Published Mon, Nov 07, 2011 02:00 AM Modified Mon, Nov 07, 2011 06:22 AM

BY ELIZABETH HUDGINS AND SARAH VERBIEST PUBLISHED IN: OTHER VIEWS Birthdays are always cause for celebration - and last year a higher percentage of North Carolina babies reached their first birthday than ever before. Bring out the cake!

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The lowest infant mortality rate ever in our state's history is a testament to strategic and sustained investments that North Carolina has made in systems to support communities, families and new parents. These critical infrastructures must be maintained, because the future prosperity of our state depends on the health and well-being of our next generation. To take this progress to the next level will require building on these infrastructures and applying the same ingenuity that has brought North Carolina such recognition as a great place to live, work and play. Indeed, infant mortality is one of the most basic indicators when it comes to reflecting the overall health and well-being of our state and the prospects of our next generation. All sorts of things affect a woman's health when she becomes pregnant, her health during pregnancy and delivery, and her baby's health during the first year. About 20 years ago, when North Carolina was ranked worst in the nation when it came to infant mortality, leaders around the state focused energy into turning these statistics around. The creation of the Child Fatality Task Force was part of that effort; here are some examples of programs that we supported or endorsed through our Perinatal Health Committee that contributed to the lowest infant mortality rate in North Carolina history for 2010: Distributing Folic Acid and Preconception Health Information: Building on years of infrastructure development, the March of Dimes continues to work to improve the health of North Carolina women who are planning to have a baby. Neural tube defects - the brain damage that can be caused by a lack of folic aciddeclined 40 percent between 1995 and 2005. Avoiding second Preterm Births: North Carolina is a recognized national leader in its use of the drug 17-P to help women who have had one preterm birth avoid a subsequent preterm birth. Promoting Safe Sleep: This year fewer babies died from Sudden Infant Death Syndrome (SIDS) than ever before. While it is too early to call this a trend, it is definitely good news. The Healthy Start Foundation has used a variety of strategies to educate hospitals, child care providers, families and others about safe sleep practices. Making deliveries even safer: The Perinatal Quality Collaborative of North Carolina identifies and promotes best practices in hospitals leading to fewer infections and better birth outcomes. Encouraging breastfeeding: Breastfeeding is associated with a host of benefits for baby and mother. Numerous efforts to support new mothers in their decision to breastfeed have resulted in a 12 percent

increase in the percentage of mothers nursing their babies for at least six months. Good news indeed - strategic, sustained multifaceted efforts have had the desired result of more babies making it to their first birthday. Continued progress for infant mortality in North Carolina will require systematically promoting equities in birth outcomes. Even with recent improvements and the sustained work of proven programs such as Baby Love Plus and Healthy Beginnings, black babies die at a rate more than twice that of white babies in North Carolina. There is still a long way to go before equity is reached. Emerging science tells us toxic stress and other community factors that disproportionately affect African-American women are the key to tackling this disparity. It will take continued sustained and strategic investment, partnership and ingenuity to make the progress we need and can achieve. During this time of faltering funding and systems stretching to the breaking point, we can't step away from our commitment to our youngest citizens. That is why the Child Fatality Task Force is proud to partner with the UNC Center for Maternal and Infant Health and the state Division of Public Health to convene an N.C. Equity in Birth Outcomes Partnership. This effort brings together leaders from many different sectors - including business and faith communities, economists, environmentalists and social scientists - to create and advance a comprehensive plan to reduce disparities in birth outcomes in our state. We already know a lot about what works. North Carolina's infrastructure is ready and our ingenuity is proven. It will take work, dedication and lots of different kinds of expertise. It's time to roll up our sleeves - and then get ready to celebrate lots more birthdays.
Elizabeth Hudgins is executive director of the Child Fatality Task Force. Dr. Sarah Verbiest chairs the organization's Perinatal Health Committee.