Every year, 2.5 million babies around the world die before reaching their 1-month birthday. In the United States, this translates to a national average of 5.8 deaths for every 1,000 babies born. While this rate is low in comparison to the global rate of 29 deaths per 1000 live births, the United States trails behind 53 other countries—including Greece, Canada, Germany, Italy, France, Iceland, and Japan among others—where these rates shrink to as low as 1.8.
As a nation, we are failing our children, but states are making strides in the right direction. For example, with a rate of just 3.7, Massachusetts has the lowest infant mortality rate in the country. Other states should strive to follow in Massachusetts’ footsteps to drive down mortality rates across the country and, eventually, throughout the world.
Massachusetts is the country’s leading innovation hub and, with the heightened interest and recognition of the value of digital technologies to advance health, digital health innovation is emerging as a powerful means to the end of infant and maternal mortality. So, the question is: How can digital health impact maternal and child health in Massachusetts, the United States, and the world?
Nutrition: Appropriate care before, during, and after pregnancy
Did you know The World Health Organization estimates that 133,000 lives can be saved with appropriate nutritional care before, during, and after pregnancy? To drive progress towards achieving this goal, we look to current digital health technologies impacting and advancing nutrition. One digital health solution with the capacity to impact nutritional health and bring us closer to saving these lives is Nutrimedy, a Boston-based startup.
Nutrimedy: Nutrition reimagined
CEO Karolina Starczak, a registered dietician with a diverse background in healthcare, is leading her team on a mission to improve health through access to convenient, expert, personal, and affordable nutritional counseling around the world. Using a novel online wellness platform integrating science, technology, and behavioral health, Nutrimedy is redefining telenutrition and bringing health to the people who need it most: Expectant mothers.
“For about 50% of expecting moms, appropriate nutrition during pregnancy is a core component of managing health to reduce the risk of adverse outcomes.”
At Nutrimedy, the critical importance of maternal nutrition during pregnancy cannot be understated. With the implementation of the nuExpecting program, expectant mothers can meet anytime, anywhere with expert nutritionists to take the guesswork out of eating for two and ensure a healthy mom, a healthy pregnancy, and a healthy baby.
Pregnancy: The forgotten nine months
National statistics are reported for both maternal and infant mortality rates, but what is often overlooked is the importance of care during pregnancy. According to the World Health Organization, 290,500 lives can be saved with appropriate, affordable, and effective care throughout pregnancy. One key area in desperate need of this attention is mental health.
More than half of all pregnancy-associated deaths had a documented mental health diagnosis.With maternal suicide emerging as a leading cause of maternal death, and with 50% of pregnancy-associated depression undiagnosed, identifying at-risk women is critical in ending this epidemic. Massachusetts is fighting to bridge this gap through WIC Program screening of all pregnant participants, MDPH home visiting programs, and the 2016 policy shifting the cost of depression screening from expectant mother to MassHealth insurance. These initiatives highlight steps Massachusetts is taking to maintain its ranking as the second-lowest maternal mortality rate in dismally 47th in the world ranked United States.
1 in 7 women suffer from depression during or just after birth, and organizations in Massachusetts lean on digital health solutions to combat this challenge. For starters, Harvard Pilgrim, a MassChallenge HealthTech Champion, has partnered with Doctor on Demand, a national telemedicine provider group of board-certified physicians, to proactively expand access to behavioral health services including treatment for postpartum depression, one of the leading causes of maternal deaths.
MassChallenge Boston 2019 Finalist, UpLift, just closed $1 million in seed funding to develop the technology of their mental health app. UpLift employs cognitive behavioral therapy to help users with depression, cutting rates in half and fighting an epidemic that affects women throughout the world.
Small and sick babies: The importance of caring for our most vulnerable
Newborn babies represent one of the globe’s most vulnerable populations, with small and sick newborns—particularly those requiring treatment in neonatal intensive care units—the most at-risk. The first 1,000 days of life are critical for the infant growth and brain development, and as many as 580,000 lives can be saved through advances in neonatal care. Massachusetts, with the nation’s lowest infant mortality rate, is dedicated to improving newborn health outcomes and eliminate health inequities through programs with The Neonatal Quality Improvement Collaborative and The Perinatal-Neonatal Quality Improvement Network.
The Human Milk Quality Improvement Collaborative Project, a NeoQIC initiative, unites NICU’s across the state to increase nutrition of neonates, with a special emphasis on maternal breastfeeding for low birth weight infants.
Astarte, a female-led startup and 2018 MassChallenge HealthTech alum, is developing a digital health solution to advance care during this critical period. Founded by Tracy Warren and Tammi Jantzen (both mothers themselves), Astarte Medical is the only precision medicine company using software and predictive analytics to improve neonatal outcomes. With a particular emphasis on preterm infants, Astarte has developed NICUtrition, an integrated data set of feeding protocols, microbiome profiles, and clinical information to standardize protocols and customize treatment. With NICUtrition, newborns—even the smallest and sickest—have the potential to grow, survive, and thrive.
Life after birth: caring for babies when they leave the hospital
1,910,000 potential lives can be saved with advancements in care during a newborn’s first week and early life. Massachusetts recognizes the critical nature of this period and is employing programs across the state—including the MIECHV, the EIPP, and the Welcome Family Program—to educate, intervene, and support mothers in these first few days of parenthood.
A focal area of support offered to new mothers is breastfeeding. With an incredible life-saving potential (breastfeeding can prevent over 800,000 deaths), it is no surprise that breastfeeding levels are on the rise in the United States, with 83.2% of infants breastfed and 57.6% and 35.9% continuing at 6 months and 1 year respectively. But despite these promising statistics, less than a quarter of the nation’s mothers and infants followed the 6-month exclusive breastfeeding recommendation. Why are rates so low? Mother’s aren’t getting the community support they need.
“Breastfeeding is one of those things where you need to know many things you don’t know, and you need to know them immediately… because it’s a matter of feeding your baby.”
Pumpspotting, founded by real-life two-time mom and breastfeeder Amy VanHaren, is on a mission to make breastfeeding and postpartum less isolating and more supportive at every stage in the journey. A community-driven breastfeeding and digital health platform, pumpspotting connects and nourishes new mothers with encouragement, advice, employer support, or even just a place to pump. Women’s health has historically been underfunded and overlooked. But with pumpspotting, women are being seen and their health—and the health of their new baby—is being put first.
The future of maternal and child health
While digital tools may not be the silver bullet, they are one piece of the puzzle when it comes to addressing the issue of maternal and infant mortality. It isn’t an easy problem to solve, but innovators and providers are making headway by talking to patients and listening to the communities most at risk. Through community organizations and innovative digital health technologies, we can fill this healthcare gap and play a role in ending this epidemic. After all, with the potential to save 3 million lives, women’s health is worth it.
