Perinatal/Infant Health Annual Report

As part of the Title V MCH Program, the Maternal and Infant Program (MIP) provides technical assistance, resources, and support to private and public partners serving families and infants. The MIP Coordinator works closely with these partners, as well as the MCH Director, Title V MCH Program Manager and MCAH Section Manager, to improve infant and maternal health outcomes. The Perinatal/Infant Health report demonstrates how collaboration between agencies, leadership, and MIP accomplishes the state priorities of promoting breastfeeding and safe sleep.

These collaborative efforts include MCAH staff serving on the Newborn Screening Advisory Board and reporting on Critical Congenital Heart Disease (CCHD) efforts including the CCHD Registry maintained by CYSHCN in partnership with Early Hearing Detection and Intervention (EHDI). The EHDI and Title V MCH programs work closely together and are co-located in the MCAH Section. Multiple perinatal related presentations were made to the Maternal Child Health Advisory Board (MCHAB) for which Title V MCH Program serve as support staff. Title V MCH provided packets of brochures and MCH information to the Tribal Liaison to share with Tribal partners statewide.

Association of State and Territorial Health Officials (ASTHO) Opioid Use Disorder, Maternal Outcomes, and Neonatal Abstinence Syndrome Initiative (OMNI)/ Perinatal Health Initiative (PHI) participation by Title V MCH Program was focused on systems building to provide referrals and interventions for substance exposed infants, and state interest in formalizing a statewide perinatal quality collaborative was explored as part of the OMNI Action Plan although SBIRT training was a primary focus. Title V MCH Program actively participated in numerous infant and perinatal focused workgroups, conferences, webinars, taskforces, committees, community meetings, provider outreach, hospital presentations, MCH data meetings, and breastfeeding and MCH coalitions. The MCH/CYSHCN Director serves on the AMCHP Board where perinatal and infant health policy is a key area of emphasis, and all key Title V MCH Program participated in Association of Maternal and Child Health Programs (AMCHP) efforts.

Results of the Five-Year Needs Assessment demonstrated the need to continue promoting breastfeeding (NPM4) to improve health outcomes for infants. Promoting breastfeeding is one of several priority areas for the MIP. Title V MCH partners with public and private community members to enhance efforts to meet this priority by increasing the percent of infants who are ever breastfed (NPM 4A) and who are breastfed exclusively for six months (NPM 4B).

The outcomes of the Five-Year Needs Assessment also demonstrated the need to promote safe sleep and reduce preventable infant death, resulting in the inclusion of NPM 5 as a performance measure. In addition to collaborating with existing partners to promote safe sleep, establishing new partners to increase the percent of infants placed to sleep on their backs (NPM 5A), on a separate approved sleep surface (NPM 5B), and placed to sleep without soft objects or loose bedding (NPM 5C) will continue to be a priority in funded efforts.

Breastfeeding Report

The Title V MCH Program supports the Nevada Breastfeeds domain to promote the Breastfeeding Welcome Here Campaign. The Nevada Breastfeeds website highlights businesses in Nevada that are breastfeeding-friendly and show their support to breastfeeding persons in Nevada. The goal of this campaign is to encourage more people to choose to breastfeed and breastfeed for longer by recognizing businesses who support a breastfeeding-friendly environment.

The website had 6,571 total sessions with 5,329 users, of which 5,314 were new users. New users represent 86.7% of the total sessions and 13.3% were from returning visitors. A total of 9,672 page views occurred. More than half (56%) of sessions came from Nevada, followed by California, Virginia, and Texas.

Title V MCH Program continued the statewide campaign to improve infant feeding practices and increase community and business support for those choosing to breastfeed. Nevada WIC supported WIC participants by providing free professional lactation services, breast pumps, and an enhanced food package to those breastfeeding. MCH and WIC continue to work with Nevada Medicaid to increase access to breast pumps and lactation supports.

The breastfeeding campaign in Nevada is designed to increase awareness, promote WIC breastfeeding services, normalize breastfeeding in public locations and recognize breastfeeding-friendly businesses. A social media campaign with DP Video Productions, LLC was purchased during this grant period and executed in the following grant period to promote the NevadaBreastfeeds.org website and bring awareness to the site.

Title V MCH Program distributed resources about breastfeeding and posted information on the MCAH website. The Breastfeeding Welcome Here (BFWH) Campaign allowed businesses to receive placards informing patrons breastfeeding is welcomed at the agency. Furthermore, organizations ‘taking the pledge’ were listed on the Nevada Breastfeeds website as a breastfeeding-friendly business. Carson City Health and Human Services (CCHHS) promoted the BFWH Campaign to 40 local businesses when informing about Nevada breastfeeding laws.

Title V MCH Program coordinated with the Carson City Planning Division to hang a Breastfeeding Awareness Month Banner on Carson Street in Carson City, Nevada. The banner was hung the first week in August 2022 to recognize August as Breastfeeding Awareness Month.

Special Breastfeeding Project

Title V MCH partnered with Nevada WIC on a special breastfeeding project using State Partnerships Improving Nutrition & Equity (SPINE) funds. Funds were used to enhance the Breastfeeding Welcome Here Campaign and provide breast pumps to childcare providers.

The Breastfeeding Welcome Here Campaign highlights businesses in Nevada that are breastfeeding-friendly and show their support. According to the American Academy of Pediatrics, lack of support is one of the many obstacles to successful breastfeeding. The goal of this campaign is to encourage more people to choose to breastfeed and breastfeed for a longer duration. This will support making communities stronger and healthier and promote breastfeeding as the standard for infant feeding. However, without other breastfeeding supports in place breastfeeding for those returning to work may be too difficult and may stop. Childcare providers that are breastfeeding friendly may be what is needed to keep parents breastfeeding.

To accomplish this goal, SPINE funds are used to create a breastfeeding space at childcare facilities including the purchases of a chair, side table, and a collapsible breastfeeding space, a breast pump, and pump kits.

Pregnancy Risk Assessment Monitoring System (PRAMS) Report

PRAMS is part of a national effort to reduce infant mortality and adverse birth outcomes. The PRAMS questions cover the period before, during, and shortly after pregnancy. The PRAMS questionnaire packets include a cover letter, a question brochure, and a consent document. If a mother does not respond after three questionnaires are sent, an attempt is made to reach her by telephone. Mothers who complete the survey by mail or telephone are offered a $20 Walmart gift card (funded by PRAMS). PRAMS data will be used to monitor the progress of national and state pregnancy and birth-related health measures. PRAMS data will also be used to identify and monitor self-reported maternal behaviors and experiences occurring before, during, and shortly after pregnancy among women who deliver live-born infants. Nevada PRAMS started collecting data in September 2017. For 2018, 2019, and 2020 births, Nevada PRAMS completed full years of data collection of 12 batches each. The weighted data from the 2018 births had a response rate of 39.4%, 2019 births weighted data had a response rate of 42%, 2020 births weighted data had a response rate of 43% and 2021 births weighted data had a response rate of 34%, which falls below the CDC-required threshold of 55% for 2018 and 50% for 2019, 2020 and 2021 data. Due to this response rate, the data are to be interpreted with caution.

PRAMS entered its fifth year of funding in May 2020 and applied for and received an additional five years of funding beginning May 2021. The Title V MCH Program provided funds to cover the costs of printing and distribution of PRAMS survey covers, informational brochures, and posters. The Title V MCH Program has supported efforts to increase the survey response rate through funding a Nevada Broadcasters Association and DP Video Productions media campaign airing of PRAMS television, radio, and social media advertisements in both English and Spanish. The most recent social media campaign through DP Video Productions was purchased during the reporting year and ran through next year’s reporting period. Nevada Broadcasters Association aired radio advertisements for PRAMS from September 2021 until August 2022.

All Title V MCH subrecipients have language in contracts to educate pregnant persons about PRAMS. Promotional materials are disseminated to appropriate agencies educating about PRAMS, such as posters, brochures, water bottles, ice packs, pens, and tote bags. CCHHS promoted awareness of the survey through the clinic digital signage and social media. A month-long campaign allowed patients and people passing by to view PRAMS messages on the outdoor digital signage. The one-month Facebook promotion reached 5,845 individuals with 3.6% engaged users. Title V MCH Program sit on the PRAMS Steering Committee.

Fetal Infant Mortality Review Report

The Title V MCH funded Washoe County Health District (WCHD) Fetal Infant Mortality Review (FIMR) program activities continued, and data was abstracted and entered into the National Fatality Review Case Reporting System (NFR-CRP) with 40 new cases reported. Seven of those cases were from outside Washoe County yet received medical and other services in Washoe County. MCAH continued to serve on FIMR and provide data support and TA.

No comprehensive maternal interviews were conducted during this grant period. Staff successfully contacted several women who were receptive to information about local bereavement and other resources. Many of these women declined full interviews or only answered a limited number of questions due to the grieving process and/or their time constraints. Other barriers for completing maternal interviews continue to be transiency, invalid phone numbers and incomplete information. Interviews are not attempted in cases involving litigation, out of jurisdiction, complex and extenuating circumstances, and patients with psychiatric comorbidities. Additional obstacles for maternal interviews were staff turnover and training. The FIMR program is prepared to serve diverse populations with interpreter services provided in multiple languages. Sympathy cards and educational materials are available in both English and Spanish.

The FIMR Case Review Team (CRT) expanded over the last year as staff actively recruited additional members from the community. The CRT welcomed new members from Regional Emergency Medical Services Association (REMSA), The Life Change Center, and Thrive Counseling. The CRT is seeking new members from Renown Regional Medical Center (RRMC), Northern Nevada Sierra Medical Center (NNSMC), The Child Advocacy Center, insurance companies, and mental health clinics due to staffing changes in those organizations. FIMR strives to enhance CRT member diversity to improve understanding and address prevention strategies to improve fetal and infant health outcomes.

The FIMR CRT met a total of ten times and reviewed forty cases between October 1, 2021, and September 30, 2022. The FIMR Team typically reviews four cases per meeting. See “Accomplishments” below.

The FIMR Community Action Team (CAT) helps to implement recommendations of the CRT through the Northern Nevada Maternal Child Health (MCH) Coalition. Staff continued to provide FIMR updates at the NNMCH Coalition meetings. Northern Nevada MCH Coalition held a total of eight meetings during this reporting period.

FIMR coordinators attended Child Death Review meetings every other month and presented summaries of natural infant death cases not currently under investigation by Child Protective Services or local law enforcement agencies. FIMR coordinators also participated in National Western Region FIMR support calls held quarterly.

Throughout the year FIMR coordinators were actively involved in Congenital Syphilis Review Board and review of local congenital syphilis cases, which are presented to the FIMR team in the event of a death.

FIMR attended the Pregnancy and Infant Loss Support Organization of the Sierras (PILSOS) committee meetings and assisted in planning the annual PILSOS Yard Sale that was held on June 11, 2022, to raise funds for bereavement services in the area. FIMR coordinators also assisted with planning the 11th Annual “Time for Remembrance Event” held on October 10, 2021 and began planning and preparation for the 2022 event. Staff assisted with the Arts and Crafts Fair Fundraiser on August 6, 2022.

FIMR attended several virtual trainings during this reporting period, including:

• Count the Kicks Webinar in partnership with Health Plan of Nevada" webinar. It focused on stillbirths and the introduction of the “Count the Kicks” campaign for providers in Nevada on 10/28/2021.

• COVID-19 + Pregnancy How to Improve Outcomes in a Global Pandemic Webinar presented by Healthy Birth Day, Inc. on 10/21/2021. Information on this webinar was shared with FIMR partners.

• Black Maternal Health Awareness Roundtable online 02/18/2022

• Reproductive Health: Prenatal Substance Exposure Learning Series I in-person on 03/04/2022

• Reviewing Deaths During the COVID-19 Pandemic webinar with National Center for Fatality Review and Prevention on 03/23/2022

• COVID-19 Vaccine Myths and Implications for Pregnancy, Breast Feeding, and Chest Feeding Webinar 4/12/2022

• Lesbian, gay, bisexual, transgender, queer and/or questioning, intersex, asexual/aromantic/agender and Cultural Training Webinar 4/12/2022

• Diversity, Equity, and Inclusion course through Washoe County on 5/10/2022

• Prenatal Trauma: Raising Children Who Have Been Exposed to Substances In Utero Virtual Conference 5/18-5/19/2022

 • NRC-CRS Version 6.0 Update webinar 5/24/2022

• Reshaping Comfort: Perinatal Bereavement webinar 5/25/2022

• Effective Review of Stillbirths NCFRP webinar on 6/21/2022

• Sudden Infant Death Syndrome Awareness Month Webinar 07/19/2022

• Suicide Awareness on 08/25/2022

• The Northern Nevada Maternal Health Annual Symposium, Camp Creating Open-hearted Peaceful Experiences on 09/16/2022

• The National Baby and Me Tobacco Free Facilitator Training the week of 09/19/2022

• Syphilis MPox Inservice on 09/27/2022

• Mental Health First Aid on 9/28/2022

Cribs for Kids/Safe Sleep Report

The Regional Emergency Medical Services Authority (REMSA), funded through the Title V MCH Block Grant, operates as the lead agency for the Cribs for Kids (C4K) Program in Nevada. C4K provides educational resources to parents and caregivers on the importance of practicing safe sleep behaviors with infants to prevent mortality. Partner agencies participate in train-the-trainer sessions, which include evidence-based, best practice Safe Sleep Education endorsed by the American Academy of Pediatrics (AAP). Safe Sleep Survival Kits for infants are provided to families who cannot afford to purchase a crib for their infant. Safe Sleep Survival Kits are available in English and Spanish, and include:

• Pack n Play (Cribette®)
• Branded SleepSack
• Cribette® Sheet with Safe Sleep Message
• ABCs of Safe Sleep Photo Magnet
• Philips Soothie Pacifier
• Cribs for Kids Step-Down Booklet (educational brochure)
• Sleep Baby Safe and Snug Children's Book

During the reporting period, the C4K Coordinator participated in 24 community-based awareness opportunities and activities. Of those activities, six were community outreach events. The coordinator attended the Nevada State Health Conference in late May 2022. Six trainings were completed with 20 trainees.

During community events and the train-the-trainer sessions, the C4K Program shared additional internal MCH agency materials with the public, including Nevada 211, SoberMomsHealthyBabies.org (SMHB), the Nevada Tobacco Quitline, and Medical Home Portal (MHP) information. 

Nine hundred and eighteen Safe Sleep Survival Kits were distributed, and 6,286 families were entered into the REDCap database. Ongoing communication efforts are prioritized to ensure Safe Sleep education and materials are widely distributed and participation in C4K activities continues to increase.

Other safe sleep materials were distributed statewide and included 27 binders, 77 posters, 32,746 brochures, 2 flip charts, and 754 Sudden Unexplained Infant Death (SUID) intake questionnaires. Also, 398 three-(3) month follow-ups and 31 twelve-(12) month follow-up surveys were conducted to identify knowledge gaps related to infant safe sleep practices. The survey showed 96.1% of parents laid their infant on their back at 3 months, and 89.3% laid their infant on their back at 12 months.

In June 2022, the AAP published new safe sleep recommendations. The Cribs for Kids (C4K) current curriculum was updated to reflect these changes, and information was presented to partners. The curriculum is also available online through a shared drive for C4K partners to access the most recent changes or forms. The curriculum includes a section on how to set up a REDCap account and enter data.

C4K also attended Washoe County Safe Kids meetings, Maternal Child Health Coalition meetings, and Child Death Review meetings. These groups aim to ensure evidence-based, standardized statewide safe sleep messaging are disseminated to raise public awareness of the importance of following Safe Sleep Guidelines and reducing infant deaths.

The C4K Program also distributes infant, convertible, and booster car seats statewide. During this grant cycle, 52 seats were distributed, all on rural Tribal reservations. Owyhee Community Health Facility distributed 2 car seats, South Bands Health Center distributed 16 car seats, and the Walker River Paiute Tribe distributed 2 car seats. The Washoe Tribe did not distribute any car seats in FY2022.

Safe Sleep Media Campaign Report

The Safe Sleep Media Campaign ran from October 1, 2021, through September 30, 2022, with English and Spanish radio and television public service announcements statewide. For this funded period, the media campaign had a total of 14,509 total spots aired (12,879 radio advertisements and 1,630 television advertisements). The average return on investment for airtime was 26 to 1 with a 3 to 1 guaranteed return on investment from the Nevada Broadcasters Association.

All local health authorities promote Safe Sleep messaging. The Title V MCH Program works closely with partners across the state The Statewide Executive Committee to Review Child Fatalities membership includes the MCH Director, working closely with other members to leverage statewide efforts to end preventable infant and child mortality statewide, including Sleep-related Sudden Unexpected Infant Death (SUID).

Perinatal/Infant Health and Wellness Report

CCHHS and 11 nursing clinics within DPBH Community Health Services (CHS) serving Nevada’s rural and frontier areas were awarded Title V MCH Program funding to improve perinatal and infant health. Clinic staff provided information about the importance of securing a medical home, being adequately insured, attending postpartum and infant visits, practicing safe sleep, receiving developmental screens, breastfeeding, and practicing proper nutrition. Clinic staff distributed immunization schedules for pregnant persons and family members (flu and Tdap cocooning). Title V MCH Program provided materials for CCHHS and CHS to disseminate during clinic visits and outreach events pertinent to safe sleep, Text4Baby, substance use in pregnancy (including marijuana), PRAMS, Nevada 211, and the MHP. Furthermore, staff promoted Medicaid coding and coverage for long-acting reversible contraceptives immediately postpartum.

CCHHS provided counseling and education to pregnant persons about establishing an obstetrician, breastfeeding, PRAMS, immunizations, and WIC support services. Individuals with a positive pregnancy test or indicated consideration of pregnancy were given swag bags with materials provided by Title V MCH Program. Content promoted healthy pregnancy outcomes by endorsing Text4Baby, Go Before You Show, NTQ, Cribs for Kids, being alcohol and substance-free, as well as other pertinent information. Furthermore, 42 pregnant persons were referred to WIC for breastfeeding education and support. The clinic digital signage promoted infant immunizations, Text4Baby, PRAMS, and SMHB. A Text4Baby Facebook campaign reached 6,408 individuals with 1.3% engaged users.

CHS Success Story 

 

Nye County Community Health Nurse:

 

“We have women who find out about our services through word of mouth and social media. One client was coming in for a pregnancy test. She was pregnant and was an undocumented individual. She was barely able to afford rent and her boyfriend was also undocumented. She was not only able to be set up with education on how to have a safe pregnancy but was given prenatal vitamins and referred to WIC. She was also referred to HHS to get help with finding a shelter and getting services to ensure she is in a safe environment. I was able to contact organizations in Las Vegas who were able to help her not only get emergency Medicaid, but also get set up with the birthing center in a Level one Trauma Center who would assist her in a healthy and safe delivery of her baby. She was not only able to have a healthy and safe pregnancy, but she was empowered with the information and resources to make sure she had a safer and healthier lifestyle. She was able to get a Tetanus vaccination and then return as a family planning client after her 6-week post-partum checkup for birth control.”

 

Nevada 211

Nevada 211, a program of Money Management International, was awarded Title V MCH Program funds to provide access to health and social service information and resources for maternal and child health populations and their families. Enhanced efforts were conducted to ensure pregnant individuals and those residing with them received a full set of resources for healthy pregnancy and postpartum outcomes. Title V MCH Program funding supports a portion of personnel costs to manage the Nevada 211 website and operate the telephone call center connecting people with needed services. Nevada 211 is a special telephone number and text line providing information and referrals to health and social service organizations. Resources include but are not limited to places to find food, housing, emergency shelter locations, children’s services, adoption and foster care, mental health and counseling services, safety for those affected by intimate partner violence, and resources for individuals living with disabilities. Specific services for children include breastfeeding support, diaper programs, childcare and assistance with related expenses, clothing, family support, and respite care.

Nevada 211 has several online data reports. Nevada 211 Counts provides real-time data via in an interactive format allowing the viewer to choose specific data categories and time-periods. The Nevada 211 Annual Report categorizes call, chat, and website data by state fiscal year. During nine-months of this funded period, calls and chat sessions were initiated by 15,498 individuals and 70% were women. As many as 91% used the phone line to talk with a call specialist. Only 2% of overall users were under the age of 20 y.o.

During the report period, Nevada 211 call specialists answered 816 calls from pregnant persons or those residing in the household with someone who was pregnant. Ninety one percent of the MCH population callers were pregnant. Most callers were insured through Medicaid (70%) with the largest needs for assistance being housing followed by utilities, then access to health care, including COVID-19 resources. Pregnant individuals and new parents were provided with information to help improve maternal and infant health outcomes. Below are information and referrals made to Title V MCH program recommended resources:

MCH SPECIFIC INFORMATION PROVIDED	PERCENT
Text4Baby	20%
Pregnancy Risk Assessment Monitoring System	10%
Medical Home Portal	7%
Nevada Tobacco Quitline	1.4%
Cribs for Kids	1.2%
Perinatal Mood and Anxiety Disorder helpline	0.7%
Sober Moms, Healthy Babies information	0.5%

 

Title V MCH Program arranged trainings for Nevada 211 call specialists to enhance caller’s experiences. To help ensure callers are treated with respect, the Title V MCH Program facilitated a discussion using the CDC Equity Style Guide allowing Call Specialists to engage in discussions about appropriate person-first language terms. Title V MCH Program arranged trainings for Nevada 211 call specialists to enhance callers’ experiences. Staff provided refresher content about PMAD, Safe Sleep, Text4baby, PRAMS, SMHB,  and Medical Home Portal. Furthermore, Title V MCH Program funds provided staff resources for Call Specialist’s to attend Suicide Prevention 101, increasing one’s understanding of warning signs and reviewing best-practice strategies while waiting for individuals to be connected to Crisis Support Services of Nevada. and MHP. Furthermore, Title V MCH Program funds provided staff resources for Call Specialist’s to attend Suicide Prevention 101, increasing one’s understanding of warning signs and reviewing best-practice strategies while waiting for individuals to be connected to Crisis Support Services of Nevada.

Nevada 211 provided the University of Utah, Department of Pediatrics with a quarterly export of Nevada 211 agency-level information to be placed into the database supporting Nevada’s MHP webpages. A key offering of the MHP is information about local community and professional services to assist families of CYSHCN.

Title V MCH program funded agencies promoted Nevada 211 by providing information to staff and clientele about the value of the service and how to access its resources. CCHHS promoted Nevada 211 through clinic digital signage and social media. Facebook posts reached 7,211 individuals with 4.2% engaged users. All DHHS staff include information in their email closings to find help 24 hours a day by dialing 211; texting 898-211; or visiting Nevada 211 website. Title V MCH program awarded partners are required to register and update program information with Nevada 211.

Nevada 211 Success Story

Nevada 211 Call Specialist received a call from young woman:

“I spoke with a young woman that recently relocated to Nevada. She stated she was a few months pregnant and new to Nevada and basically was on her own and had no family or friends to rely on. The caller was concerned about her health insurance being transferred from out of state to Nevada and mentioned she was currently homeless and needed financial assistance with move-in costs. She also wanted to know if we had any resources for expectant mothers. I provided her resources for Medicaid and was also able to locate a resource for rent deposit assistance. I also provided a few resources for expectant mothers (diapers, baby items, direct baby services etc.) as well and offered the resource Text4Baby and mentioned the PRAMS survey. The caller expressed her gratitude for the resources that were provided to her and greatly appreciated that Nevada 211 was available to the community”

Perinatal Immunizations Report

CHS provided immunizations to infants in the rural and frontier regions. As many as 308 vaccinations were administered to 72 infants and Title V MCH-funded education, resources, and referrals were provided to caregivers.

The Health Resources and Services Administration (HRSA) Maternal, Infant, and Early Childhood Home Visiting (MIECHV) and Title V MCH Program funded Nevada Home Visiting (NHV) Program provided education and referral supports promoting timely vaccination for NHV families and numerous evidence-based screenings and supports to promote healthy pregnancy and infancy for NHV families. MCAH facilitated information sharing on immunizations and catch-up immunizations.

Perinatal/Infant Domain Accomplishments

MCAH added COVID-19 MCH population-related content into the DPBH website and shared pandemic information and resources with partners pertinent to pregnant persons. MCAH participated in the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) and will continue to do so in the next reporting period

Perinatal infant health highlights include active work in relation to substance use disorders (SUD) and pregnancy, with newborn screening regulation development, the production of data to action reporting related to PRAMS promotion efforts and substance use in pregnancy. Extensive outreach activities and partnerships of Title V MCH supported varied messaging, and funded efforts to improve birth outcomes, continuing medical education development and provision to prevent preterm birth and widespread safe sleep messaging and perinatal mortality prevention efforts.

Perinatal/Infant Domain Data

NPM 4A - Percent of infants who are ever breastfed

According to the National Immunization Survey (NIS), the percent of infants who are ever breastfed in Nevada fluctuated from 2007 to 2017, reaching a high of 83.5% in 2015 but then falling to 79% in 2016. In 2019, Nevada rose to 83.8%. which is above the national average of 83.2% and above the Healthy People (HP) 2020 objective of 81.9%. Nevada ranks near the bottom, at 36th out of 50 states and D.C. for this measure.

NPM 4B - Percent of infants breastfed exclusively through 6 months

The percent of infants breastfed exclusively through 6 months in Nevada reached a high of 28% in 2018 but decreased to 22.3% in 2019. (NIS). This is below the 2019 national average of 24.9%, and below the Healthy People 2020 objective of 25.5%. Nevada ranks near the bottom, at 41st out of 50 states and D.C. for this measure.

NOM 5 - Percent of preterm births (<37 weeks)

NVSS data indicate the percent of preterm births (<37 weeks) in Nevada did not significantly change from 2009-2020 but experienced a significant increase to 11.2% in 2021. This is above the national average of 10.5%. Nevada has not met the HP 2030 objective of 9.4% and ranks near the bottom at 39th out of 50 states and D.C. When stratifying by race and ethnicity, Non-Hispanic Black (15.6%), Non-Hispanic Native Hawaiian/other Pacific Islander (13.0%), Non-Hispanic Asian (12.5%), Non-Hispanic American Indian/Alaska Native (12.1%), and Non-Hispanic Multiple Race (12.0%) have percent of preterm births higher than the average for Nevada. Hispanics (10.8%) and Non-Hispanic White (9.4%) have the lowest preterm birth rates.

NOM 9.1 - Infant mortality rate per 1,000 live births

According to NVSS, Nevada’s infant mortality rate per 1,000 live births significantly decreased from 5.7 in 2019 to 4.6 in 2020. Nevada ranks near the top, at 13th out of 50 states and D.C, an improvement from 25th in 2019. Racial and ethnic disparities exist in infant mortality in Nevada. Three-year estimates for 2018-2020 indicate Nevada’s Non-Hispanic Native Hawaiian/Other Pacific Islander (12.1) and Non-Hispanic Black infant mortality rates (10.6) were over twice that of non-Hispanic White (4.9) and Hispanic (4.8) rates. Three-year infant mortality rates among women with less than high school education (7.0) were the highest, followed by high school graduates (6.4) and women with some college (5.2). Infant mortality rates were lowest in women who were college graduates (2.8).

NOM 9.5 - Sleep-related Sudden Unexpected Infant Death (SUID) rate per 100,000 live births

According to the NVSS, the sleep-related SUID rate per 100,000 live births in Nevada increased sharply from 81.1 in 2017 to 142.9 in 2018. In 2019, Nevada’s rate decreased modestly to 139.7, and then sharply to 101 in 2020. This is slightly higher than the 2020 national average of 92.5. A maternal age of less than 20 years old had the highest rate (219.6), compared to 168.8, 125.1, 114.5, and 84.4 for the 20-24, 25-29, 30-34, and greater than 35 age groups, respectively. Non-Hispanic Black women had the highest rate among any race or ethnicity (251.6) and was lowest for Hispanic women (73.8). Non-Hispanic White women had a rate of 129.4.