DOCSLIB.ORG

Special Care for Sick Babies – Choice Or Chance? the First BLISS Baby Report

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Special Care for Sick Babies – Choice Or Chance? the First BLISS Baby Report SURVEY OF NEONATAL CARE Special care for sick babies – choice or chance? The first BLISS Baby Report BLISS, the premature baby charity, has worked with a number of organisations and individuals to ascertain current practice and provision of neonatal care in neonatal units throughout the UK and to gather parents' views of their experiences of the care of their baby. Conclusions drawn from the data should help to highlight areas of concern and if effective action is taken then neonatal care and outcome for these vulnerable babies will improve. Bonnie Green sing the BLISS Baby Charter (FIGURE 1 Head of External Relations U1) for special care babies as a BLISS framework for establishing goals and benchmarks, a review has been undertaken to identify current neonatal practice and service provision for each core value and to establish how this measures against what we consider sick and premature babies should be receiving. The results were published in July 2005 as the first BLISS Baby Report entitled Special care for sick babies – choice or chance?2 BLISS commissioned the National Perinatal Epidemiology Unit (NPEU) to undertake an independent research review to identify some baseline data about current organisation and aspects of policy in neonatal care, and independent consultants to undertake a gap analysis on Keywords staffing levels. The review included: FIGURE 1 The BLISS Baby Charter. I a national survey of neonatal units capacity; staffing; developmental care; undertaken in the winter of 2004/5 Information was requested on networks, networks; closures; nursing vacancies; I kangaroo care; skin-to-skin contact; unit a questionnaire sent to 220 units admissions/capacity, cots, transfer arrange- environment; gap analysis throughout the UK ments, staffing, practice in relation to I a questionnaire for parents about their developmental care and facilities and Key points experiences , which was available for on- information for parents. This article Green, B. (2005) Special care for babies – line completion via the BLISS website discusses the results in relation to staffing, choice or chance? The first BLISS Baby for a period in Spring 2005 capacity, gap analysis, developmental care Report Infant 1(6): 194-98. I a study to identify staff levels and to and parents’ issues. The parent questionn- 1. Ninety five per cent of units that quantify the cost of eliminating the gap aire asked similar questions but related to responded reported having taken in against British Association of Perinatal their personal experience. It was interesting more babies than they were resourced Medicine (BAPM) standards of care3. to note that parents’ experiences of service or staffed for. The response rate was as follows: provision did not always match with the 2. Only 2% of units have reached BAPM I 153 units completed the questionnaire, unit responses. staffing standards. representing a 70% response rate across 3. Forty per cent of units say they have an the UK; 70% from England, 80% from Staffing levels and BAPM standards identified lead for developmental care Scotland, 57% from Wales and 71% Recommendations on staffing levels have but only 24% of units have anyone trained or in training. from N. Ireland. changed over time. The most recent I 4. Research shows service needs an 150 responses were received from par- recommendations about optimal staffing additional 2,700 nurses at an extra cost ents representing experiences from 127 levels from BAPM suggest that the of £75 million per year. hospitals, which were also analysed by following should be regarded as the NPEU. minimum standard: 194 VOLUME 1 ISSUE 6 2005 infant SURVEY OF NEONATAL CARE I Level 3 Units provide the whole range of Unit type Total required establishment Total current Total medical neonatal care but not necessarily (WTEs) (2001/2003 WTE mismatch all specialist services such as neonatal recommendations (WTEs) surgery. Type 1 (n=27) 579.31 402.57 -176.74 Both Level 2 and 3 would also provide Type 2 (n=51) 1901.81 1253.08 -648.73 special care for their local babies. Type 3 (n=65) 4948.38 3532.18 -1450.20 For the purposes of this project, units are described as Type 1, 2 or 3 but they map TABLE 1 Recommended and current total nurse establishment and mismatch for study units. onto the levels described above. BAPM also Source: NPEU recommended that units are so configured, I Intensive Care: because of the complexi- Review4, neonatal care services are resourced and staffed that they operate at ties of care needed for a baby receiving currently being reorganised into Managed 75% capacity – thus allowing for intensive care, there should be 1:1 nurs- Clinical Networks. Each network will admission of new babies or return of ing. Occasionally when a baby is partic- comprise a range of neonatal units offering recovering babies at all times. The ularly unstable, two nurses per baby will differing levels of care with the intention of development of the networks, if they are be required having sufficient and appropriate capacity funded and staffed adequately, should I High Dependency Care: one nurse to care for the babies born within the result in mothers and babies no longer should not have responsibility for the network. There are three levels of units as being transferred often hundreds of miles care of more than two babies recommended by BAPM3: away because their local neonatal unit is I Special Care: one nurse should not have responsibility for more than four babies who are receiving special care The Department of Health (DH) Neonatal Intensive Care Review4 developed a formula for calculating the number of nurses needed to provide this standard. Using this, the establishments required for the study units working in their current configuration were calculated for each unit type and compared to their current total Whole Time Equivalent (WTE) establishment (TABLE 1). Most study unit establishments showed a negative value using this formula, with only three of the 143 units (2.1%) for which data were available found to be up to or over the recommendation. Of note, these estimates do not take into account FIGURE 2 Nurse staffing mismatch in % WTEs by unit type (Type 1 n+27; Type 2 n=51; Type 3 vacancies and the functional establish- n=65). Source: NPEU ments providing the nursing element of neonatal care were thus lower than what is I Level 1 Units provide special care but do closed to new admissions. actually shown. not aim to provide any continuing high Almost all units (95%, n=146) reported The distribution according to unit type is dependency or intensive care. This term that they exceeded their unit cot capacity. shown in FIGURE 2. The extent of the includes units with or without resident TABLE 2 details the cot demands, which current mismatch is greatest in type 2 units. medical staff. exceed the unit provision for each category I Level 2 Units provide high dependency of cot, grouped according to unit type. Of Capacity care and some short-term intensive care note, 40% of type 1 units (with special care As a result of the Neonatal Intensive Care as agreed within the network. and less than 3 high dependency care cots) cared for babies requiring intensive care. Overall, high dependency care was in Type of unit n (%) units n (%) units n (%) exceeding n (%) greatest demand with 81% units reporting exceeding exceeding HD cots exceeding ‘going over’ on high dependency care cots. overall cot SC cots IC cots The distribution of excessive unit numbers demands is detailed for all four countries Type 1 28 (93.3) 3 (76.7) 18 (60) 12 (40) within the UK (FIGURE 3). All the Type 2 53 (94.6) 40 (71.4) 50 (89.3) 37 (66.1) responding units in Northern Ireland Type 3 67 (100) 49 (73.1) 56 (83.1) 51 (76.1) reported ‘going over’ on cot demands, versus 97.7% for those in England and TABLE 2 Cot demands exceeding unit provision by unit type. Source: NPEU 91.7% for those in Scotland. The Welsh infant VOLUME 1 ISSUE 6 2005 195 SURVEY OF NEONATAL CARE WTEs WTE vacancies % vacant of Unit type Total Mean (s.d.) Range Total Mean (s.d.) Range total WTEs Type 1 402.6 14.91 (4.32) 4-24.2 25.93 0.96 (1.28) 0-5.1 6.4 Type 2 1253.08 24.6 (8.1) 10.5-49.0 102.12 1.96 (1.76) 0-7.5 8.2 Type 3 3532.18 54.34 (23.51) 21.5-130.0 272.45 4.26 (4.07) 0-16.8 7.7 TABLE 3 WTE and WTE vacancies by unit type. Source: NPEU units reported the lowest incidence of current establishment through vacancies or least costly, is likely to contribute to further excessive cot demands at 87.5%. absence. Units were asked about nursing staffing difficulties. BLISS is aware of vacancies amongst their current considerable anecdotal evidence of staff Closures establishment. demoralisation and fatigue caused by Currently neonatal units throughout the Nurse staffing and vacancies, measured increasing shortages and non-replacement country find they have to close their unit in whole time equivalents (WTEs), are of staff. to new admissions. This can be due to full shown for the study units (TABLE 3). occupancy or cots closed because of staff Overall, the total number of WTEs was Developmental care shortages. These closures lead to transfers, 5187.83 with 400.5 WTE (7.72%) There is increasing recognition that the frequently out of the local network and vacancies. This equates to a mean nursing needs and development of premature and sometimes hundreds of miles away, babies establishment of 36.28 WTE (4-130) with sick babies can be better addressed by from multiple births being split up and an average vacancy rate of 2.8 per unit.
Load more

Recommended publications
  • Bliss Family Friendly Accreditation Scheme Helping to Make Family-Centred Care a Reality on Your Neonatal Unit
    Bliss Family Friendly Accreditation Scheme Helping to make family-centred care a reality on your neonatal unit bliss.org.uk 1st edition, 2015 © Bliss – the special care baby charity No part of this booklet may be reproduced without prior permission from Bliss. Bliss 2nd Floor, Chapter House 18-20 Crucifix Lane London SE1 3JW t 020 7378 1122 f 020 7403 0673 e [email protected] bliss.org.uk Helpline 0500 618140 RNID typetalk 018001 0500 618140 Bliss is a member of Language Line. Bliss Publications 0500 618140 or order online at bliss.org.uk Registered charity no. 1002973 Scottish registered charity SC040878 2 Bliss Family Friendly Accreditation Scheme Foreword The Bliss Baby Charter Standards are based on the UN Rights of the Child. The Standards evolved from the Bliss Baby Charter, originally published in 2005, which was an aspirational document aiming to inspire staff to continually deliver the highest quality of family-centred care (FCC). This new resource is now also in line with the statements outlined in All Wales Neonatal Standards, 2nd Edition (2013) and Neonatal Care in Scotland: A Quality Framework (2013). It is a practical guide to help hospitals provide the best possible family-centred care for premature and sick babies, an approach which places the parents at the centre of their baby’s care. This booklet is part of the Bliss Family Friendly Accreditation Scheme (BFFAS), which recognises and rewards hospital units caring for premature and sick babies for embedding the principles of FCC. Our aim is that BFFAS becomes a quality standard that serves as a meaningful and effective benchmark for assessing performance, rewarding achievement and driving improvement.
    [Show full text]
  • Breastfeeding in Northern Ireland, February 2020
    Breastfeeding in Northern Ireland, February 2020 Contents Page List of figures 1 List of tables 2 Northern Ireland context and policy on breastfeeding 3 UNICEF Baby Friendly Initiative 4 Baby Friendly Initiative in Northern Ireland 4 Northern Ireland Maternity System (NIMATS) and Northern Ireland Child Health System 6 Feeding at birth 7 Skin-to-skin contact at birth 8 Breastfeeding attempted 10 Health and Social Care Trust 11 Maternal age 12 Deprivation 12 Maternal age and deprivation 13 Place of birth 14 Feeding during postnatal stay 15 Feeding at discharge - NIMATS 16 Supplementation 17 Support with feeding 18 Feeding at discharge - CHS 19 Health and Social Care Trust 19 Place of birth 20 Prevalence of breastfeeding 21 Trends in breastfeeding prevalence; 2015, 2016, 2017 21 Maternal age 22 Deprivation 22 Breastfeeding and inequality 23 Breastfeeding rates at discharge by HSCT / Local Commissioning Group (LCG): 24 - Belfast HSCT 25 - Northern HSCT 26 - South Eastern HSCT 28 - Southern HSCT 29 - Western HSCT 30 Breastfeeding prevalence by HSCT / LCG and Local Government District (LGD1992): 31 Council Areas 32 - Breastfeeding at discharge by Council Area (LGD2014) 32 - Breastfeeding prevalence by Council Area (LGD2014) 33 Sure Start Services: 34 - Belfast Child Care Partnership Area 35 - Northern Child Care Partnership Area 36 - South Eastern Child Care Partnership Area 37 - Southern Child Care Partnership Area 38 - Western Child Care Partnership Area 39 Breastfeeding in neonatal units 40 Comparing Northern Ireland breastfeeding rates to
    [Show full text]
  • Bliss Statement: COVID-19 and Parental Involvement on Neonatal Units
    Bliss Statement: COVID-19 and parental involvement on neonatal units Updated 7 January 2021 Information correct as at time of writing; this document will be updated regularly in line with new and emerging guidance and evidence. Bliss is the UK’s leading charity for babies born premature or sick. Every year over 100,000 babies across the UK will be admitted to neonatal care after they are born - many will need to receive life-saving care for weeks or months before they are ready for home. Sadly, some babies will never go home at all. Updates 7 January 2021 • Updated to reflect new lockdown measures imposed in January 2021 • Current guidance section updated to reflect current national guidance across the UK • New evidence included demonstrating the impact of parent access restrictions to babies and their families New substantive additions to this version have been written in teal throughout the document. In response to the growing intensity of the COVID-19 pandemic, hospitals across the UK severely limited who was able to come onto hospital sites to reduce the spread of infections. These policies were introduced to protect vulnerable patients, and the dedicated staff who care for them, from contracting the virus. While many units had started to amend their policies to ensure both parents could be present and be involved in their baby’s care, and some units have even been able to return to full unrestricted access for parents, these restrictions continued to affect parents’ access to their babies, and their ability to deliver their baby’s care. Hospitals across the UK are once again adapting their policies to cope with the strain which is being put on the system to ensure everyone in hospital is kept safe, and we anticipate some services will introduce more restrictive measures which may limit parent access and involvement on neonatal units during this time.
    [Show full text]
  • Bliss and Tinylife: Northern Ireland Baby Report 2018 PIC
    Bliss and TinyLife: Northern Ireland Baby Report 2018 PIC 2 Contents Foreword .................................................................................................................................................................4 Summary of findings .............................................................................................................................................6 Introduction ..............................................................................................................................................................8 Health policy and political context.......................................................................................................................9 Neonatal standards ................................................................................................................................................11 Nursing .....................................................................................................................................................................12 Specialist nurses and nurse training .................................................................................................................14 Community outreach ............................................................................................................................................17 Medical staffing............................................................................................................................... .......................20 Shortfall
    [Show full text]
  • Bliss Baby Charter Helping to Make Family-Centred Care a Reality on Your Neonatal Unit Foreword
    Bliss Baby Charter Helping to make family-centred care a reality on your neonatal unit Foreword The Bliss Baby Charter Standards are based on the UN Convention on the Rights of the Child and align with the UK’s Human Rights Act. The Standards evolved from the Bliss Baby Charter, originally published in 2005, which was an aspirational document aiming to inspire staff to continually deliver the highest quality of family-centred care (FCC). This second edition of the Bliss Baby Charter has been updated with statements outlined in All Wales Neonatal Standards, 3rd Edition (2017) and Best Start (2017). It is a practical guide to help hospitals provide the best possible family-centred care for premature and sick babies, an approach which places the family at the centre of their baby’s care. The Bliss Baby Charter is acknowledged as a quality standard that serves as a meaningful and effective benchmark for assessing performance, rewarding achievement and driving improvement. © Bliss – for babies born premature or sick. No part of this information may be reproduced without prior permission from Bliss. Acknowledgements Bliss would like to thank the following people, Specialist support without whom the development of this booklet would not have been possible: Kathryn Ashton, Infant Feeding Coordinator The Bliss Baby Charter refresh advisory group Helen Brown, Operational Delivery Network Director Sanjeev Bali, Consultant Neonatologist Joan Burns, Consultant Clinical Psychologist Dr Sarah Bates, Consultant Paediatrician & Rebecca Chilvers, Clinical
    [Show full text]
  • Association of Early Postnatal Transfer and Birth Outside a BMJ: First Published As 10.1136/Bmj.L5678 on 16 October 2019
    RESEARCH Association of early postnatal transfer and birth outside a BMJ: first published as 10.1136/bmj.l5678 on 16 October 2019. Downloaded from tertiary hospital with mortality and severe brain injury in extremely preterm infants: observational cohort study with propensity score matching Kjell Helenius,1,2,3 Nicholas Longford,3 Liisa Lehtonen,1,2 Neena Modi,3 Chris Gale,3 on behalf of the Neonatal Data Analysis Unit and the United Kingdom Neonatal Collaborative 1Department of Paediatrics and ABSTRACT odds of death before discharge (odds ratio 1.22, 95% Adolescent Medicine, Turku OBJECTIVE confidence interval 0.92 to 1.61) but significantly University Hospital, Turku, Finland To determine if postnatal transfer or birth in a non- higher odds of severe brain injury (2.32, 1.78 to 3.06; 2Department of Clinical tertiary hospital is associated with adverse outcomes. number needed to treat (NNT) 8) and significantly Medicine, University of Turku, DESIGN lower odds of survival without severe brain injury Turku, Finland (0.60, 0.47 to 0.76; NNT 9). Compared with controls, 3 Observational cohort study with propensity score Section of Neonatal Medicine, matching. infants in the non-tertiary care group had significantly Department of Medicine, higher odds of death (1.34, 1.02 to 1.77; NNT 20) but Chelsea and Westminster SETTING no significant difference in the odds of severe brain campus, Imperial College National health service neonatal care in England; London, London SW10 9NH, UK injury (0.95, 0.70 to 1.30) or survival without severe population data held in the National Neonatal Correspondence to: C Gale brain injury (0.82, 0.64 to 1.05).
    [Show full text]
  • 2014 Prematurity Campaign Progress Report
    prematurity campaign 2014 pro gress report © 2015 March of Dimes Foundation Photo by Anne Geddes © Moving forward: a letter from the president Table of contents The March of Dimes Prematurity We were proud to open two new centers in 2014, Campaign, launched in 2003, at Washington University in St. Louis and at the has stimulated widespread University of Pennsylvania. These four centers bring A letter from the president ....................................................................................................................................1 action and attention around the together an unprecedented array of scientists from problem of premature birth. The many different disciplines to examine, identify and 10 Campaign highlights preterm birth rate in the United States has declined prevent the causes of preterm birth. I. U.S. preterm birth rate declines for 7 years ............................................................................................3 for the 7th year; as a result, 231,000 fewer babies have been born prematurely, saving $11.9 billion in health Over the course of the Campaign, the March of II. Prematurity on the global health agenda ..............................................................................................3 and societal costs. Dimes has set forth ambitious goals for reducing the III. Prematurity on the nation’s health agenda ...........................................................................................4 preterm birth rate, charting a course for the future Preterm Birth Reductions
    [Show full text]
  • The Very Real Costs of Having a Premature Or Sick Baby in Northern Ireland Need to Talk? Contact Tinylife Our Helpline Is Open Monday to Friday 9Am to 9Pm
    without collecting £5OO collecting without Pass ST Pass AR T T income Lost Lost Miss a tur a Miss Panic e n ake a loan a ake T expenditur Unexpected Unexpected Unexpected expenditur T ake a loan n e Miss a tur Panic income Lost without collecting £5OO Pass ST Lost 5OO BEST PRACTICE T income NATIONAL AR AR GUIDANCE T Panic Pass ST without collecting £ TY Parking L A N E penaltyP P Miss a tur Unexpected expenditur Lost n e income Pay £30 T Take a loan START AR 5OO Pass ST without collecting £ It,s not a game: the very real costs of having a premature or sick baby in Northern Ireland Need to talk? Contact TinyLife Our helpline is open Monday to Friday 9am to 9pm. 02890 815050 0500 618140 Or email TinyLife [email protected] RNID typetalk 018001 0500 618140 Or email Bliss at [email protected] anytime About TinyLife and we’ll get back to you as soon as possible. TinyLife is the premature baby charity for Northern Ireland, dedicated to reducing About Bliss premature birth, illness, disability and death in babies. TinyLife provides a range of family Bliss is the UK charity dedicated to ensuring support services within neonatal units, at that the 80,000 premature and sick babies home and in local community settings, born each year survive and go on to have which meet the growing needs of families the best possible quality of life. We provide with premature and ill babies in Northern practical and emotional support to families, Ireland.
    [Show full text]
  • Infant Mortality and Stillbirth in the UK
    Number 527 May 2016 Infant Mortality and Stillbirth in the UK Overview Stillbirth and infant mortality rates have fallen in the UK since the early 1900s, but in the last two decades progress has slowed. Stillbirths and infant deaths are linked to a number of complex and interacting risk factors, many of which can be addressed. These include obesity, smoking, maternal age and inequalities across different socioeconomic and ethnic groups. Improvements in care received during Stillbirth and infant mortality rates are higher in pregnancy, labour and early infancy could the UK than several European countries, also improve mortality rates. including Germany and Sweden. This Studies show that many existing guidelines POSTnote reviews recent UK data and to improve care in the UK are not being examines the factors contributing to increased followed, such as those relating to testing risk. It then looks at the policy options that may and monitoring of women with an increased help to improve health outcomes for infants risk of complications during pregnancy. and their families. Background Data on stillbirth and infant mortality is reported in national statistics.1 In the UK the following definitions apply:2 Stillbirth applies to babies born after 24 weeks of pregnancy, who did not breathe or show signs of life. Miscarriage is a pregnancy lost before 24 weeks. Infant mortality is the death of a child in the first year of life, including babies born at any stage of pregnancy who show signs of life after birth. Infant mortality is further defined as either neonatal (in the first 28 days) or post-neonatal (28 days to 1 year).
    [Show full text]
  • Under-Resourced Transport Services for the UK's Sickest Infants: New Bliss
    EDITORIAL Under-resourced transport services for the UK’s sickest infants: new Bliss research was not able to travel with either of my them they carry out 16,000 transfers of premature “Itwins. It was very emotional to see them and sick infants each year. Caroline Davey strapped inside the travel incubator… The Specialist transport services are integral to hospital hired a private neonatal ambulance to the delivery of a high quality neonatal service, Bliss Chief Executive transport one twin because the NHS neonatal allowing infants to be cared for in the right place, [email protected] ambulance had to cover an emergency.” as close to home as possible. There has been good This experience, recounted to Bliss by a mother progress in developing these services in the past 15 of twins born at 29 weeks’ gestation, is just one years, but there is still much to do so that all serv- example of the real-life impact that the under- ices can provide consistent, safe, high quality care. resourcing of neonatal transport services can have Based on the report’s findings, Bliss’ on premature or sick infants. Neonatal transport recommendations include: services are a vital part of their care, ensuring they ■ Governments and the UK’s health services must can be moved quickly to access the right care in ensure that all neonatal transport services have the right place for their often complex needs, and the funding they need to provide a 24-hour therefore play a major role in their chances of service with dedicated road vehicles, sufficient survival and then going on to thrive.
    [Show full text]
  • Bliss Community Health Professionals' Information Guide
    Bliss Community Health Professionals’ Information Guide Supporting families of premature and sick babies following discharge from hospital. www.bliss.org.uk Bliss Community Health Professionals’ Information Guide Second edition, Bliss 2011 © Bliss 2011 No part of this booklet may be reproduced in any form or by any electronic or mechanical means without prior permission from Bliss. Whilst every care is taken providing information, please note that it is of a general nature. Bliss does not accept any liability, including liability for any error or omission. Bliss, the special care baby charity This publication has been endorsed by Unite/Community Practitioners’ and Health Visitors’ Association (CPHVA). This publication has been made possible with financial support from Abbott. We are grateful to Sands, the stillbirth and neonatal death charity, for permission to use and adapt some material from their parent support leafletSaying goodbye to your baby. Bliss Bliss Scotland 9 Holyrood Street PO Box 29198 London SE1 2EL Dunfermline KY12 2BB t 020 7378 1122 f 020 7403 0673 t 0845 157 0077 e [email protected] e [email protected] www.bliss.org.uk www.bliss.org.uk Family Support Freephone Helpline 0500 618140 RNID typetalk 018001 0500 618140 Online parent messageboard www.blissmessageboard.org.uk Bliss is a member of Language Line the telephone interpreting service, which has access to over 170 languages. Bliss Publications 01933 318503 or order online at www.bliss.org.uk Registered charity no. 1002973 Scottish registered charity SC040878 Acknowledgements Written by Layla Brokenbrow, edited by Mark Gorman, designed by Jess Milton. A special thank you to the reviewing panel; it would not have been possible to produce this guide without their valuable support.
    [Show full text]
  • Infant Mortality and Stillbirth in the UK
    Number 527 May 2016 Infant Mortality and Stillbirth in the UK Overview Stillbirth and infant mortality rates have fallen in the UK since the early 1900s, but in the last two decades progress has slowed. Stillbirths and infant deaths are linked to a number of complex and interacting risk factors, many of which can be addressed. These include obesity, smoking, maternal age and inequalities across different socioeconomic and ethnic groups. Improvements in care received during Stillbirth and infant mortality rates are higher in pregnancy, labour and early infancy could the UK than several European countries, also improve mortality rates. including Germany and Sweden. This Studies show that many existing guidelines POSTnote reviews recent UK data and to improve care in the UK are not being examines the factors contributing to increased followed, such as those relating to testing risk. It then looks at the policy options that may and monitoring of women with an increased help to improve health outcomes for infants risk of complications during pregnancy. and their families. Background Data on stillbirth and infant mortality is reported in national statistics.1 In the UK the following definitions apply:2 Stillbirth applies to babies born after 24 weeks of pregnancy, who did not breathe or show signs of life. Miscarriage is a pregnancy lost before 24 weeks. Infant mortality is the death of a child in the first year of life, including babies born at any stage of pregnancy who show signs of life after birth. Infant mortality is further defined as either neonatal (in the first 28 days) or post-neonatal (28 days to 1 year).
    [Show full text]