Perinatal/Infant Health

Annual Report Year FY2024

The following section outlines strategies and activities to be implemented between 10/1/2023 to 9/30/2024 to meet the objectives and show improvements on the measures related to perinatal/infant health.

 

PRIORITY: Access to Care (Women, Children, Adolescents, and Families)

 

Objective: By September 30, 2025, increase the number of infants participating in a case management/home visiting program by 30% (from 291 to 378)

 

Strategy: MCH-serving/supported programs will work with internal and external partners to identify opportunities for collaboration in providing services geared toward improving perinatal/infant health

 

Activity: Extend existing or select by competitive RFP, subgrantees, including health systems or community- based partners, to execute specific activities for recruitment, referral, enrollment, direct services, and participant navigation to address social conditions impacting the health of MCH program participants that improve perinatal/infant health

 

During the reporting period, HM/HB provided services to 674 mothers and 461 infants enrolled in the program. Intervention services included infant safe sleep education (34), health education for families, such as the Partners for a Healthy Baby curriculum, from HM/HB and its collaborators (70), oral health education (30), depression/postpartum depression screenings (61), discussed and/or received contraceptive care options (325), reproductive life planning options (43), STI/safer sex education, and referrals for nutrition services, including a lactation specialist (25).

 

HM/HB nurse case managers provide a postpartum home visit, 2-4 weeks after delivery, no later than 6 weeks.  Using the Postnatal Assessment, identify any needs of the woman and make referrals.  They also assess the infant for any risk and need for enrollment into HM/HB. 

 

HM/HB has made several partnerships with internal and external programs and organizations to extend the reach of the program and increase access to social and health services to newborn infants. To achieve this HM/HB has partnered with WIC, Office of Tobacco Control (Baby and Me Tobacco Free), Maternal and Infant Health Bureau (MIHB), Office of STD/HIV Prevention, Mississippi SIDS Alliance/Cribs for Kids, Healthy Birthday, Inc., Count the Kicks, Mississippi Department of Child Protective Services (MDCPS), Office of Oral Health, and the Office of Lead Poisoning Prevention.

 

HM/HB partnered with a Certified Nurse Midwife.  She led Midwife Mondays, an educational hour on various maternal and infant health education and provide clinical consultation, updates, and trainings for HM/HB staff (nurses, nutritionists, and social workers). She was the liaison between providers and HM/HB staff. 

 

HM/HB’s Clinical and Program Directors hosted a monthly clinical Case Rounds involving nurses, nutritionists, and social workers.  On a rotating schedule, the Nurse Team Lead or Nurse Case Manager from a single public health district presented one case (maternal or infant) in which there were challenges in meeting the patient or family’s needs or in which there were still questions about how best to serve the patient. During the review, challenges were staffed for a team approach on additional resources and support. Each month a success case was also presented outlining resources and supports provided for the family.

 

During the reporting period, Healthy Start provided services to 90 participants including expecting mothers, parents, and infants 0-18 months enrolled in the program. During monthly meetings, participants are provided health education on pregnancy and postpartum care, Count the Kicks, breastfeeding support, and mental health support. Parents received breastfeeding education and support, referral to WIC, child development education using the Milestone Moments booklets, ABC of safe sleep education, interconception care support, and mental health support.

 

The MSDH WIC Program provides referrals to internal programs based on the needs of WIC Program participants. The total number of referrals from WIC was 6683, including 209 to Early Intervention, 5943 to Healthy Moms Healthy Babies, 303 to Lead and Healthy Homes, 4 to Opioid Program, 209 to Oral Health, and 15 to the Safe Sleep Program.

 

Because the county level nurses serve a vital role in identifying woman and infant who would benefit from enrollment in one of the Health Service case management programs, the Regional MCH nurses provide an orientation to new nurses and ongoing support for current county level nurses. During the “new nurse orientation”, all nurses learn the following regarding HM/HB, MIECHV, and Healthy Start, within the county health departments: eligibility criteria, location of programs, benefits of the program, what are the differences between the various case manager and care coordination programs, and how to enroll a person.  Because of their knowledge, infants are routinely identified and referred for other MSDH services.

 

In February 2024, the MSDH Genetics Bureau was invited to collaborate with other regional states to assess hospital birthing facilities, tertiary clinical data to increase newborn screening and follow-up timeliness through the HRSA, Co-Propel Collaborative. The HRSA Co-Propel (Cooperative Newborn Screening System Priorities Program) Collaborative assists in strengthening state and regional consortia newborn screening programs through financial and technical support. The goal is to increase accuracy and improve timely newborn screening, as well as identify conditions for early diagnosis and treatment. Finally, the program collaborates with state agencies, families, communities, and various organizations to increase patient and family care coordination. The collaborative includes Georgia, Florida, Louisiana, and Mississippi. Genetics received acknowledgement of the award and began reporting approved newborn screening data in July 2024.

 

Activity: Engage with other MCH-serving programs to share lessons learned to advance program knowledge. Activities may include hosting or participating in local/regional meetings calls, participating in peer-to-peer calls, presentations delivered by webinar, mentoring other programs, technical assistance, etc.

 

As part of the University of North Carolina (UNC), MCH National Workforce Development, Learning Journey, a team from UNC came to MS for a two-day onsite program. The theme was “Building Stronger Links for Better Outcomes”.  The purpose was to:

• Reconnect with our collective why- rediscover the shared purpose that drives us and how each Health Service program contributes to our vision
• Illuminate each Health Service program’s mission to ensure we all know who we serve and how we do it
• Create collaborative synergy-explore new ways to collaborate and support each other, so we have unified efforts to support our clients
• Strength our relationships by building meaningful connections with colleagues across all Health Services programs, nurturing a “no wrong door” environment for children and families we serve.

 

Activities included learning about the collective “why”, conversational capacity, mutual learning teams, lesson on and creating an ecosystem map, along with whole system mapping.  The outcome of the event was a “quilt” identifying how each Health Service Program interconnects with other programs illustrating the importance for internal referrals for services.

 

The CYSHCN Director is the MSDH team member for Developmental Understanding and Legal Collaboration for Everyone (DULCE), a pediatric primary care intervention designed to address social conditions impacting the health for families with infants birth to six months of age. DULCE is comprised of  medical providers, behavioral health specialists, early childhood system representatives, legal partners and family specialist trained in child development and problem-solving. As the acting representative, the CYSHCN Director shares information with the team regarding MSDH MCH-serving programs for referrals.

 

The MCH Engagement and Coordination Office Director is the MSDH team member for the Children’s Trust Fund hosted by MDCPS. The Children’s Trust Fund focuses on seeking ways to reduce abuse and neglect in MS before it occurs.  As the acting representative, the MCH Engagement and Coordination Office Director shares information with the team regarding MSDH MCH-serving programs for referrals.

 

Objective: By September 30, 2025, increase the number of outside MSDH referrals for the case management/home visiting program by 20% (from 1,266 to 1,519)

 

Strategy: Home visiting/case management programs will develop and improve relationships with internal and external partners to increase referrals to the program

 

Activity: Identify 3-4 potential healthcare settings, community-based, faith-based, social, volunteer service organizations, homeless/domestic violence shelters, residential programs, treatment programs, housing complexes, etc. to outreach per quarter. Request opportunities to share information with “gatekeepers” of (i.e., community health workers, patient navigators, care coordinators, case managers, faith leaders, non-profit social service workers, helpers, etc.) or to the target population

 

Through the University of North Carolina, MCH National Workforce Development, Learning Journey, the Health Service team worked on developing a “no wrong door” referral form for expecting/postpartum mothers, infants, children, and children with special health care needs.  This moved the current Health Service form (#1037) from paper to an online portal within REDCap.  Incorporated in this online portal are the following programs for easy review, determination of what is appropriate for the person, and completing of the referral (HM/HB, FSEIP, CYSHCN, MIECHV, WIC, EHDI, Newborn Screening, Oral Health).  This portal has been added to the MSDH front page website for easy access by providers and families for referrals.  The desired outcome is for the “no wrong door” Universal Referral Form to increase the number of referrals from external and internal MCH-serving programs.

 

From October 2023 to September 2024, HM/HB utilized multiple referral pathways and received a total of 2,741 referrals (maternity = 1,226; infant = 1,515). This represented an increase in referrals to the program from the prior reporting period due to an updated referral process, increased collaborative initiatives with other internal and external and internal maternal health programs and organizations, and increased program awareness in the surrounding communities. Using multiple methods (email, REDCap, fax, EPIC, and mail), key sources including health departments, three Coordinated Care Organizations contracted by the Mississippi Division of Medicaid, obstetric and pediatric practices, genetics, STD/HIV, and Child Protective Services sent referrals to the program.

 

Activity: Optimize MSDH electronic health record (EPIC) and other platforms to create referral management processes and templates for use by external and internal referral sources to home visiting/case management programs.

 

Healthy Start strengthened its referral pathways by optimizing MSDH’s electronic health record (EPIC) to facilitate referral management processes between different MSDH programs i.e., HM/HB and Family Planning, improving efficiency for internal referral sources. There were 114 total referrals (17 from external providers and 107 from MSDH program i.e., HM/HB and WIC)

 

Objective: By September 30, 2025, promote 15 or more health observances, activities, or educational campaigns related to perinatal/infant health via media, social media, and other public-facing platforms

 

Strategy: MCH programs will collaborate on health promotion activities, health observances, and other outreach/engagement strategies to increase awareness of perinatal/infant health issues

 

Activity: Submit work requests to the Office of Communications to promote CDC/HRSA/other approved messaging related to perinatal/infant health issues etc. Prepare social media post schedules and templates for observance months/days

 

Office of Communications posted Facebook messages to increase awareness of perinatal/infant health issues. An example includes:

• Your blood sugar can rise to higher-than-normal levels during PREGNANCY. this can cause problems when you deliver and put you and your BABY susceptible for developing type 2 diabetes. you can avoid #gestationaldiabetes by having your blood sugar checked regularly while PREGNANT, eating right, and planning on a healthy weight before you become PREGNANT. read more about gestational diabetes and what you can do: https://www.cdc.gov/PREGNANCY/diabetes-gestational.html    you or someone you know may qualify for care management from MSDH for a healthier PREGNANCY. get in touch with our #healthyMOMshealthyBABIES program: healthyms.com/HMHB (1,019 reaches)
• your diabetes can make your BABY grow larger than normal, creating complications during delivery. it can mean a greater chance that your CHILD will develop diabetes, too. controlling your blood sugar, staying active, and seeing your  doctor regularly can keep your PREGNANCY a healthy one — for you and your BABY.  if you have diabetes, you may qualify for free, personalized care management during PREGNANCY. learn more at healthyms.com/HMHB   #healthyMOMs #healthyBABIES #healthyms  (1,677 reaches)
• 🍼 September is INFANT mortality awareness month! 🍼  did you know MS has one of the highest INFANT mortality rates in the nation? at the MSDH, we are committed to changing this. INFANT mortality rate (IMR): the number of INFANTs who die per 1,000 BIRTHs. in 2021, MS had an IMR of 9.3, but we have seen a slight improvement to 9.2 in 2022. while progress is being made, we have more work to do! programs & resources to help: 👶 community BABY showers providing essentials like car seats and sleep sacks 👶 healthy MOMs/healthy BABIES program with home visits and caregiver education 👶 count the kicks initiative for stillBIRTH prevention 👶 maternal, INFANT, and early CHILDhood home visiting program (MIECHV) 👶 maternal center of excellence in partnership with JSU👶 early intervention services, genetic screenings, and EPSDT screenings how you can help lower IMR risks: ✨ practice safe sleep habits ✨ encourage early prenatal care ✨ avoid alcohol and tobacco during PREGNANCY ✨ focus on improving maternal health before and between pregnancies ✨ take steps to lower pre-term delivery risks by addressing the social conditions of health and encouraging safe practices, we can create a healthier future for MS’s BABIES! 💛 please visit our website for more information, link in bio! #healthyms #healthcantwait #INFANTmortalityawareness (3,058 reaches)

 

Activity: Maximize available funding and in-kind support to develop or enhance direct health education approaches for consumers of MCH-serving programs focused on improving perinatal/infant health issues

 

No activities were done on this during the reporting period.

 

PRIORITY: Increase Breastfeeding, Healthy Nutrition, and Healthy Weight

 

Objectives: By September 30th, 2025, increase enrollment and participation in the WIC Program by 5% via partnerships and evidence- based initiatives

 

Strategy: Partner with other MCH-serving programs on the Community Innovation and Outreach (CIAO) project

 

Activity: Maintain and create additional community partnerships as referral sources to the MSDH WIC Program

 

Activity: Educate community partners on approaches to recruiting new WIC enrollees and encouraging ongoing uptake of WIC services among enrolled population

 

The MSDH WIC Programs CIAO (Community Innovation and Outreach) project aimed to increase WIC enrollment and participation for target populations annually through partnership, outreach, and promotional activities while addressing language, cultural, and environmental challenges. Strategies included establishing partnerships with internal entities to enhance the referral process and facilitate resource sharing. Internal entities included Office of Oral Health, Office of Lead and Healthy Homes, Healthy Moms Healthy Babies, and the Office of Early Intervention. Monthly meetings were conducted to discuss collaborations, allocate funds, review monthly reports, share outreach materials, and plan future activities. The partnering programs provided WIC information at 206 partner locations, distributed over 13,864 WIC-centered education items, and made 7 social media posts (including 937 likes and 116 shares).

 

1,763 expectant mothers in 16 counties received oral health education. Regional Oral Health Consultants participated in the WIC CIAO grant activities where they distributed flyers, handouts, and postcards about the WIC program. From June to October 2024, 471 flyers, 339 handouts, and 183 postcards were disseminated at school and community events.  Twenty-one hundred (2,100) people received oral health education provided by WIC nutritionists during appointments and reenrollment sessions.

 

Objectives: By September 30th, 2025, increase breastfeeding initiation and duration rates through prenatal breastfeeding education and post discharge support

 

Strategy: Increase breastfeeding initiation and duration rates through prenatal breastfeeding education, during delivery admission, and post discharge support

 

Activity: Provide breastfeeding education and support to prenatal WIC participants

 

The MSDH WIC Program operates the WIC Breastfeeding Promotion and Support Program. Breastfeeding peer counselors provide basic breastfeeding education, assist with and teach prenatal and breastfeeding classes, issue breastfeeding devices to WIC participants, troubleshoot breastfeeding issues and concerns with WIC participants, promote breastfeeding awareness in the community, and partner with community organizations to improve breastfeeding outcomes. This includes providing peer breastfeeding support to prenatal and breastfeeding participants. WIC Peer Counselors provide prenatal education to participants during WIC clinic visits. Families receive peer support, access to an IBCLC to address any complex breastfeeding issues, and access to breastfeeding devices and supplies. A total of 10,432 contacts were made, including 132 home visits, 75 hospital visits, 3,673 office visits, and 6,552 phone calls. The MSDH WIC Program also provides 24/7 free access to IBCLCs for breastfeeding support via the Pacify tele-lactation mobile app. 

 

WIC breastfeeding staff receive referrals from interagency, hospitals, and community organizations.  WIC Peer Counselors provide education about the benefits of breastfeeding, addressing individual breastfeeding issues, and providing support and reassurance for women and families. Peer counselors provide group classes based on the needs of the clinic. Some topics include basic evidence-based techniques that help ensure a successful start in breastfeeding, including milk production, skin-to-skin care, positioning and latch, and milk expression and storage.  Breastfeeding education follows the Ready, Set, Baby curriculum which was developed for counseling women about breastfeeding benefits and management including education on optimal maternity care practices.

 

Families served by HM/HB and Healthy Start are potentially eligible WIC participants. HM/HB distributed health education and items such as breastfeeding kits, to support breastfeeding for pregnant and postpartum mothers. The kits included a silicone handheld breast pump with strap and cap, topical cream to help with breastfeeding soreness and cracking, hot and cold packs, nursing pads, and milk storage bags. HMHB leveraged funding from the MIHB and WIC CIAO grant to purchase a small supply of kits.  Educational materials used include those from WIC and the Partners for A Healthy Baby Home Visiting Curriculum (Florida State University).  Healthy Start delivered comprehensive breastfeeding support and education services through a multi-faceted approach. One of the Healthy Start staff, a dually trained CHW and IBCLC provided individualized breastfeeding education and counseling, and assisted families with essential infant supplies (i.e., diapers, wipes, grooming kits, health education, and gift cards). Approx. 21 pregnant/postpartum women were served.  Through case management services, the staff connected mothers with certified lactation specialists within MSDH, creating a sustainable support network.

 

Activity: Support hospitals in achieving Baby Friendly designation

 

The MSDH WIC Program established memorandums of understanding (MOU) with delivering hospitals in Mississippi to support Steps 3 (prenatal breastfeeding education) and 10 (post-discharge support) of the Baby- Friendly Initiative. Thirty (30) of the 41 delivering hospitals in Mississippi have been designated as Baby Friendly. The MSDH WIC Program continues to support delivering hospitals with retaining the Baby Friendly designation by providing prenatal breastfeeding education at local hospitals and a referral source for post-discharge support. Formal MOUs for a period of 3 – 5 years have been signed by 5 of the 30 Baby- Friendly delivering hospitals in MS. 

 

Strategy: Assist in the creation and maintenance of Mississippi MILC Leagues across the state of Mississippi

 

Activity: Maintain and create additional community partnerships as referral sources to the MSDH WIC Program

 

Activity: Provide WIC participants access to certified lactation consultants

 

The WIC Program partners with the Mississippi Breastfeeding Coalition (MBFC) to establish and staff MILC Leagues. The Mississippi MILC League stands for Making an Impact in the Lactation Community. The purpose of the MILC League is to improve breastfeeding rates in Mississippi by offering access to lactation support statewide. MILC Leagues offer free peer support groups for new and expectant mothers virtually or in-person in communities throughout Mississippi. Support groups are facilitated by certified lactation professionals, with most leagues meeting weekly. There is a total of 12 MILC Leagues across the state.

 

WIC participants are referred from peer counselors to IBCLCs for complex breastfeeding needs. Participants may access IBCLCs via the WIC clinic (where applicable) and the Pacify app. The Pacify app provides 24/7 access to IBCLCs free of charge for WIC participants.  IBCLCs provide support for complex breastfeeding issues outside of the scope of breastfeeding peer counselors. They conduct various components of a comprehensive assessment, including feeding history, feeding assessment, breast assessment, and infant assessment.  The WIC Breastfeeding Program provides a variety of devices to meet the specific needs of breastfeeding participants. Devices are only issued to WIC participants by the WIC designated breastfeeding expert, peer counselor, and/ or regional breastfeeding coordinator. Available devices include manual breast pumps, single user electric pumps, multiuser electric pumps with kits, Supplemental Nursing Systems, car adapters, Breast shells, and flanges.

 

PRIORITY: Infant Mortality (and associated preterm/low birth weight factors)

 

Objective: By September 30, 2024, produce the annual Child Death Review Report to include recommendations for preventing infant deaths

 

Objective: By September 30, 2025, participate in at least 18 community outreach events to address infant mortality and promote Child Death Review and FIMR Committee recommendations

 

Objective: By September 30, 2025, expand the FIMR program to all 9 public health districts of Mississippi

 

The Fetal and Infant Mortality Review (FIMR) is a community-based process designed to examine fetal and infant deaths to improve maternal and infant health outcomes. Its purpose is to identify and address factors contributing to these deaths through comprehensive case reviews and community engagement. The goals of FIMR include improving systems of care, and informing local public health initiatives.  MSDH had only one operational FIMR program during the reporting period, located in the lowest six counties, the Gulf Coast area.  From the Case Review Team meetings, recommendations centered on the regulation of Kratom, education on unregulated products such as nutrition supplements, tobacco and marijuana prevention, stillbirth prevention, infant CPR education at discharge, referrals to case management for high-risk neonates and infants, increase treatment options for pregnant and parenting women with opioid and other drug addiction, breastfeeding, infant safe sleep, and syphilis testing and treatment during pregnancy.

 

MIHB began the initial infrastructure work to expand FIMR to the other 8 public health districts across the state. This included engaging other organizations charged with FIMR for their areas, other Healthy Start programs, developing policy, forms, data collection documents, and standard operating procedures based off of the National Center for Fatality Review and Prevention’s guidelines, securing MCH Block Grant funding to support modest subgrants to external organizations, developing a request for proposals and recruiting organizations to lead the FIMR work in their areas. By May 2024, four organizations had been identified to lead FIMRs in public health district’s 5, 6, 7, and 8. The existing Tougaloo Healthy Start program will lead FIMR in districts 1 and 3. The existing MSDH Healthy Start Enhanced program will lead FIMR in Districts 2 and 4. To support these organizations in their work, MIHB will provide orientation, training, and ongoing technical assistance. The 8 new FIMRs are expected to be fully operational by September 30, 2025.

 

The MIHB was also awarded a competitively funded capacity building grant from the National Center for Fatality Review and Prevention in the reporting period. This grant aimed to provide resources for training coroners and medical examiners statewide in completing SUIDI forms, enable more accurate death scene investigations by equipping coroners and medical examiners with anatomically correct infant dolls, hiring a temporary staff member to catch up data entry and improve data quality in the fatality reporting systems, and to support the implementation of Community Action Team recommendations.

 

Objective: By September 30, 2024, add informant interviewing of family members/next-of-kin to the Child Death Review and FIMR case exploration processes

 

Strategy: MIHB will provide the administrative support for the death case abstraction, exploration, and determination process to fidelity for all maternal deaths through the Child Death Review Panel and FIMR

 

Strategy: MCH-serving/supported programs will work with internal and external partners to identify opportunities for collaboration in providing services geared toward improving infant mortality based on CDR and FIMR recommendations

 

Activity: Extend existing or select by competitive RFP, subgrantees, including health systems or community- based partners, to execute specific activities for providing health promotion and health education focused activities that improve infant health

 

Activity: Engage with other Child Death Review Panel, FIMRs, workgroups, and taskforces, to share lessons learned to advance program knowledge. Activities may include hosting or participating in local/regional meetings calls, participating in peer-to-peer calls, presentations delivered by webinar, mentoring other programs, technical assistance, etc.

 

The Mississippi SUID Prevention Task Force, a subset of individuals serving on Mississippi’s Child Death Review Panel and organized in 2023, requested help from MIHB to better understand the practices of safe sleep education among birthing facilities. The MIHB led work to organize a survey during the reporting period to explore the types of information and resources provided to parents and caregivers at discharge, the types of teaching provided on safe sleep/SUID prevention prior to discharge, materials provided to encourage safe sleep, and obstacles to providing safe sleep education. Responses from 18 facilities, including some non-birthing facilities, were received upon conclusion in June 2024 and informed additional strategies around safe sleep initiatives. Results of the surveys showed that nearly all birthing hospitals offered some type of safe sleep education, instruction, or materials, had dedicated staff for those activities, and partnered with other agencies or organizations to support safe sleep messaging and activities. 

 

Additionally, at the request of the SUID Prevention Task Force, MIHB led work to organize three focus groups starting in April 2024. Focus groups invited families and caregivers of infants ages 2 to 12 months old to provide feedback on infant safe sleep practices, known/given information regarding infant safe sleep, as well as the challenges around infant safe sleep. Virtual sessions were held over three separate days and times and followed a structured set of questions approved by the Task Force. Participants were offered $50 gift cards for their participation. A total of 15 individuals participated. Results of the focus groups showed that most parents/caregivers received some type of information or instruction on safe sleep prior to hospital discharge, most knew the safest position for infant sleep is on the back, and co-sleeping was common due to convenience (i.e., not wanting to get up, breast feeding, and wanting to have the infant close out of care and worry). The groups were also shown two short videos on safe sleep, concluding them to be informational but not new information to them. Overall, the groups suggested that if stakeholders were to do a Back to Sleep or Infant Safe Sleep Campaign, social media campaigns, TV ads, and mailout would all be effective methods of getting this information out. The groups also suggested having in-person training/birthing classes at the local health departments or day care during or after pregnancy, to cover topics like safe sleep practices, swaddling and having these trainings during accessible hours for working parents.

Informed partly by the work of the FIMR, the state-level Child Death Review Panel, and information gained from the surveys and focus groups, a state-level infant mortality report was prepared and submitted to the Mississippi Legislature and made public-facing in December 2024, however, was later revised in April 2025 for improved formatting and additional content. The report is accessible online at: https://msdh.ms.gov/page/resources/21026.pdf Staff of the MIHB, the Office of Health Data and Research, and the Office of Vital Records assisted in the preparation of the revised report.

 

Some key findings included:

• The top three causes of infant deaths in 2022 were (1) congenital malformations/chromosomal abnormalities, birth defects/ malformations, (2) accidents which includes death related to unsafe sleep or Sudden Unexpected Infant Death, and (3) deaths related to short gestation and low birthweight.
• The rate of Sudden Unexpected Infant Death (SUID) decreased from 87 to 82 or from 2.5 per 1,000 to 2.4 per 1,000. But this SUID rate is over twice the United States. Deaths due to ASSB (accidental suffocation and strangulation in bed) was up from 18 to 34 in 2022 accounting for 41% of SUID.
• 120 babies born less at than 27 weeks accounted for 38% of all infant deaths in 2022. These infants either died in the hospital or at home within the first year.
• Of the 48 SUID cases reviewed from 2021, 65% were found to have sleep environment related factors. Among sleep-related factors, 58% were not sleeping in a crib, bassinette, side sleeper, or baby box, 27% were not sleeping on their back, 29% had unsafe bedding or toys in the sleeping area, 50% were co-sleeping with other people (including adult caregivers or siblings) in an adult bed, couch, or recliner, and 10% cases had the caregiver/supervisor to fall asleep due to tiredness or while feeding (including bottle and breast feeding) while co-sleeping. Unsafe sleep practices (infants not sleeping alone on their back, or in a crib, bassinet, or pack n’ play) continue to be a contributing factor of sudden unexpected infant deaths.

 

Key recommendations included:

1. Early and Comprehensive Prenatal Care
   1. Promote preconception health and ensure early obstetric care through policies like presumptive Medicaid eligibility, which can provide care up to 6 weeks earlier.
   2. Provide screening and treatment for syphilis and substance use, and refer women with high-risk pregnancies for additional support (e.g., mental health, tobacco cessation, remote monitoring, nutrition).
2. Safe Sleep Education
   1. Educate caregivers about the risks of co-sleeping and promote safe sleep practices through mass media campaigns, prenatal care, and hospital discharge education.
3. Enhanced Perinatal Systems
   1. Incentivize obstetricians to transfer high-risk mothers to hospitals with NICUs.
   2. Strengthen education and training in all delivery hospitals to manage preterm or complicated deliveries.
   3. Develop a referral system for mothers and babies to deliver at appropriate facilities, potentially involving out-of-state partners.
   4. Prioritize maternal over neonatal transports to reduce newborn complications and mortality.
4. Better Data and Oversight
   1. Require coroners to complete death scene investigations (SUIDI forms).
   2. Track maternal and neonatal transports and NICU outcomes.
   3. Strengthen collaboration between the MS Perinatal Quality Collaborative, Child Death Review Panel, Fetal Infant Mortality Review (FIMR) programs, and the Maternal and Infant Health Bureau.
   4. Require full information sharing from all agencies involved in infant death reviews.
   5. Expand and operationalize FIMR programs, especially in high-risk areas.
   6. Establish an expert physician committee to review and analyze infant mortality statistics annually.

Many of these recommendations are already being materialized with progress to be shared in future MCH Block Grant reports.

 

The Child Death Review Panel (CDRP) remained active holding its case review meetings on a regular schedule throughout the year. Informed partly by the work of the existing FIMR, and surveys and focus groups, a mortality report was prepared and submitted to the Mississippi Legislature and made public facing in December 2024, however was later revised in February 2025 for improved formatting and additional content. The report is accessible online at: https://msdh.ms.gov/page/resources/21025.pdf

Staff of the MIHB, the Office of Health Data and Research, and the Office of Vital Records assisted in the preparation of the revised report.

 

One key finding included:

• The leading causes of external death among all cases reviewed from 2022 was (1) Sudden Unexpected Infant Death, (2) firearm-related deaths, (3) homicides, and (4) motor vehicle/transport accidents.

 

Key recommendations included:

• Challenges to Reviewing Child Deaths: Many child deaths can't be reviewed due to lack of access to full records, even though the Child Death Review (CDR) has legal authority. Hospitals, police, and coroners often ignore requests, and there is no way to enforce compliance. More staff and accountability are needed to obtain records.
• Sudden Unexpected Infant Death (SUID): SUID is the leading external cause of child death. There is a critical need for better education on safe sleep practices—starting in prenatal classes, and continuing through hospitals, doctors, and a statewide coalition-led campaign. A dedicated team should lead this education effort.
• Distracted Driving and Child Deaths: First responders report an increase in child fatalities from car crashes linked to phone use. Stronger laws, educational traffic stops, and incentives like usage-tracking insurance apps are recommended to reduce distracted driving. Coordination with the insurance commissioner is encouraged.
• Gun-Related Child Deaths: These now exceed motor vehicle deaths. Many involve unsecured firearms in homes. Although gun safety discussions are governmental sensitive, the committee stresses the need for accountability laws and public education, possibly through PSAs using real cases (with family consent), to highlight the preventable nature of these tragedies.

 

Many of these recommendations are already being materialized with progress to be shared in future MCH Block Grant reports.

 

The MIHB staff also dedicated effort to developing policy, forms, data collection documents, and standard operating procedures based off of the National Center for Fatality Review and Prevention’s guidelines for the operational/administrative work related to the Child Death Review Panel.

 

Activity: Partner with other stakeholders to promote/expand offerings of safe sleep/infant safety training (i.e., car seat/travel safety) and material resources (i.e., cribs, sleep sacks, car seats) to professionals and individuals/families

 

During the reporting period, Health Service Programs actively participated in community outreach events to promote safe sleep and to educate the public about the danger of SIDS, SUIDS. HM/HB provided health education to patients, provided access to cribs (pack n plays), and demonstrated how to properly utilize a crib. HM/HB Central Office team has participated in over multiple community outreach events which have been previously described in other sections of this report. A total of 13,650 safe sleep educational materials were distributed by the LPPHHP to birthing hospitals statewide for distribution to new parents.

 

Activity: Initiate and launch a statewide stillbirth awareness campaign (i.e., Count the Kicks ™)

 

MIHB partnered with Healthy Birthday, Inc. to launch public-facing evidence-based stillbirth prevention activities and programming throughout the state through its Count the Kicks™ (CTK™) program. CTK™ educates expectant parents on how to track their baby’s movements and identify changes in fetal movements. The free CTK™ app is available in more than 20 languages in the Google Play and iOS app stores and has more than 260,000 registered users in all 50 U.S. states, and more than 140 other countries. There were 7,474 visits to the Count the Kicks website by those in Mississippi from July 1, 2023, to June 30, 2024. There were 648 new app users. Two webinars were held with healthcare providers and community-based organization support staff. There were 82 requests for materials, which were co-branded with MSDH’s logo, and 25,340 pieces of CTK materials distributed. Additionally, 100 toolkits were shipped to Mississippi providers. This partnership was supported by MCH Block Grant funding. HM/HB and Healthy Start were active partners for distributing information about the Count the Kicks ™ MSDH was delighted to receive word of a “Baby Save” in March 2024. A news article about the baby who was saved when his mother alerted her doctor about reduced fetal movement can be found at: https://jacksonadvocateonline.com/mississippi-mom-uses-count-the-kicks-saves-her-babys-life/

 

Activity: Partner with National SIDS Alliance and Cribs for Kids ™ to establish centralized resource for Mississippi families in need of cribs/safe sleep environments

 

MIHB served as a safe sleep resource distribution center for internal programs and community and health systems by obtaining and distributing safe sleep materials and resources.  These resources included, but were not limited to, pack-n-play cribs, sleep sacks, and safe sleep educational resources. MIHB provided funding to Cribs for Kids® to purchase “cribettes,” which have all the safety features of the Pack n Play and brings the infant safe sleep message front and center to all caregivers with “A B C – Alone on my Back in a Crib” imprinted on the fabric. From July 1, 2023, to June 30, 2024, 199 cribs were distributed from MIHB through other MSDH programs, including HMHB and Healthy Start.