After a significant decline in infant mortality in the District, the number of babies who died in the city jumped 19 percent in 2005, according to a report released by the District's chief medical examiner.
The number of deaths rose to 81, up from 68 in each of the previous two years. The increase is a reversal of a downward trend that started in 1999, when 115 deaths of children younger than 1 year old were reported.
More than 70 percent of the deaths in 2005 were attributed to premature births and complications such as low birth weight, according to the report by the Child Fatality Review Committee.
"Undetermined" was the second leading category with 15 deaths, about twice as many as the year before, the report said. The study found that a little more half of those deaths were linked to "inappropriate sleeping environments."
To improve infant care in the District, especially among low-income families, Parklands Community Center and the Children's Health Project health center are working in a venture in Southeast Washington that started in 2005.
Each week, Frances Brown sits in a circle with other new mothers attending a Parklands parenting class at THEARC, a community center that provides services for low-income residents east of the Anacostia River.
Instructors have shown Brown how to pick up a crying infant and put the baby to her chest to hear her heartbeat. She has learned the dangers of suffocation, such as placing blankets or stuffed animals in an infant's crib. Sharing a bed with siblings or an adult and putting infants on their stomachs to sleep also are associated with infant deaths.
The classes have helped the single mother of two cope with the demands of her year-old son, Jermaine.
"I go down to the classes and unwind and say what I have to say," said Brown, 37, who enrolled in October at the encouragement of an instructor she knew. "It's almost like a support group."
In some deaths, lack of prenatal care played a role. The 43-page report, which was released to city officials in December, found that 12 mothers did not receive prenatal care and 24 had problems with substance abuse.
Wards 7 and 8 had the highest number of infant deaths in 2005, the report said -- 13 and 25, respectively. Eight of 10 infants who died in the District were black.
"What's happening in Ward 8 is uncalled for, and Ward 5 is getting worse," with 12 deaths, said Maria Gomez, president and chief executive of Mary's Center for Maternal and Child Care in Adams Morgan. Ward 5 had 10 infant deaths in 2004.
"There still needs to be a major emphasis on outreach, making sure we go door to door, getting these people into care early," she said.
The review committee made several recommendations. It suggested that health officials aggressively reach out to women who miss prenatal appointments by writing, calling or visiting. It also suggested that the health department determine whether there are adequate resources in the District to care for women with high-risk pregnancies and for critically ill infants.
The panel is made up of about 50 people from District social and public service agencies, including the police department, the school system, hospitals and the departments of Health, Human Services, and Child and Family Services.
D.C. Council member Tommy Wells (D- Ward 6), chairman of the Human Services Committee, plans two hearings, today and March 2, to review the report as part of his review of the Department of Human Services and the city's Children and Youth Investment Fund, said his spokesman, Charles Allen.
Leila Abrar, a Department of Health spokeswoman, said that the 2005 data might represent a one-year glitch in a downward trend. According to the report, infant deaths dropped 15 percent from 2002 to 2003 and remained flat before increasing in 2005. The department plans to release its own statistics, including information on infant mortality rates, in the spring.
Some deaths occur because many young parents don't know how to act around their newborns, said Brenda H. Jones, executive director of the Parklands Community Center. That's particularly true of parents who were born during the 1980s crack epidemic, she said.
"Many of them weren't taught themselves, and now they're parents," she said.
"Although their physicians tell them they have to take their babies for their six-week follow-ups," she said, "there's no follow-up to make sure that they do, even if that means picking them up at home and making sure they make that appointment."