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State of Child Health 2026: Infant mortality

Health Policy team
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Infant mortality is defined as the death of a child under the age of one year and is measured as deaths per 1,000 live births. This includes the neonatal (first 28 days) and post-neonatal (28 days to 1 year) periods.
Last updated
Post date
14 July 2026
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This is one of 12 indicators in our State of Child Health resource.

What is the problem?

Infant mortality is an important marker of the overall health of a society, as laid out in the UN Sustainable Development Goals.1

In the UK, infant mortality rates are higher than in other European countries, according to World Bank Data.2 The infant mortality rate for the UK remains high at a rate of 4.1 per 1,000 (2024), with no improvement since the last State of Child Health report in 2020, which had a rate of 3.9 per 1,000. Stalling progress is clear as the rate has not dropped below 3.8 per 1,000 (last achieved in 2019). 

Rates of infant mortality have remained stable in both England (3.9 per 1,000 in 2018 and 2023) and Wales (3.5 in 2018 and 3.6 per 1,000 in 2023). Northern Ireland has seen a slight reduction in infant mortality since 2018 (4.2 per 1,000) to 2023 (4 per 1,000). However, in Scotland, rates of infant mortality have risen since 2018 from 3.2 to 3.7 per 1,000 in 2023.

See chart in full

Worsening ethnic and socio-economic inequities in the UK are contributing to higher risks of infant death. In England, infant mortality rates in 2025 are more than twice as high in the most deprived areas (5.3 per 1,000 in Index of Multiple Deprivation (IMD) 1) compared to the least deprived areas (2.2 per 1,000 in IMD 5).

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The Index of Multiple Deprivation (IMD) ranks small areas by relative deprivation using factors such as income, employment, education, health, crime, housing and the living environment. These inequalities in infant mortality by deprivation have widened over time (since 2020).

Infant mortality rates are highest amongst ethnic minorities including Black, Bangladeshi, and Pakistani children. In 2025, Black infants had the highest rate of infant mortality at 7 per 1,000, followed by Pakistani infants at 5.2 per 1,000, which is more than twice the rate of their White peers, at 3 per 1,000.

See chart in full

Why does it matter?

Poverty and inequality are not inevitable, and high infant mortality rates are a clear indicator of a failing healthcare system. The UK government’s core mission is to raise the healthiest generation of children ever.3 However, this is not possible without reducing inequalities within infant mortality rates.

The death of a baby is a traumatic event for parents and their families, and the care they receive afterwards can have a long-term impact on how families cope with their loss.4 Even with good bereavement support, it can cause everlasting impact on the family.

Infant mortality rates are an important marker of the overall health of society, as well as being indicative systematic issues in the health service. It is important to monitor this data because improvements in infant mortality are closely linked to health and development during a child’s first 1,000 days. Tracking these indicators helps assess progress in early years outcomes and overall population health.5

Drivers of poor outcomes

While there are multiple causes of infant mortality, there is clear evidence of socioeconomic and demographic inequalities in outcomes. In the UK, there are both direct and indirect factors contributing to poor infant mortality outcomes, including cuts to local government services, pressures on NHS maternity and early years services, and rising levels of family poverty.6

Access to the care and support needed for a good start in life is a key driver of inequalities in infant mortality outcomes. Ethnic minority groups are more likely to live in deprived areas with under-resourced healthcare, which can impact their access to maternity services.7 For example, over 30% of Bangladeshi and Pakistani people live in the most deprived neighbourhoods in England – three times the national average.8

Systemic racism persists in parts of the healthcare system. Women from minority ethnic backgrounds often face barriers to high-quality maternity care due to structural and cultural biases, and reduced access to services, with past experiences of racism, microaggressions, dismissal of concerns and loss of trust shaping their interactions with preconception and maternity services.9

The impact of limited and unequal access to primary care services is also evident. There are ethnicity-based differences in the quality of interactions patients have with healthcare professionals in primary care, which affect patient trust and engagement. It has been shown that poor experiences in maternity care among ethnic minority groups may lead to disengagement from healthcare services as a result.10,11 Workforce pressures within early years services can also limit access to care, for instance health visitors are under significant pressure with reduced capacity.12

Inefficient, non‑interoperable IT systems also increase staff workload by requiring care to be delivered and documented across multiple, poorly integrated systems, increasing patient safety risks, particularly during emergencies.13

Poverty and adverse socioeconomic conditions can increase maternal risk factors for adverse pregnancy outcomes, and the accumulation of these risks drives inequalities in infant mortality rates. Poor nutrition and obesity,14 inadequate housing and poor mental health are higher in more socially disadvantaged groups.15 Poor housing conditions and obesity have been shown to be associated with a range of adverse birth and infant outcomes, including those that are risk factors for infant mortality.16 Infant mortality is also strongly associated with low birthweight (under 2,500 grams).17

Why we need to act now

If we do not act now, infant mortality rates will continue to remain stagnant and lag behind those of comparable European countries. The current postcode lottery experienced by families for infant mortality is unacceptable and must be addressed. The disparity in infant mortality outcomes between groups continues to grow, driven by multiple, interrelated factors rooted in social inequalities. Recent independent reviews—including the Ockenden18 and Kirkup19 reports—have already highlighted systemic failures in maternity and neonatal care, including inconsistent standards, poor accountability, and missed opportunities for early intervention. These findings underline the urgent need for coordinated, equitable action; without this, preventable inequalities will persist and mortality rates will remain unacceptably high in the UK.

Infant mortality has a direct impact on affected families. Beyond the immediate emotional devastation, it can also lead to longer-term reduced social cohesion and mistrust in health services, particularly in the instance of poor bereavement care.20

A paediatrician's insight

From Dr Joanna Garstang, Consultant Community Paediatrician

Your experience of supporting infants at risk of mortality - has anything changed over time?

"The fact that UK infant mortality remains stubbornly high is disappointing and should be a call for action. Premature birth is the biggest driver of infant mortality, so any efforts to reduce prematurity will have the largest impact. This is primarily a public health issue rather than for paediatricians, but this does not absolve paediatricians from responsibility. Instead, it reminds us of the importance for paediatricians to develop a sound understanding of public health issues in order to advocate effectively for children and families.

"Maternal smoking increases the risk for low birth weight, premature birth and stillbirth, and thankfully rates of maternal smoking have declined from 10.6% at delivery to 6.1% between 2018-2024. Despite this, infant mortality has remained unchanged. Although vaping is highly effective in helping mothers to quit smoking, concerns remain about potential harms to developing infants; this may become an increasing issue as young people take up vaping. Paediatricians should therefore be advocating for a nicotine-free generation.

"The leading cause of post-neonatal mortality is sudden infant death syndrome (SIDS) - these deaths have plateaued since 2015 at between 0.28 to 0.32 per 1,000 live births. Safe sleep messaging has previously been very effective in reducing SIDS rates. Health visitors have traditionally provided safe sleep education, but the decline in health visitor provision has reduced opportunities for safe sleep conversations with parents."

What have been the challenges to supporting infants in this space - what contributes to this?

"Infant mortality is strongly associated with families defined as ‘hard to reach’, such as those in social deprivation and minoritised communities. Maybe it is instead our health services, not vulnerable families, that are ‘hard to reach’. We must ensure that our services are designed to be friendly, culturally appropriate, and easily accessible to families at all times, including out of hours.  

"Infant loss is devastating for families. Parents need time and space to hold their baby and say goodbye, and they want professionals to show compassion and answer their questions as to why their baby died. Providing such compassionate care takes time and emotional capacity, which can be in short supply with busy units, staff shortages and paediatricians experiencing burnout."

Any examples of good practice to tackle mortality rates that you have been part of or aware of that we should signpost to paediatricians?

"Many hospitals now provide pre-conception clinics for women at high risk of pregnancy complications or pre-term delivery. The NHS has developed the Best Start in Life resource, although this starts with pregnancy rather than pre-conception.

"Neonatal care has been organised through Operational Delivery Networks since 2013, and many have adopted the PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth) care bundle. This provides evidence-based interventions and multi-disciplinary working to reduce brain injury and mortality rates amongst babies born prematurely.

"'Eyes on the baby' is an innovative project developed in the North-East of England, providing training for police, social care, local authorities, and healthcare staff in sudden infant death prevention. This has allowed a wider multi-agency group of professionals to have conversations with vulnerable families about safe sleep, rather than leaving this task to health visitors. 

"Many local authorities and baby banks also provide moses baskets and travel cots to vulnerable or homeless families."

Any advice you'd give to other paediatricians that would help prevent mortality risk?

"The UK has invested in learning from all child deaths with a robust clinician led Child Death Review (CDR) process. The English National Child Mortality Database publishes an annual data report, which paediatricians can use to understand current causes and risk factors both locally and nationally. Paediatricians should ensure they take part in reviews for any child, as their information and experience of caring for that child is vital to a high-quality review. Even if a death could not have been prevented, we can still learn something from every death to help improve care of future children."

Recommendations

England
  • Strengthen primary care access and both universal and targeted support for maternal care and early years services during the first 1,000 days of life, ensuring Best Start in Life and Healthy Babies services are sufficiently funded and equipped.  
  • Strengthen joint ownership and accountability between the Department for Education and the Department of Health and Social Care to coordinate action, tackle inequalities, and address high infant mortality rates, taking into account evidence from relevant independent maternity and neonatal investigations.
  • Strengthen system learning and data collection on infant deaths by integrating audit, regulatory and investigation data into a single, proactive view of risk, drawing on best practice and insights from the National Child Mortality Database (NCMD), and support better identification of intersectional risks through the national roll-out of equity reviews.
  • Strengthen monitoring and reporting of neonatal staffing standards, use National Neonatal Audit Programme (NNAP) data to inform workforce planning, investment, and accountability, and promote healthy, multidisciplinary cultures with clear expectations for safe team behaviours. 
Scotland
  • Strengthen the National Hub for Child Death Review to ensure consistent collection, analysis and application of high‑quality data, with improved transparency, clear accountability for implementation, and systematic translation of learning into policy and practice across Scotland.
  • Require active Health Board engagement in the Child Death Review Programme, including full participation in reviews and clear responsibility for implementing identified learning and service improvements.
  • Refresh and build on The Best Start plan, with a stronger focus on reducing inequalities in maternal and infant outcomes, ensuring equitable access to continuity of care, and addressing workforce capacity.
Wales
  • Address inequalities by implementing the recommendations of the All-Wales Maternity and Neonatal Assurance Assessment, The path to safer beginnings in Wales.
  • Develop a Long-Term Workforce Plan for child health, informed by a gap analysis of the workforce, current and projected child health demand and clinician informed retention initiatives.
  • Enhance community and primary care access to universal and targeted services during the first 1,000 days of life, including ensuring that the Flying Start and Healthy Child Wales programmes are sufficiently funded and equipped.
Northern Ireland
  • Establish and fund a Northern Ireland-wide Child Death Review (CDR) system.  
  • Fully implement the refreshed Healthy Child, Healthy Future Framework, including enhanced universal and targeted antenatal and early years contacts (especially during the first 1,000 days), new developmental reviews and improved early identification pathways for additional needs.  
  • Increase investment in the maternity and early years workforce to ensure delivery of the enhanced visiting schedule of Healthy Child, Healthy Future is viable and recognise that the delivery of targeted support requires strengthened midwifery, health visiting and family nurse capacity.  
  • Deliver and fund targeted services that prioritise families in the most disadvantaged areas, supported by enhanced health visiting capacity, early intervention and referral pathways. 

This is one of 12 indicators in our State of Child Health resource.