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Infant mortality
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====Early childhood trauma==== [[Early childhood trauma]] includes physical, sexual, and psychological abuse of a child from birth to five years old. [[Childhood trauma|Trauma]] in early childhood has an extreme impact over the course of a lifetime and is a significant contributor to infant mortality. Developing organs are fragile, when an infant is shaken, beaten, strangled, or raped, the impact is exponentially more destructive than when the same abuse occurs to a fully developed body.{{Fact or opinion|date=July 2023}} Studies estimate that 1β2 per 100,000 U.S. children are fatally injured annually, and it is reasonable to assume that these statistics underrepresent actual mortality.<ref name="child welfare">{{Cite book |last=Child Welfare Information Gateway |url=https://www.childwelfare.gov/pubpdfs/fatality.pdf |title=Child Abuse and Neglect Fatalities 2018: Statistics and Interventions |date=2020 |publisher=Children's Bureau, U.S. Department of Health and Human Services |location=Washington, DC |access-date=22 October 2020 |archive-date=16 October 2020 |archive-url=https://web.archive.org/web/20201016192931/https://www.childwelfare.gov/pubPDFs/fatality.pdf |url-status=dead }}</ref><ref>{{Cite journal |vauthors=Palusci VJ, Covington TM |date=January 2014 |title=Child maltreatment deaths in the U.S. National Child Death Review Case Reporting System |journal=Child Abuse & Neglect |volume=38 |issue=1 |pages=25β36 |doi=10.1016/j.chiabu.2013.08.014 |pmid=24094272}}</ref> Almost three-quarters (70.6%) of child fatalities in [[Fiscal year|FFY]] 2018 involved children younger than 3 years, and children younger than 1 year accounted for half (49.4%) of all fatalities.<ref name="child welfare" /> In particular, correctly identifying deaths due to neglect is problematic, and children with sudden, unexpected deaths or deaths from apparently unintentional causes often have preventable risk factors that are substantially similar to those in families with maltreatment.{{citation needed|date=August 2023}} There is a direct relationship between the age at which maltreatment or injury occurs and the risk of death. The younger an infant is, the more dangerous the maltreatment.<ref>{{Cite journal |vauthors=Imamura JH, Troster EJ, Oliveira CA |date=September 2012 |title=What types of unintentional injuries kill our children? Do infants die of the same types of injuries? A systematic review |journal=Clinics |volume=67 |issue=9 |pages=1107β16 |doi=10.6061/clinics/2012(09)20 |pmc=3438254 |pmid=23018311}}</ref>{{Failed verification|date=July 2023|reason=Improper synthesis?}} Family configuration,<ref>{{Cite journal |vauthors=Smith-Greenaway E, Trinitapoli J |date=April 2014 |title=Polygynous contexts, family structure, and infant mortality in sub-saharan Africa |journal=Demography |volume=51 |issue=2 |pages=341β66 |doi=10.1007/s13524-013-0262-9 |pmc=3974908 |pmid=24402794}}</ref><ref>{{Cite web |title=Child Maltreatment: Risk and Protective Factors |url=https://www.cdc.gov/violenceprevention/childmaltreatment/riskprotectivefactors.html |url-status=dead |archive-url=https://web.archive.org/web/20100306061203/https://www.cdc.gov/violenceprevention/childmaltreatment/riskprotectivefactors.html |archive-date=6 March 2010 |website=Centers for Disease Control and Prevention}}</ref> child gender, social isolation, lack of support, maternal youth, marital status, [[poverty]], parental [[Adverse Childhood Experiences Study|adverse childhood experiences]], and parenting practices<ref>{{Cite journal |vauthors=Leventhal JM, Garber RB, Brady CA |date=March 1989 |title=Identification during the postpartum period of infants who are at high risk of child maltreatment |journal=The Journal of Pediatrics |volume=114 |issue=3 |pages=481β7 |doi=10.1016/S0022-3476(89)80580-3 |pmid=2921696}}</ref> are all thought to contribute to increased risk.<ref name="child welfare" />
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