Does infant mortality matter to Baltimore?

Members of health agencies such as the Family League of Baltimore have been campaigning and visiting homes for almost a year as part of B’More For Healthy Babies, a city initiative aimed at reducing infant death and promoting a healthy family life.

There is no concrete data compiled on the success of the programs first phase: “Healthy and Safe Parenting.” But Gena O’Keefe, director of healthy community initiatives for the Family League of Baltimore City, said the B’More for Healthy Babies campaign “Alone. Back. Crib.” has improved the safe sleep environment in households.

Five-Star Daycare on East Biddle Street uses vans that tote the slogan "No Child Left Behind." Photo by Lauren Slavin.

Five-Star Daycare on East Biddle Street uses vans that tote the slogan "No Child Left Behind." Photo by Lauren Slavin.

Preterm birth in Maryland decreased by more than three percent from 2006-2008. But in 2009, infant mortality in Baltimore was at an all-time high. More than 120 babies did not live to see their first birthday, according to the B’More For Healthy Babies website, with African-American infants especially at risk.

“It was really a spike,” O’Keefe said. “Deaths due to unsafe sleep are things that we can prevent. If the baby is placed in a safe sleep environment, they are much less likely to die during sleep.”

“The Strategy to Improve Birth Outcomes in Baltimore City” identified 12 high-risk areas for infant mortality, and three of those communities — Patterson Park North and East, Upton/Druid Heights, and Greenmount East — were funded to create cross-sector support between health and social service departments, mothers, and non-profit organizations.

Some young mothers in Baltimore have already been impacted through efforts of the initiative. LaShawn Hughes, 19, of Druid Heights, was made to watch B’More For Healthy Babies’ “Baby Basics” video before she was allowed to leave the hospital with her daughter, Cayden, now one.

While she had a basic idea of how to take care of her baby, Hughes said the informational video taught her how to properly swaddle Cayden and that the baby should sleep on her back in a crib.

“I already kind of know from aunts and grandparents not to put the baby in the bed [with you],” Hughes said. “You can roll on the baby and the baby can die.”

Many of Baltimore’s parents who haven’t been exposed to B’More For Healthy Babies messages, or the messages of any other health organization, continue the behavior that has led to infant mortality in the past, such as smoking and unsafe sleep practices.

Antonio Lynch has been smoking for more than 13 years, the age of his oldest daughter.

The Druid Heights resident has three children: a 4-year-old son and two daughters, ages nine and 13. Lynch smoked in his home during each child’s infanthood through their adolescence, a factor that directly affects an infant’s health before birth and after delivery, according to the Baltimore City Health Department.

“I know it’s unhealthy,” Lynch said. But he believes he is a responsible parent.

“I don’t care how responsible you are, something can go wrong,” Lynch’s aunt, who would not give her name, said. “Even with a responsible parent, accidents can happen.”

Lynch’s aunt has six children of her own and nine grandchildren, none of which slept in a crib during infanthood. That’s not the culture of raising babies in Baltimore, she said. Babies sleep in bed with their parents or in bassinettes, small rocking beds that are oval shaped. And babies never sleep on their backs.

“It’s hard for anyone to breathe sleeping on their back. You can choke on your own saliva,” Lynch’s aunt said. “

These practices have been cited by BCHD as leading causes for high infant mortality rates in Baltimore, according to the 2009 document “The Strategy to Improve Birth Outcomes in Baltimore City.”

But don’t tell Lynch’s aunt she can’t smoke around the children in her family, put babies to sleep on their sides or stomachs, or let them sleep anywhere but a crib.

“Why would they send people out here?” Lynch’s aunt said. “I’ll tell them, ‘Who the f*** is you to tell me I can’t smoke in my … house? I’ll tell them, ‘You can’t teach me nothing I’ve already done. What could they teach me? You’re never too old to learn nothing.”

While the initiative has yet to track its own progress and the citizen’s affected have mixed views on how infant mortality should be approached, one national organization has made it clear where Maryland is and where it should be in terms of baby health.

In 2008, the March of Dimes began rating states on pregnancy, baby prematurity, and birth defects. The nation was given a “D,” but the state of Maryland got an “F,” according to Anne Eder, director of program services for the March of Dimes’ Maryland-national capital area chapter.

Maryland was graded again last November, this time with a result of “D.” While by school standards this is still a low score, Eder considers it an achievement for the state.

“I know it doesn’t sound like much … but the process of reducing preterm birth weight is a really difficult one that needs a lot of work and determination,” Eder said. “We recognize we still have a long way to go, because babies are still being born too soon, dying too early.”

The report also analyzes several contributing factors to the state’s grade, including rates of late preterm birth, smoking, and uninsured women of childbearing age. While Baltimore is a heavy contributor to the state’s low grade, the March of Dimes recognizes Maryland is moving in the right direction with initiatives like B’More For Healthy Babies.

“I know among the public health community the feeling is in general is it has the potential to be very successful,” Eder said. “I think it is perhaps a little too soon to determine if it has had a strong impact. I suspect it will probably be within the next two to three years.”


A child eats a free meal at Greenmount's Knox Presbyterian Church, who offers food to the community every Friday. Photo by Lauren Slavin.
In its first year, B’More for Healthy Babies focused on reducing unsafe sleep practices in Druid Heights. Difficulty getting information to those most affected, lack of funds for continuing programs to help end unhealthy practices before they begin, and the unwillingness of Baltimore citizens to address the issue of infant mortality have kept officials from fully determining if the initiative is making progress. >>Read More


Members of health agencies, such as the Family League of Baltimore, have been campaigning for safe sleep practices and visiting homes for almost a year as part of B’More for Healthy Babies. That’s not the culture of raising babies in Baltimore, one Druid Heights resident said. >>Read More


A mother serves her two small children comfort food offered for free at Greenmount's Knox Presbyterian Church. The church offers food to the community every Friday. Photo by Lauren Slavin.More than 40 percent of women in Baltimore are obese, Administrator for Maternal and Infant Care Program for the Baltimore City Health Department Stacey Tuck said. Obese women have more problems during pregnancy and delivery than those at healthy weights. In fall 2010, a pilot obesity reduction program was run in the Patterson Park North and East, Upton/Druid Heights, and Greenmount East communities. The B’More Fit for Healthy Babies program, an offshoot of the original initiative, created Weight Watchers support groups for women of child-bearing age to learn how to take care of themselves and their families in a way that fits into their lifestyle. >>Read More

B’More for Healthy Babies, the People’s Community Health Center, and Baltimore’s Healthy Start sponsored a town hall meeting to discuss the data accumulated by those focus groups
and how the community can access what they vocalized was needed to curb infant mortality rates. The meeting was cancelled after waiting an hour and a half with no one showing up to attend.
>>Read More


 The Baltimore City government has been working for over a decade to lower rates of infant mortality, low birth weight, and sleep-related deaths.

Director of the Mayor’s Office of Policy and Communications Ryan O’Doherty and Press secretary for the Office of the Mayor Ian Brennan discuss the importance of the B’More For Healthy Babies campaign and the effectiveness of the initiative’s first phase.

Infant Mortality Statistics Infant mortality statistics for Baltimore City have remained stagnant for the past decade.
Maryland has 7.3 deaths per 1000 live births, ranking 19th worst in infant mortality rates in the United States.


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