another
shot, called HBIG that helps the baby’s immune
system. If your baby receives these shots there
is less than a 15 percent chance your baby will
become infected.
Trichomoniasis (Trich): Trich is a common
sexually transmitted infection. With this infection,
you may have an increased yellow-green vaginal
discharge with itching and a foul odor. Pregnant
women with Trich may have babies who are born
early or weigh less than five pounds.
For more information on HIV, call the Perinatal HIV Hotline/National Perinatal
HIV Consultation and Referral Service at 1-888-448-8765 or the National HIV Testing
Resources at the Centers for Disease Control and Prevention (CDC-Info, 24 hours/
day) at 1-800-232-4636 or visit http://www.hivtest.org.
Preparing for a Lifetime, It’s Everyone’s Responsibility
http://iio.health.ok.gov
Maternal and Child Health Service - Oklahoma State Department of Health
1000 Northeast Tenth Street, Oklahoma City, OK 73117-1299
Phone 405-271-4480 Fax 405-271-2944
STOP BY, CALL
OR VISIT
OUR WEBSITE
AN EQUAL OPPORTUNITY EMPLOYER
This publication was issued by the Oklahoma State Department of Health, as authorized by Terry Cline, Ph.D., Commissioner of Health. 4,000 copies were printed as part of a set by Heritage Solutions in
June 2010 at a cost of $10,500. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Funding provided by the Title V Maternal and Child Health Block
Grant, Maternal and Child Health Bureau, Department of Health and Human Services.
Your Baby’s Safety
Crib
• Place baby to sleep on back (Reduces
danger of sudden infant death syndrome
(SIDS))
• Keep crib or bassinet side up so baby
is protected from pets, other children
and falls
• Keep crib clear of loose blankets, bumper
pads, toys, pillows and strings
Baby’s Bath
• Non-slippery surface
• Shallow water, test temperature on wrist
• Hold baby’s head up with arm around
back of neck
• If you feel tired or ill, give baby a
sponge bath
• Never leave baby alone or with siblings,
not even for a second
Dressing or Changing Baby
(table, crib or floor)
• Do not leave baby alone on an
elevated surface
• Keep powder, lotion, or other uncovered
materials, caps, small objects, strings and
jewelry etc. out of baby’s reach
• Place arms and legs carefully into
clothing, without bending out of
normal position
Car Safety
• Use directions for installing car seat
securely or have installed by
trained person
• Use rear-facing infant car seat and place
in back seat of vehicle
• Vehicle should be safe and in good
condition
• Baby must always be in properly buckled
car seat, which should be reclined
• Keep objects in car secured so as not to
injure baby during sudden stops
Carriage/Stroller
• Strong and stable so it will not tip over
• Baby securely placed and strapped
• At this age, stroller back should be
reclined at about 45° (Keeps chin off of
chest and airway from being blocked)
• Keep face clear of blankets for breathing
Back or Front Carry Pack
• Correct size and material for age of baby
• Keep baby’s head supported
• Check that baby does not slide inside and
have trouble breathing
• Make sure pack is tied securely to person
carrying baby
Safety – Environment
• Do not smoke or take drugs or alcohol
• Do not drink or handle hot liquids while
holding baby
• Keep area around baby clear of food,
toys, small items, strings, jewelry
• Maintain a functioning smoke alarm
• Keep home clean and temperature
about 70°
• Learn infant CPR
• Keep nearby emergency phone numbers
for your child’s pediatrician, the
ambulance service, local emergency
room, local hospital, fire station, Poison
Control and your nearest relative handy
Crib
• Firm mattress that fits close to crib sides
• Crib slats/bars not farther apart than
2 3/8 inches
• No pillows, toys, loose blankets, or
bumper pads
Bassinet/Cradle
• Firm, thin mattress with no space
between it and the sides
• Sides high enough so baby cannot fall out
• Stable and cannot be knocked over
• Cradle that cannot swing high enough
to overturn
Dressing or Changing Baby
(table, crib or floor)
• Uncluttered, firm surface
• Stable, not slippery
Bathing Baby (in baby tub, tub placed in
big tub or regular bathtub)
• Non-slippery surface
• Do not use baby bath seat because it can
tip over easily
• Never leave baby alone or with siblings,
not even for a second
Playpen
• If has slats, no wider than 2 3/8 inches
apart
• If net, closely woven
• Sturdy, sides cannot collapse
• Firm cushion, no bumper pads
Infant Car Seat
• Use seat approved by federal agency
• Know history of used seat – cannot have
been in a crash
• Install rear-facing, 45° angle
• Install in back seat of vehicle
• Use directions in car seat manual to
install car seat securely or have it installed
by a trained person
Infant Carrier (cannot use as car seat)
• Plastic with cushioned lining
• Baby should be belted in
• Use only for infants 1-6 weeks because it
tips easily when baby moves
• Cannot be used on shopping cart unless
belted/attached
Safety – Environment
• Mother, or anyone around her, should
not use alcohol, drugs, or tobacco
• Rest and eat a healthy diet
• Keep floors and stairs clear/good
condition
• Maintain home temperature at
around 70°
Preparing for Your Baby’s Safety
Items to Prepare 2-3 Months before Expected Delivery –
Places Where Baby will Spend the Most Time
Birth to Two Months
Write down all the new physical, language and social advances baby has made. If your baby was born early or has a disability, carry out the
doctor’s orders and advice on how to care for your child.
Preventing Baby From Falling
• Lower crib mattress to keep baby from
falling out over sides
• Keep crib free of stuffed animals and toys
so baby will not stand up on them
• Support baby when sitting up to prevent
head or neck injury
• Always keep one hand on baby when the
baby is on high surfaces (changing tables,
beds, sofas)
• When using carrier in shopping carts,
hold baby in with belt and secure carrier
to cart or else both carrier and baby
could fall out
• Children must be seated and watched
carefully if allowed to hold baby
• If you use a swing, it must be stable; baby
must be belted in so as not to fall
Vehicle Safety
• Continue using rear-facing safety seat
properly secured in back seat of car;
never in front seat
• While baby is in vehicle, do not prop a
bottle and keep small objects, cords and
plastic bags out of reach
• Keep siblings from giving baby their toys
Play Pen (A safe place for baby)
• If it has slats, must be less than 2 3/8
inches; if it has net sides, holes must be
less than ¼ inch
• No stuffed animals, plastic bags, or
pillows in play pen
• Playpen floor must be secure and strong
with firm padding
Keeping Baby Safe Around Water
• Always supervise babies around water
• Test bath water on your wrist to make
sure it is not too hot for baby
• Do not leave alone or with siblings in tub
or bathing area, even when baby is able
to sit
• Remember, babies can drown in less than
an inch of water in a few seconds
• Keep pails, cups and other containers
with liquid away from baby
• Do not give baby water-filled plastic bags,
gloves, or balloons
Keeping Environment Safe for Baby
• Check smoke alarm every month
• Make a plan for family to escape home in
case of smoke or fire
• If baby is burned with hot solid or liquid,
apply cool water and call doctor
• If baby falls or head is bumped, watch
for unconsciousness, vomiting, unusual
behavior. If so, call doctor or take to
emergency room.
• Remember never to shake a baby because
the brain can be injured
• Baby proof home with outlet plugs,
door locks
• Call Poison Control (1-800-222-1222) or
bring baby to emergency room if baby
swallows poisonous material and tell what
poison is suspected
Two to Six Months
Baby begins moving more, pushing, pulling, rolling over, getting caught in things nearby, or falling off high places. Baby also is putting
hands and things in mouth. Begin child-proofing your home.
Six to Twelve Months
Baby grows and develops rapidly. New personality and physical changes can be seen each day. Baby can sit, crawl and stand and will fall
often. Home must be made safe.
Preventing Falls
• Install sturdy gates at top and bottom
of stairs
• Install operable window guards
• Keep space in front of windows free of
chests, tables
• Do not allow baby to crawl onto furniture
• Never use a baby walker because it may
tip over or fall down the stairs
• Keep play area clear of hard, sharp-edged
objects and toys and furniture
• If baby falls, check that baby is alright
before picking baby up. If baby acts
differently, call the doctor or take to
emergency room.
Bathroom Safety
• Keep baby away from bathroom by
keeping the door closed
• Keep toilet lid down
• Keep free of pails or other water
containers
• Keep water heater lower than 120°
• Bathe baby on a non-slippery surface and
hold neck and head up
Safety Habits to Prevent Suffocating
and Choking
• Stay with baby while baby is eating
• Do not give baby food that could cause
choking (peanuts, popcorn, carrots,
grapes, hotdogs)
• Learn how to remove food or other items
from choking baby
• Learn CPR and first aid
• Keep baby’s crib away from windows,
curtains and cords from blinds. Tie cords
should be kept high and out of reach.
• Remove labels from stuffed toys
• Remove mobiles from crib because baby
can reach parts, pull and put into mouth
Kitchen Safety
• Keep baby away from kitchen, especially
while cooking
• Do not use the microwave to heat baby’s
milk bottles to avoid internal burns
• Place baby in a safe place nearby
(playpen, low highchair) when you
cook or work in kitchen
• Keep baby away from stoves, refrigerators
and hot appliances
• Keep pans toward back of stove; turn
handles inward
• Do not hold baby and work with the stove
at the same time
• Keep waste baskets closed and out
of baby’s reach
• Keep small fire extinguisher available
in kitchen
• If child is burned, apply cool water and
loose bandage and call 9-1-1
Child-Proofing Home for Safety
• Keep matches and lighters away
from children
• Do not keep guns or firearms in the
home, or keep guns unloaded, with a
safety device and stored in a locked place
• Throw away all water, chemicals and
other mixtures after use
• Check smoke alarm batteries monthly
• Keep tool chests locked so baby will not
be caught or injured
• Keep baby out of garage and basement
• Apply child-proof latches to cabinets
Preparing for a Lifetime, It’s Everyone’s Responsibility
http://iio.health.ok.gov
Maternal and Child Health Service - Oklahoma State Department of Health
1000 Northeast Tenth Street, Oklahoma City, OK 73117-1299
Phone 405-271-4480 Fax 405-271-2994
STOP BY, CALL
OR VISIT
OUR WEBSITE
AN EQUAL OPPORTUNITY EMPLOYER
This publication was issued by the Oklahoma State Department of Health, as authorized by Terry Cline, Ph.D., Commissioner of Health. 4,000 copies were printed as part of a set by Heritage Solutions in
June 2010 at a cost of $10,500. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Funding provided by the Title V Maternal and Child Health Block
Grant, Maternal and Child Health Bureau, Department of Health and Human Services.
Prescription for
a Healthy Future
• Take a multivitamin
with 400 mcg of folic
acid every day to
prevent birth defects
and reduce the risk of
certain cancers. Foods
that contain folic acid
are beans, leafy green
vegetables, orange juice and fortified/
enriched breads and cereals.
• Eat a variety of nutritious foods every day;
avoid foods high in fat and sugar; cut back
on caffeine
• Talk with your healthcare provider to learn
your healthy weight and ways to reach it
• See your healthcare provider and dentist
before becoming pregnant
• Wash your hands often. Some infections harm
a growing baby.
• Find out if you have a sexually transmitted
disease (STD)
• Ask your healthcare provider about screenings
for STDs and Human Immunodeficiency Virus
(HIV)
• Stop smoking. Smoking while you are
pregnant puts your baby at greater risk for
being born prematurely or too small.
• Stop using drugs and alcohol. Beer, liquor,
wine and wine coolers can cause your baby
to have lifelong problems such as Fetal
Alcohol Spectrum Disorders (FASD), which
may include physical, mental, behavioral and
learning problems. Using or abusing legal
and illegal drugs may also result in physical,
mental, behavioral and learning problems
in babies.
• Talk with your family members about their
health conditions or those that run in your
family
• Have a healthy relationship with your partner.
Talk to your healthcare provider if you are in
an abusive relationship.
• Manage stress. Stress can increase the risk of
preterm labor and low birthweight.
Prescription for a Healthy Future
- Females -
Prescription for a Healthy Future
- Males -
___ Take a multivitamin with at least 400 mcg
of folic acid daily
___ Eat right and maintain a healthy weight
___ Engage in physical activity on most days
of the week
___ Quit smoking and avoid secondhand smoke
___ Get help for alcohol and/or drug problems
___ Schedule regular health and dental check-ups
___ Schedule pap smear, mammogram, colon
and other screenings as recommended by
your doctor
___ Get any health problems under control
___ Practice abstinence or, if sexually active,
use birth control
___ Use latex condoms to reduce the risk
of sexually transmitted diseases
___ Limit exposure to hazardous chemicals
___ Talk with your family members about their
health history
___ Reduce stress in your life
___ Learn to recognize signs of an abusive or
violent relationship and talk with someone
you trust
___ Plan for a healthy pregnancy when and if you
want a baby
___ Take a multivitamin with at least 400 mcg
of folic acid daily
___ Eat right and maintain a healthy weight
___ Engage in physical activity on most days
of the week
___ Quit smoking and avoid secondhand smoke
___ Get help for alcohol and/or drug problems
___ Schedule regular health and dental check-ups
___ Schedule testicular, prostate, colon and other
screenings as recommended by your doctor
___ Get any health problems under control
___ Practice abstinence or, if sexually active,
use condoms
___ Use latex condoms to reduce the risk of sexu-ally
transmitted diseases
___ Limit exposure to hazardous chemicals at
home and at work
___ Talk with your family members about their
family health history
___ Reduce stress in your life
___ Learn to recognize signs of an abusive or
violent relationship and talk with someone
you trust
___ Plan with your partner for a healthy
pregnancy when and if you want a baby
Preparing for a Lifetime, It’s Everyone’s Responsibility
http://iio.health.ok.gov
Maternal and Child Health Service - Oklahoma State Department of Health
1000 Northeast Tenth Street, Oklahoma City, OK 73117-1299
Phone 405-271-4480 Fax 405-271-2994
STOP BY, CALL
OR VISIT
OUR WEBSITE
AN EQUAL OPPORTUNITY EMPLOYER
This publication was issued by the Oklahoma State Department of Health, as authorized by Terry Cline, Ph.D., Commissioner of Health. 4,000 copies were printed as part of a set by Heritage Solutions in
June 2010 at a cost of $10,500. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Funding provided by the Title V Maternal and Child Health Block
Grant, Maternal and Child Health Bureau, Department of Health and Human Services.
Recognizing Postpartum
Depression
What is Postpartum Depression?
Postpartum depression (PPD) can be disabling for a new
mother. PPD is a type of major depression that affects
about one in 10 new mothers within the first year after
childbirth. Postpartum depression has the potential to
negatively impact a new mother’s health and her ability
to care for and nurture her infant.
New mothers most commonly experience what is known as ‘the baby blues.’ Up to 70 to 80 percent
of new mothers experience this. Baby blues are normal reactions following childbirth triggered
by hormonal changes and stress that having a baby brings. Characterized by mood swings, mild
sadness, irritability and some worry, the baby blues usually occur around 3 – 5 days after delivery
and tend to subside as hormone levels begin to stabilize. The baby blues differ from PPD in
that the symptoms tend not be severe, do not need treatment and generally do not last beyond
two weeks.
A woman with PPD experiences the symptoms much more strongly and can be impaired to the
point where she is unable to do the things she needs to do every day. PPD can begin at any time
within the first year after giving birth and lasts longer than the blues. While PPD is a serious
condition, it can be treated successfully with medication and counseling.
Symptoms of Postpartum Depression
The following symptoms of PPD may mean that a mother is experiencing something more serious
than the baby blues. Multiple symptoms that do not go away or thoughts of suicide may mean the
mother could need an evaluation by a physician or mental health professional.
Emotions
• Increased crying and irritability
• Hopelessness and sadness
• Uncontrollable mood swings
• Feeling overwhelmed or unable
to cope
• Fear of harming the baby, her partner
or herself
• Fear of being alone
Behaviors
• Not having any interest in the baby
or overly concerned for it
• Poor self-care
• Loss of interest or pleasure in activities
• Decreased energy and motivation
• Withdrawal or isolation from friends
and family
• Inability to think clearly or
make decisions
Physical Symptoms
• Exhaustion, sluggishness and fatigue
• Sleep and appetite disturbances not
related to care of the baby
• Headaches, chest pains,
hyperventilation, heart palpitations
Risk Factors
Certain factors may increase a new mother’s risk of depression during and after pregnancy.
Detection of risk factors early is critical to preventing postpartum depression. The following
represent possible risk factors:
In Oklahoma
• One in four Oklahoma mothers suffer from key
symptoms of postpartum depression between two
and six months postpartum
• Approximately 40 percent of all Oklahoma
mothers reported that their healthcare provider
did not discuss postpartum depression in their
prenatal care
• Women ages 20 – 24 were twice as likely to
indicate symptoms of depression when compared
to women ages 35 or older; adolescents (under
20) were 2.5 times as likely
• Stressors found to increase the risk of depression
symptoms were having an unintended pregnancy,
arguing with a partner more than usual during
pregnancy and having bills one could not pay
• A personal history of depression or another
mental illness or substance abuse
• A family history of depression or another
mental illness
• A lack of support from family and friends
• Anxiety or negative feelings about the pregnancy
• Previous pregnancy, birth or postpartum difficulties
• Marriage or money problems
• Stressful life events
• Young and/or single mother
• Complications during labor/birth
• Low confidence as a parent
• Problems with baby’s health
• A major life change at same time as birth of baby
Mental Health Association
Toll Free 1-800-969-NMHA(6642)
TTY 1-800-433-5959 http://www.nmha.org
Postpartum Support International (PSI)
National hotline 1-800-944-4PPD www. Postpartum.net
Oklahoma Department of Mental Health
and Substance Abuse Services
http://www.odmhsas.org
Reachout hotline 1-800-522-9054
Sources:
US Department of Health and Human Services, Office on Women’s Health:
http://www.womenshealth.gov/faq/depression-pregnancy.pdf
Oklahoma Pregnancy Risk Assessment Monitoring System, v. 12 no. 2 Spring 2008
For more information contact:
Preparing for a Lifetime, It’s Everyone’s Responsibility
http://iio.health.ok.gov
Maternal and Child Health Service - Oklahoma State Department of Health
1000 Northeast Tenth Street, Oklahoma City, OK 73117-1299
Phone 405-271-4480 Fax 405-271-2994
STOP BY, CALL
OR VISIT
OUR WEBSITE
AN EQUAL OPPORTUNITY EMPLOYER
This publication was issued by the Oklahoma State Department of Health, as authorized by Terry Cline, Ph.D., Commissioner of Health. 3,000 copies were printed as part of a set by Heritage Solutions in
May 2011 at a cost of $2,957.50. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Funding provided by the Title V Maternal and Child Health Block
Grant, Maternal and Child Health Bureau, Department of Health and Human Services.
Facts About Preterm Birth
Preterm Birth:
• A birth that occurs before 37 completed
weeks of pregnancy
• A full-term pregnancy lasts about 40 weeks,
more than nine months
In an average week in Oklahoma:
• 1,039 babies are born
• 144 babies are born preterm
• 87 babies are born low birthweight (<2,500 grams)
• 8 babies die before their first birthday
Prematurity Facts
• In the United States, 12.8 percent of babies are born preterm (500,000 per year)
• In Oklahoma, 13.9 percent of babies are born preterm (one in seven)
• The rate of preterm birth is highest for African American infants, 20.1 percent in Oklahoma
• Most preterm babies are born between 34 and 36 weeks, 71 percent
Source: Final data for 2006. National vital statistics reports; vol 57 no 7. Hyattsville, MD: National Center for Health Statistics, 2009
Who is at risk for preterm birth?
Three groups of women have the highest risk
for preterm birth:
• Women who have had a preterm baby before
• Women who are pregnant with twins, triplets or more
• Women with some abnormalities of the uterus or cervix
Some medical conditions may increase the risk
for preterm birth:
• High blood pressure
• Infections
• Diabetes
• Short time between pregnancies
• Obesity
The way you live may increase the risk for preterm
birth:
• Smoking
• Drinking alcohol
• Using illegal drugs
• Taking some medications
• Not getting prenatal care
• Domestic violence
• Lack of social support
• High stress
• Long working hours or long periods of standing
What medical complications are common in
premature babies?
• Babies born too soon may have problems with breathing,
bleeding in the brain, heart problems, intestinal
problems and other problems
• Premature babies have not finished developing when
they are born. This is true for all of their organ systems,
including the brain
• The last few weeks of pregnancy are very important for
brain development
• Babies born too soon may have more learning and
behavior problems than babies born at 40 weeks
• Premature babies are more likely to have cerebral palsy,
mental retardation, vision problems and hearing loss
than babies born at 40 weeks
What are the costs of U.S. preterm births?
• The emotional costs to a family of having a preterm
baby are high
• Direct healthcare costs to employers in the first year of
life for a premature infant are about $49,033 compared
to $4,551 for a full-term infant without complications
• Direct healthcare costs to employers for maternal health
care for a premature birth are $18,419 compared to
$10,499 for a full-term birth
• The annual economic burden of preterm birth is
estimated to be $26.2 billion
What can be done to prevent preterm births?
Some causes of preterm birth cannot be changed,
but women who are healthy during pregnancy are
more likely to have a healthy baby. A woman can:
• Plan pregnancies, be healthy and see a doctor before she
gets pregnant
• Get prenatal care before 10-12 weeks and keep all
appointments
• Stop smoking, drinking alcohol and taking illegal drugs;
avoid secondhand smoke
• Take vitamins
• Eat healthy - lots of fruits and vegetables. Avoid excess
sugar and fat
• Maintain a healthy weight before and during pregnancy
• Know the signs of preterm labor
• Avoid scheduling the time of the baby’s birth unless
there is a medical reason to deliver early
• If you do schedule the baby’s birth, wait until you are at
least 39 weeks
Information from the March of Dimes and the Institute
of Medicine. Preterm Birth: Causes, Consequences, and
Prevention. National Academy Press: Washington, D.C.,
2006.
Every Day Makes A Difference
In Your Baby’s Development
To find out more about preterm birth:
• Visit the March of Dimes website at:
www.marchofdimes.com
Preparing for a Lifetime, It’s Everyone’s Responsibility
http://iio.health.ok.gov
Maternal and Child Health Service - Oklahoma State Department of Health
1000 Northeast Tenth Street, Oklahoma City, OK 73117-1299
Phone 405-271-4480 Fax 405-271-2944
STOP BY, CALL
OR VISIT
OUR WEBSITE
AN EQUAL OPPORTUNITY EMPLOYER
This publication was issued by the Oklahoma State Department of Health, as authorized by Terry Cline, Ph.D., Commissioner of Health. 4,000 copies were printed as part of a set by Heritage Solutions in
June 2010 at a cost of $10,500. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Funding provided by the Title V Maternal and Child Health Block
Grant, Maternal and Child Health Bureau, Department of Health and Human Services.
Safe Sleep for Your Baby
Protect Your Baby From Unsafe
Sleep Deaths And Injuries
The American Academy of Pediatrics (AAP)
guidelines for reducing the risk of Sudden Infant
Death Syndrome (SIDS) recommend using a
separate but close sleeping environment for
babies. The AAP also notes that it is appropriate
to take the baby to bed for nursing, comforting,
and bonding, but after the baby is nursed the baby
should be returned to a separate crib or bassinet
sleeping space.
If you bring your baby to bed to nurse
or comfort:
• Make sure your bed has a firm mattress, with no
heavy blankets, comforters or pillows that could
cover your baby’s face or make the baby hot
• Make sure that your mattress fits tightly against
the headboard and the sides are at least two feet
away from the wall
To keep your baby safe, make sure no one
in the bed:
• Is very tired or a heavy sleeper
• Is extremely overweight
• Smokes
• Has been drinking
• Has taken medications (illegal, prescribed,
or over-the-counter) that could make
them sleepy
How should baby be placed for sleep?
• Always place your baby on his or her back to
sleep at all times, even for naps, unless baby’s
doctor tells you to do something different for the
baby’s health
• Placing baby on the side or stomach increases the
chances of SIDS
• Tell everyone caring for your baby to place baby
to sleep on the back at all times, even for naps
Where is the safest place for baby
to sleep?
Doctors agree that the safest place for baby to sleep
is in your room in a separate sleep area.
• Keep baby’s bed right next to your bed so it is easy
to put baby in the crib, portable crib, or bassinet
after feeding
How do I make baby’s bed safe?
Baby’s bed should have:
• Railings that are no more than 2 3/8 inches
apart (a soda can will not fit through railings)
• A firm mattress that fits snugly in the frame with a
fitted sheet that is tight around the mattress
Do not use:
• Bumper pads
• Quilts
• Comforters
• Duvets
• Blankets
• Stuffed animals
• Sheepskins
These items are dangerous and can result in
suffocation or strangulation
How should baby be dressed for sleep?
• Do not overheat or overdress baby
• Make sure your baby’s head and face remain
uncovered during sleep
• Keep the room temperature comfortable
for a lightly clothed adult (68° to 72°)
• Your baby should be in a one-piece sleeper with
nothing over him
• If it is cold, layer the baby’s clothing. For example,
add a tee-shirt and socks under his or her sleeper.
Use only a light blanket, if necessary.
What else can I do to keep my
baby safe?
• Do not smoke or allow anyone else to smoke in
the house, car, or anywhere your baby will be.
Secondhand smoke increases baby’s risk
of SIDS.
To keep baby from being smothered, make sure
baby does not sleep in an adult bed, futon, sofa, chair,
or recliner because:
• Baby can roll out of your arms, become trapped
and suffocate
• An adult, child, or pet can roll over on the baby
without meaning to
• Baby can get caught between the bed and
the wall and smother
• Baby can smother next to or under a pillow,
bumper pads, or bed covers
Provide tummy time for play and exercise while
baby is awake and being watched.
Preparing for a Lifetime, It’s Everyone’s Responsibility
http://iio.health.ok.gov
Maternal and Child Health Service - Oklahoma State Department of Health
1000 Northeast Tenth Street, Oklahoma City, OK 73117-1299
Phone 405-271-4480 Fax 405-271-2994
STOP BY, CALL
OR VISIT
OUR WEBSITE
AN EQUAL OPPORTUNITY EMPLOYER
This publication was issued by the Oklahoma State Department of Health, as authorized by Terry Cline, Ph.D., Commissioner of Health. 4,000 copies were printed as part of a set by Heritage Solutions in
June 2010 at a cost of $10,500. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Funding provided by the Title V Maternal and Child Health Block
Grant, Maternal and Child Health Bureau, Department of Health and Human Services.
Smoking & Pregnancy
When you are pregnant, the things you do affect your
unborn child. Smoking – or even being around other
people who smoke – exposes your baby to harmful
chemicals that can have a lifelong impact. No matter
how far along you are in your pregnancy, your baby
will be healthier if you quit.
By quitting smoking you can:
• Reduce the risk of miscarriage
• Reduce the number of colds that both you and your
baby have
• Avoid having your baby go through nicotine
withdrawal at birth
• Decrease your baby’s risk of sudden infant death
syndrome (SIDS)
• Assure your breast milk will be healthier for your
baby
• Increase the chance of your baby having healthier
lungs
• Increase the amount of oxygen your baby gets,
helping the baby grow
• Reduce the chance that your baby will be born too
early, before the lungs and other organs are fully
formed
• Save money to buy more things for your baby – and
yourself
When you are pregnant and smoke:
• Your baby receives less oxygen which will slow
your baby’s growth
• Your baby’s lungs may develop slower
• Your baby could develop asthma, allergies
and other lung problems
• Your baby could suffer from attention deficit
hyperactivity disorder (ADHD)
The Oklahoma Tobacco Helpline is here to
help you quit. Even if you have tried before,
there are new tools and medications that can
help you quit tobacco for good.
When you call the Helpline you:
• Receive free one-on-one quit coaching with a
highly trained quit coach
• Receive specialized help if you are a pregnant
or postpartum caller
Call Today!
Secondhand
smoke
and children
According to the Surgeon General:
• Because their bodies are developing, infants and
young children are especially vulnerable to the
poisons in secondhand smoke
• Both babies whose mothers smoke while pregnant
and babies who are exposed to secondhand smoke
after birth are more likely to die from sudden
infant death syndrome (SIDS) than babies who are
not exposed to cigarette smoke
• Mothers who are exposed to secondhand smoke
while pregnant are more likely to have lower birth
weight babies, which makes babies weaker and
increases the risk for many health problems
• Babies whose mothers smoke while pregnant
or who are exposed to secondhand smoke after
birth have weaker lungs than other babies, which
increases the risk for many health problems
• Secondhand smoke exposure causes acute lower
respiratory infections such as bronchitis and
pneumonia in infants and young children
• Secondhand smoke exposure causes children who
already have asthma to experience more frequent
and severe attacks
• Secondhand smoke exposure causes respiratory
symptoms, including cough, phlegm, wheezing,
and breathlessness, among school-aged children
• Children exposed to secondhand smoke are at
increased risk for ear infections and are more
likely to need an operation to insert ear tubes for
drainage
• Children aged 3-11 years, who are exposed to
secondhand smoke, have cotinine levels (a
biological marker for secondhand smoke exposure)
more than twice as high as nonsmoking adults
• Children who live in homes where smoking is
allowed have higher cotinine levels than children
who live in homes where smoking is not allowed
The Surgeon General also concluded that there is
no safe level of secondhand smoke exposure and
eliminating smoking in indoor spaces is the only way
to fully protect children from exposure to secondhand
smoke. A primary source of children’s secondhand
smoke exposure is in their homes and vehicles.
Secondhand smoke permeates the entire house and
lingers long after the cigarette has been extinguished,
so smoking in certain rooms, at certain times, or by a
window or fan is not safe.
What You Can Do To Protect Kids from
Secondhand Smoke
Sadly, children are powerless to protect themselves
from the dangers of secondhand smoke. But we each
can play an important role in protecting them from
secondhand smoke exposure.
The single best step you can take to protect your family’s
health and your own is to quit smoking. Quitting
smoking will also reduce the chance that your children
will grow up to become smokers themselves.
While quitting smoking may be difficult, there are a num-ber
of proven resources available to help including free
counseling and a range of FDA-approved medications.
To receive free counseling to help you quit, please call
1-800-QUIT-NOW.
Preparing for a Lifetime, It’s Everyone’s Responsibility
http://iio.health.ok.gov
Maternal and Child Health Service - Oklahoma State Department of Health
1000 Northeast Tenth Street, Oklahoma City, OK 73117-1299
Phone 405-271-4480 Fax 405-271-2994
STOP BY, CALL
OR VISIT
OUR WEBSITE
AN EQUAL OPPORTUNITY EMPLOYER
This publication was issued by the Oklahoma State Department of Health, as authorized by Terry Cline, Ph.D., Commissioner of Health. 4,000 copies were printed as part of a set by Heritage Solutions in
June 2010 at a cost of $10,500. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Funding provided by the Title V Maternal and Child Health Block
Grant, Maternal and Child Health Bureau, Department of Health and Human Services.
Initiative Partners
Coalition of Oklahoma Breastfeeding Advocates
Community Health Centers, Inc./Central
Oklahoma Healthy Start
Community Service Council of Greater Tulsa
Indian Health Services
Infant Crisis Services, Inc.
March of Dimes
Oklahoma Child Death Review Board
Oklahoma City Area Inter-Tribal Health Board
Oklahoma City-County Health Department
Oklahoma Department of Human Services
Oklahoma Department of Mental Health and
Substance Abuse Services
Oklahoma Family Network
Oklahoma Health Care Authority
Oklahoma Hospital Association
Oklahoma Institute for Child Advocacy
Oklahoma State Department of Health
OU Medical Center
Safe Kids Coalition
Smart Start Oklahoma
The Oklahoma City Indian Clinic
The Parent Child Center of Tulsa
The State Chamber
Tulsa Health Department/Tulsa Healthy Start
Turning Point Coalitions
University of Oklahoma Health Sciences Center
OKC /Departments of OB/GYN and Pediatrics
University of Oklahoma College of Continuing
Education