Infant Mortality in Mississippi: How Pharmacists and New Moms Can Work Together for Healthier Babies

The first 90 days

The first three months of a baby’s life are the highest risk window for infant mortality. Many of the most preventable causes of death in this window connect to medication safety, recognizing symptoms early, and knowing when to escalate care. All three are areas where a phone call to your pharmacist can be the right next step.

Medication safety for newborns

Newborns and young infants are not just smaller adults. Their kidneys, livers, and metabolism are different. Many medications that are safe and effective in older children are not appropriate for newborns at all.

• Aspirin should never be given to children, particularly during viral illness, due to the risk of Reye’s syndrome.
• Ibuprofen is generally avoided under 6 months of age.
• Acetaminophen dosing is by weight, not age. Using the wrong dose is one of the most common medication errors in young infants.
• Honey should not be given to babies under 12 months due to botulism risk.
• OTC cough and cold medications are not recommended for children under 4, and most are not appropriate under 6.
• Topical numbing gels with benzocaine carry a risk of methemoglobinemia in infants and should be avoided.

Mom’s medications during breastfeeding

Many medications are compatible with breastfeeding. Some are not. The decision is rarely as simple as a label says. The Drug Facts label often lists pregnancy and breastfeeding under one warning that defaults to caution. The actual evidence on specific medications during breastfeeding is more nuanced than the package allows for.

Common categories worth reviewing with a pharmacist:

• Pain medications. Acetaminophen and ibuprofen are generally compatible with breastfeeding.
• Antidepressants. Several SSRIs have been studied extensively and are widely considered compatible.
• Antibiotics. Most common antibiotics are compatible. A few are not.
• Cold and allergy medications. Many are compatible. Some can reduce milk supply, including pseudoephedrine.
• Birth control. Estrogen containing methods can reduce milk supply in some women. Progestin only methods generally do not.

Recognizing serious illness early

Newborns and young infants often do not show symptoms the way older children do. They cannot localize pain. Their fever response is different. Several signs warrant immediate medical attention, and these are worth knowing.

• Any fever in a baby under 3 months old. A rectal temperature above 100.4 degrees Fahrenheit (38 degrees Celsius) is a medical emergency. Call your pediatrician or go to an emergency room (ER).
• Refusing to feed for an unusual length of time.
• Excessive sleepiness or inability to be roused for feeding.
• Unusual irritability that does not resolve with the normal soothing strategies.
• Difficulty breathing, fast breathing, or grunting with each breath.
• Color changes, particularly blue around the lips, mouth, or fingertips.
• A sunken soft spot, fewer than 6 wet diapers in 24 hours, or other signs of dehydration.

These are not pharmacy questions. They are emergency room or pediatrician questions. The reason I mention them in a pharmacy article is that confusion about whether a symptom is normal is one of the most common reasons new mothers delay calling. If you are unsure, call. The pediatric line at your provider’s office is open after hours. Mississippi has a poison control line. The ER is open.

Vaccination schedule

Routine infant vaccinations protect against diseases that have not gone away. Pertussis (whooping cough), pneumococcus, RSV, rotavirus, and several others can cause serious illness or death in infants. The vaccination schedule recommended by the American Academy of Pediatrics and the CDC is timed for a reason.

Pharmacy plays a role here too. Pharmacists in Mississippi administer many adult vaccines, including the Tdap vaccine for the pertussis booster recommended for adults who will be around a newborn. If you have an infant in your home, ask your pharmacist whether your Tdap booster is current.

How Fairview supports new families

Free pharmacist consultations for new mothers in Hattiesburg, Petal, Oak Grove, Laurel, and across the Pine Belt. Delivery service so you do not have to load a newborn into the car for a prescription pickup. Compounded medications when an infant needs a different formulation. Coordination with your pediatrician when something needs adjusting. Serving Hattiesburg, the Pine Belt, Central Mississippi, and South Mississippi.

When to call a pharmacist

• Before giving any OTC medication to a baby under 12 months.
• Any time you are uncertain about a dose for a baby or young child.
• When you are breastfeeding and start any new medication.
• When your baby has been prescribed a new medication and you want to walk through dosing.
• If you have postpartum questions about your own medications.
• If you are due for your Tdap booster or seasonal flu vaccination.

This article is for general information only and is not a substitute for personalized medical advice. Before starting or changing any medication, including over the counter products and supplements, talk with your pharmacist or physician about your specific situation.