Editing Infant mortality (section)

=== Medicine and biology ===
Causes of infant mortality and deaths that are related to medical conditions include: low birth weight, [[sudden infant death syndrome]], malnutrition, congenital malformations, infectious diseases, and low income for health care, including [[neglected tropical diseases]].

The American Academy of Pediatrics recommends that infants need multiple doses of vaccines such as [[DPT vaccine|diphtheria–tetanus–acellular pertussis vaccine]], [[Hib vaccine|''Haemophilus influenzae'' type b (Hib) vaccine]], [[Hepatitis B vaccine|hepatitis B (HepB) vaccine]], [[Polio vaccine|inactivated polio vaccine]] (IPV), and [[pneumococcal vaccine]] (PCV). Research conducted by the [[Institute of Medicine]]'s [[Immunization Safety Review Committee]] concluded that there is no relationship between these vaccines and the risk of SIDS in infants.<ref>{{Cite book |last1=Institute of Medicine (US) Immunization Safety Review Committee |url=http://www.nap.edu/catalog/10649 |doi-access=free |title=Immunization Safety Review: Vaccinations and Sudden Unexpected Death in Infancy |last2=Stratton |first2=K. |last3=Almario |first3=D. A. |last4=Wizemann |first4=T. M. |last5=McCormick |first5=M. C. |date=2003-10-28 |publisher=National Academies Press |isbn=978-0-309-08886-2 |location=Washington, D.C. |doi=10.17226/10649 |pmid=25057654 |url-status=live |archive-url=https://web.archive.org/web/20231211061018/https://nap.nationalacademies.org/read/10649/chapter/1#ii |archive-date= Dec 11, 2023 }}</ref>{{rp|77–78}}

==== Low birth weight ====
{{Main|Low birth weight}}
[[Low birth weight]] makes up 60–80% of the infant mortality rate in developing countries. ''[[The New England Journal of Medicine]]'' stated that "The lowest mortality rates occur among infants weighing {{convert|3000|to|3500|g|lbs|abbr=on}}. For infants born weighing {{Convert|2500|g|lbs|abbr=on}} or less, the mortality rate rapidly increases with decreasing weight, and most of the infants weighing {{convert|1000|g|lbs|abbr=on}} or less die. As compared with normal-birth-weight infants, those with low weight at birth are almost 40 times more likely to die in the neonatal period; for infants with very low weight at birth the relative risk of neonatal death is almost 200 times greater."{{Quote without source|date=July 2023}} Infant mortality due to low birth weight is usually a direct cause stemming from other medical complications such as preterm birth, poor maternal nutritional status, a lack of [[prenatal care]], maternal sickness during pregnancy, and unhygienic home environments.<ref name="Andrews" /> Birth weight and the length of gestation are the two most important predictors of an infant's chances of survival and their overall health.<ref name="MacDorman 2009" />

According to the ''New England Journal of Medicine'', "in the past two decades, the infant mortality rate (deaths under one year of age per thousand live births) in the United States has declined sharply."{{Quote without source|date=July 2023}} The rate of low birth weights among African Americans remains twice as high as the rate for white people. Low birth weight, the leading cause of infant deaths, is preventable by effective programs to help prevent low birth weight are a combination of health care, education, the environment,{{Clarify span|mental modification,|date=August 2023}} and public policy.<ref>{{Cite web |year=2000 |title=Infant Mortality, Low Birthweight and Racial Disparity |url=http://www.nationalhealthystart.org/site/assets/docs/Infant%20Mortality%20Low%20Birthweight.pdf |archive-url=https://web.archive.org/web/20191230004308/http://www.nationalhealthystart.org/site/assets/docs/Infant%20Mortality%20Low%20Birthweight.pdf |archive-date=2019-12-30 |website=National Healthy Start Association }}</ref> Preterm birth is the leading cause of newborn deaths worldwide.<ref>{{Cite web |title= Preterm birth |url=https://www.who.int/mediacentre/factsheets/fs363/en/index.html |access-date=2013-09-29 |website=WHO |date=November 2012 |url-status=dead |archive-url= https://web.archive.org/web/20131002115944/https://www.who.int/mediacentre/factsheets/fs363/en/index.html |archive-date= Oct 2, 2013 }}</ref> Even though America has a higher survival rate for premature infants, the percentage of Americans who deliver prematurely is comparable to those in developing countries. Reasons for this include [[teenage pregnancy]], an increase in pregnancy after the age of 35, an increase in the use of [[in vitro fertilisation]] (which increases the risk of multiple births), obesity, and diabetes. Also, pregnant people who do not have access to health care are less likely to visit a doctor, therefore increasing their risk of delivering prematurely.<ref name="lag" />

====Malnutrition====
{{Main|Undernutrition in children}}
[[File:Hunger Map 2020 World Food Programme.svg|thumb|310px|Percentage of population suffering from hunger, [[World Food Programme]], 2020<br>
{{Legend|#29b8c7|< 2,5%}}
{{Legend|#16b484|2,5–5,0%}}
{{Legend|#fec960|5,0–14,9%}}
{{Legend|#f47846|15,0–24,9%}}
{{Legend|#f2203a|25,0–34,9%}}
{{Legend|#7f0928|> 35,0%}}
{{Legend|#b5aba4|No data}}]]
Malnutrition or undernutrition is defined as inadequate intake of nourishment, such as proteins and vitamins, which adversely affects the growth, energy, and development of people all over the world.<ref>{{Cite journal |vauthors=de Onís M, Monteiro C, Akré J, Glugston G |date=1993 |title=The worldwide magnitude of protein-energy malnutrition: an overview from the WHO Global Database on Child Growth |journal=Bulletin of the World Health Organization |volume=71 |issue=6 |pages=703–12 |pmc=2393544 |pmid=8313488 }}</ref> It is especially prevalent during pregnancy and in infants and children under 5 who live in developing countries within the poorer regions of Africa, Asia, and Latin America.<ref>{{Cite news |date=2012-09-26 |title=Top 9 countries fighting child malnutrition |first1=Kathryn |last1=Reid |work=World Vision |url=https://www.worldvision.org/hunger-news-stories/top-nine-countries-fighting-child-malnutrition |access-date=2018-07-27}}</ref> Children are especially vulnerable as they have yet to fully develop a strong [[immune system]] and are dependent on their parents to provide the necessary food and nutritional intake. It is estimated that about 3.5 million children die each year as a result of childhood or maternal malnutrition, with [[stunted growth]], low body weight, and low birth weight accounting for about 2.2 million associated deaths.<ref>{{Cite journal |display-authors=6 |vauthors=Martins VJ, Toledo Florêncio TM, Grillo LP, do Carmo P, Franco M, Martins PA, Clemente AP, Santos CD, de Fatima A, Vieira M, Sawaya AL |date=June 2011 |title=Long-lasting effects of undernutrition |journal=International Journal of Environmental Research and Public Health |volume=8 |issue=6 |pages=1817–46 |doi=10.3390/ijerph8061817 |pmc=3137999 |pmid=21776204 |doi-access=free}}</ref> Socioeconomic and environmental factors contribute to malnutrition, as do gender, location, and cultural practices surrounding [[breastfeeding]].<ref>{{Cite journal |vauthors=Mahgoud SE |date=2006 |title=Factors Affecting Prevalence of Malnutrition Among Children Under Three Years Of Age In Botswana |url=https://ubrisa.ub.bw/bitstream/handle/10311/219/Mahgoub_AJFAND_2006.pdf?sequence=1&isAllowed=y |journal=African Journal of Food, Agriculture, Nutrition and Development |volume=6}}</ref> It is difficult to assess the most pressing factor as they can intertwine and vary among regions.

Children suffering from malnutrition can become underweight, and experience stunting or [[wasting]]. In Africa, the number of stunted children has risen, while Asia has the most children under 5 suffering from wasting.<ref>{{Cite web |date=2015 |title=Levels and trends in child malnutrition |url=https://www.unicef.org/media/files/JME_2015_edition_Sept_2015.pdf |url-status=dead |archive-url=https://web.archive.org/web/20210525180258/https://www.unicef.org/media/files/JME_2015_edition_Sept_2015.pdf |archive-date=2021-05-25 |access-date=2018-07-27 |website=UNICEF – WHO – World Bank Group joint child malnutrition estimates}}{{Moved resource|date=July 2023}}</ref> Inadequate nutrients adversely affect physical and cognitive development, increasing susceptibility to severe health problems. Micronutrient deficiency has been linked to [[Iron-deficiency anemia|anemia]], fatigue, [[Vitamin A deficiency#Signs and symptoms|blindness]], [[Iodine deficiency#Goiter|goiter]], poor brain development, and death.<ref>{{Cite journal |vauthors=Torpy JM, Lynm C, Glass RM |date=August 2004 |title=JAMA patient page. Malnutrition in children |journal=JAMA |volume=292 |issue=5 |pages=648 |doi=10.1001/jama.292.5.648 |pmid=15292091 |doi-access=free}}</ref> Malnutrition also decreases the immune system's ability to fight infections, resulting in higher rates of death from diseases such as malaria, respiratory disease, and diarrhea.<ref>{{Cite journal |vauthors=Tette EM, Sifah EK, Nartey ET |date=November 2015 |title=Factors affecting malnutrition in children and the uptake of interventions to prevent the condition |journal=BMC Pediatrics |volume=15 |issue=1 |pages=189 |doi=10.1186/s12887-015-0496-3 |pmc=4653928 |pmid=26586172 |doi-access=free }}</ref>

[[Folic acid]] during pregnancy is one way to combat iron deficiency. A few [[public health]] measures used to lower levels of iron deficiency anemia include added iodine to salt or drinking water and including vitamin A and multivitamin supplements in the diet.<ref name="Andrews" /> A deficiency of this vitamin causes certain types of [[anemia]] (low red blood cell count).<ref>{{Cite web |title=Folic Acid |url=http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000723 |archive-url=https://web.archive.org/web/20100714151130/http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000723 |archive-date=14 July 2010 |website=PubMed Health |publisher=]National Center for Biotechnology Information, U.S. National Library of Medicine}}</ref>

====Infectious diseases====
Babies born in low- to middle-income countries in sub-Saharan Africa and southern Asia are at the highest risk of neonatal death. Bacterial infections of the bloodstream, lungs, and the brain's covering ([[meningitis]]) are responsible for 25% of neonatal deaths worldwide. Newborns can acquire infections during birth from bacteria present in the birth canal, the person may not be aware of the infection, or they may have an untreated [[pelvic inflammatory disease]] or a [[sexually transmitted disease]]. These bacteria can also move up the vaginal canal into the amniotic sac surrounding the baby causing in utero transmission. Maternal blood-borne infection is another route of bacterial infection. Neonatal infection is more likely with the [[premature rupture of the membranes]] (PROM) of the amniotic sac.<ref>{{Cite journal |vauthors=Chan GJ, Lee AC, Baqui AH, Tan J, Black RE |date=August 2013 |title=Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis |journal=PLOS Medicine |volume=10 |issue=8 |pages=e1001502 |doi=10.1371/journal.pmed.1001502 |pmc=3747995 |pmid=23976885 |doi-access=free }}</ref>

Seven out of ten childhood deaths are due to infectious diseases like [[acute respiratory infection]], [[diarrhea]], [[measles]], and [[malaria]]. Acute respiratory infections such as [[pneumonia]], [[bronchitis]], and [[bronchiolitis]] account for 30% of childhood deaths; 95% of pneumonia cases occur in the developing world. Diarrhea is the second-largest cause of childhood mortality in the world, while malaria causes 11% of childhood deaths. Measles is the fifth-largest cause of childhood mortality.<ref name="Andrews" /><ref name="Nussbaum">{{Cite book |title=Creating Capabilities |vauthors=Nussbaum M |publisher=The Belknap Press of Harvard University Press |year=2011 |isbn=978-0-674-05054-9}}</ref>