NEW TASK FORCE HOPES TO REDUCE SIDS IN BOOTHEEL

Every day, Michelle McMullan talks to mothers about how to make their babies healthy, and every day she sees what happens when those mothers don't heed her advice.

McMullan is the nutritionist for the Dunklin County Health Department's WIC (Women, Infants and Children) program, which provides vouchers to buy nutritious food, formula and vitamins for pregnant women and their young children.

Dunklin and five other Bootheel counties -- Scott, Stoddard, Mississippi, New Madrid and Pemiscot -- have teamed up through the Infant Alert Task Force, a national program aimed at reducing sudden infant death syndrome and the region's overall infant mortality rate.

SIDS is the most common cause of death among infants 2 weeks to 1 year old. Its cause is unknown, but it usually occurs at night. Possible causes may include central nervous system disorders, breathing disorders, cardiovascular anomalies, infection and low blood-oxygen concentration.

In 1993, according to state figures, 30 infant deaths were recorded in the six-county region, including three SIDS deaths. In 1994, 36 deaths, including six SIDS deaths, were recorded, and in 1995, 17 infant deaths, including three SIDS deaths, were recorded.

"Just in our county, we've had two deaths in the last two months, one SIDS infant and a stillborn infant," McMullan said of Dunklin County.

The region is one of several nationally targeted because of high SIDS and infant mortality rates, said Kendra Farmer of Infant Alert.

Missouri's infant mortality rate from 1986 through 1995 was 9.3 percent. Statewide, 7,060 infant deaths were recorded among 758,639 live births.

In the task force's service area, New Madrid County recorded a 13.5 percent infant mortality rate for that time period, while Pemiscot County recorded a 15.2 percent infant mortality rate.

Cape Girardeau County's infant mortality rate was 8.1 percent in that time period.

Infant mortality rates tend to be higher in inner-city areas and in extremely rural areas, Farmer said.

"I could tell you a million factors that contribute to SIDS," Farmer said.

The organization is focusing on three factors -- breast feeding, sleep position and teaching mothers to stop smoking while pregnant and to create a smoke-free environment for the baby after it is born -- through a public education campaign targeting mothers, day-care providers and health-care providers.

Breast feeding has not directly been shown to prevent SIDS, but it does make for a healthier baby overall by providing good nutrition and strengthening the baby's immune system, McMullan said.

Antibodies are passed via breast milk from the mother to the infant, increasing the baby's resistance to disease and possibly reducing infection and allergies.

Breast feeding also strengthens bonding between mothers and infants, she said.

Dunklin County has a "terribly low" incidence -- 13 percent -- of breast feeding among mothers receiving WIC assistance, McMullan said, and task force members want to increase that.

Sleep position is also crucial, Farmer said. Task force members are also stressing that babies should be put to sleep on their backs rather than on their stomachs.

The back position allows for better body heat distribution and freer airways, she said.

"SIDS deaths have declined 30 percent since the recommendation to put the baby to sleep on its back," Farmer said.

Studies have shown that cigarette smoking by pregnant women can cause low birth weight and premature births. Second-hand smoke has been linked to a number of health problems.

A high teen-pregnancy rate in the six-county region may also be a factor, but other agencies are addressing that issue, Farmer said.

"Low maternal age is certainly a big factor in infant mortality," she said.

Teens are not physically ready, in many cases, for the demands of pregnancy and birth. Babies born to teen mothers tend to have lower birth weights, and there is a higher incidence of premature births among teen mothers. Both factors contribute to poor infant health.

Teens are also less likely to receive prenatal care and to be educated on how to care for an infant, she said.

Information on the initiative will be provided to local health departments for distribution to mothers, doctors and nurses, local churches, schools and other agencies, Farmer said.