Observer analysis: Baby deaths in military towns rise

By Mike Hixenbaugh
The Fayetteville Observer

The rate of sudden and unexplained infant deaths in two major North Carolina military communities jumped to nearly twice the national average during the five years after the Iraq war began.

The spike in inexplicable infant deaths in Cumberland and Onslow counties – the homes of Fort Bragg and Camp Lejeune – occurred during a period when the statewide rate of such fatalities held steady, according to a Fayetteville Observer analysis of North Carolina birth and death records.

Between 2003 and 2008, about 1 in every 634 babies born in Cumberland County died of unknown causes or sudden infant death syndrome before their first birthday, nearly twice the national average.

The rate of unexplained infant deaths in Onslow County was even worse over that same period, at roughly 1 in 503, according to reports compiled from the State Center for Health Statistics.

The frequency of unexplained infant deaths in Cumberland and Onslow counties had been in line with state averages in the years leading up to 2003, when the Iraq war started. Since then, an official with the Office of the Chief Medical Examiner said, both counties have been near the top in the state in cases of inexplicable infant deaths.

While little research has been conducted examining possible connections between military life and infant mortality rates, several experts in the field said the stress of multiple deployments could be affecting how well young parents are able to care for their children.

The state does not track the number of infant deaths among families stationed at military installations, so it’s difficult to tell if the higher rates of infant deaths in those counties are attributed to military families or the civilian population.

Regardless, parental stress is an unlikely explanation for the mysterious deaths of three babies whose families lived at different times in the same housing unit on Fort Bragg, said Marta Pirzadeh of the State Child Fatality Task Force.

The parents of one of the three infants who died weren’t even in the military but were visiting family members on post.

The military is continuing to investigate those infant fatalities along with seven others that have occurred inside on-post housing units since 2007.

Military investigators have been testing building materials and air quality inside the homes to determine if environmental conditions might have contributed to the deaths. Those tests have so far come back negative. Foul play also has been ruled out in each case, officials said.

“I think it is certainly rare that there would be three undetermined infant deaths within one house,” Pirzadeh said. “I can understand why that would raise questions about conditions inside the home and other environmental factors.”

Robert Murphy, the director of the Center for Child and Family Health at Duke University has studied the effects of war and deployment on North Carolina military communities in recent years. Although most military families usually rise above the stress of deployment, he said, many young parents struggle to cope when spouses are gone for months at a time.

Roberts emphasized that he can make no conclusions regarding parental behavior and the recent deaths of several infants at Fort Bragg.

“The more stress you’re under, the more prone you are to periods of being ineffective as a parent,” Murphy said. “There are some studies that suggest stress associated with multiple deployments leads to higher rates of child abuse, domestic violence and overall parental neglect. It’s natural that when you have a population under stress, you will see more of that.”

When parents are stressed out, they’re less likely to be attentive to the needs of their children, said Deborah Gibbs, a senior research analyst with RTI International, a Triangle-based research firm that has studied the impact of military deployments on child welfare.

A stressed-out mother might not remember to lay an infant down on its back to sleep, Gibbs said, or a depressed parent might neglect to take a sick baby to the doctor.

The majority of military spouses survive deployments without falling to that level, Gibbs said. Vast support networks are set up for military families help, she said.

But for some military parents, she said, the load is too heavy.

“It certainly appears, based on the research, that deployments can be a risky time for military families,” Gibbs said. “There are some parents in the military who just get overwhelmed or depressed by the situation … and they stop doing things to care properly for their children.”

Every infant death is unique, Pirzadeh said. There have been some studies into the effects of stress and environmental conditions on infant mortality, but the research is limited, she said.

“In the absence of that, we provide families with information that will help reduce the odds that their baby will die of SIDS,” Pirzadeh said. “Whether they are in the military or not, parents should avoid smoking, always lay their baby down on its back and maintain temperatures below 85 degrees.”