Infant mortality down almost 60% as number of cot deaths reduce

Infant mortality has fallen by almost 60 per cent since the late 1990s, largely due to a reduction in the number of cot deaths, according to a new report.

However, the number of children killed in homicides and filicides is increasing, and most of these deaths are due to violence within families, according to the National Paediatric Mortality Register 2023.

Overall infant mortality from 2019-2021 was 3.1 per 1,000 births, close to the EU average. Almost half of deaths occurred within 28 days after birth.

The biggest decline in death is among infants aged 29 days to one year, largely as a result of a fall in cot deaths (sudden infant death syndrome).

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Sids deaths have fallen from 150-160 a year in the late 1980s to under 30 currently, largely due to interventions on maternal smoking and child sleeping positions.

Deaths in children aged one to 18 have declined by half since 2007.

The report includes data from 892 children who died between 2019 and 2021, extracted from multiple sources. “However, this is not the full picture and there is currently very little accurate data available on the circumstances and reasons for mortality in children, particularly after the age of five years; on how many children die in any one year, where they die and from what causes,” according to the National Office of Clinical Audit (NOCA).

After the first year, the main cause of childhood death is accident and injury, which accounts for one in five deaths among those aged one to 14 and one in two for 15-18 year olds.

Among children aged one to 14, road traffic collisions accounted for 24 per cent of deaths. However, road deaths among adolescents have fallen by half in the space of a decade.

One in five injury-related deaths in this age group was the result of homicide or filicide, but this is thought to be an underestimate of the actual figures.

A centralised child mortality database is urgently needed to better understand and address the factors contributing to deaths, according to Prof Michael Barrett, chairman of the governance committee of the register. “Accurate data on child deaths in Ireland is a beacon of hope for families, a testament to the lives lost, and a roadmap to a safer future. While many deaths may be preventable, understanding the complex landscape of child mortality, including trauma, congenital disorders and cancers, allows us to strive for better care and support for those who need it most.”

NOCA says many child deaths are preventable, making it imperative to identify the factors contributing to them and to enable effective interventions.

As the Irish State was being founded in the 1920s, the report points out, 11 per cent of all children who were born alive died before their first birthday.

Despite a 50 per cent decline in child mortality since 2007, the report says many avoidable deaths continue to occur at all age groups.