Fetal and Infant Mortality Review

The objectives of FIMR are:

• To examine the significant social, economic, cultural, safety and health system factors that are associated with fetal and infant mortality through review of individual cases;
• To plan a series of interventions and policies that address improvement to service systems and community resources;
• To participate in the implementation of community-based interventions and policies; and
• To assess the progress of the interventions.

WHY DOES CENTRAL OKLAHOMA NEED A FIMR?

Infant mortality rate (IMR) is defined as the number of infant deaths per 1,000 live births. IMR is a key indicator often used to measure the health and well being of a population. Factors such as problems in pregnancy, poverty, an unhealthy physical environment, and barriers to health care and services have a bigger impact on infants than on any other population. The first year of a child’s life is the most vulnerable.

Review of fetal and infant deaths allows the community to respond to the needs identified by the cases reviewed. Reviews provide a voice for local families who have lost their babies. FIMR is a tool that helps the community implement changes designed to address the needs of the society’s youngest population.

INFANT SAFE SLEEP
Each year approximately 3500 infants in the US die of sleep-related infant deaths, including sudden infant death syndrome (SIDS) ill-defined deaths, and accidental suffocation and strangulation in bed.*

The American Academy of Pediatrics Guidelines for Safe Sleep

• • Back to sleep for every sleep. 
  • Use a firm, flat, non-inclined sleep surface to reduce the risk of suffocation or wedging/entrapment
  • Feeding of human milk is recommended because it is associated with a reduced risk of SIDS. 
  • It is recommended that infants sleep in the parents’ room, close to the parents’ bed, but on a separate surface designed for infants, ideally for at least the first 6 mo. 
  • Keep soft objects such as pillows, quilts, comforters, mattress toppers, fur-like materials, and loose bedding away from the infant sleep area to reduce the risk of SIDS, suffocation, entrapment, wedging, and strangulation.
  • Offering a pacifier at naptime and bedtime is recommended to reduce the risk of SIDS.
  • Avoid smoke and nicotine exposure during pregnancy and after birth. 
  • Avoid overheating and head covering in infants. 
  • It is recommended that pregnant people obtain regular prenatal care. 
  • It is recommended that infants be immunized in accordance with guidelines from the AAP and CDC. 
  • Do not use home monitors as a strategy to reduce the risk of SIDS.
  • Supervised, awake tummy time is recommended to facilitate development and to minimize the risk of positional plagiocephaly (flat spots).

OCCHD’s Maternal & Child Health Program provides free, comprehensive training on the American Academy of Pediatrics recommendations for infant safe sleep.

Quarterly three-hour safe sleep training courses are available for professionals who work with families.   This course satisfies the Oklahoma Human Services childcare licensing requirement for safe sleep training, and clock hours are awarded.

For more information on safe sleep training, please contact us at [email protected].

HOW DOES FIMR WORK?

The four fundamental steps in the FIMR process include data collection, home interview, case review, and community action.

The FIMR process brings together key members of the community in order to:

• Identify the factors associated with those deaths.
• Determine if they represent system problems that require change (such as barriers to care or gaps in service delivery).
• Develop recommendations for changes and assist in the implementation of change.