Child and infant mortality in England and Wales: 2023

• 2,320 infant deaths (aged under one year) and 961 child deaths (aged 1 to 15 years) occurred in England and Wales; these figures are lower than in 2022 (2,349 and 1,019, respectively).
• There were 3.9 infant deaths per 1,000 live births (unchanged from 2022), and 9 child deaths per 100,000 population (down from 10 in 2022).
• The neonatal mortality rate (aged under 28 days) was 3.0 deaths per 1,000 live births; the mortality rate was generally lower for neonates of longer gestations.
• The highest rates of infant mortality were among infants with a birthweight under 2,500 grammes (g), of Black ethnicity, or with a mother aged under 20 years.
• The main cause of death among children aged 28 days to 15 years continued to be congenital malformations, deformations and chromosomal abnormalities.
• In England, the mortality rate for infants living in the 10% most deprived areas was over twice the mortality rate for infants living in the 10% least deprived areas.

In 2023, there were 961 child deaths (aged 1 to 15 years) and 2,320 infant deaths (aged under one year) in England and Wales. This equates to a child mortality rate of 9 deaths per 100,000 population, and an infant mortality rate of 3.9 deaths per 1,000 live births (see Table 1 of our accompanying dataset). The child and infant mortality rate followed a declining trend since records began in 1980 but has become more stable in recent years.

The overall decline in infant mortality rates since 1980 (Figure 1) likely reflects general improvements in healthcare, and specific improvements in antenatal and neonatal care.

In England, the West Midlands region continued to have the highest infant mortality rate (6.1 deaths per 1,000 live births), while the South West continued to have the lowest (2.5 deaths per 1,000 live births; see Table 3 of our accompanying dataset).

There were 98 infant deaths in Wales in 2023 and an infant mortality rate of 3.6 deaths per 1,000 live births.

Infant mortality rates in individual English regions and Wales are less reliable at describing trends than the combined England and Wales rate, because variation in the number of births and deaths has a greater effect on smaller populations.

In the UK, health is a devolved matter. In England, the government has an ambition to halve the 2010 stillbirth and neonatal mortality rates for infants born at 24 weeks or over by 2025.

The neonatal mortality rate ambition in England is 1.0 deaths per 1,000 live births of infants born at 24 weeks or over. As shown in Figure 2, the rate was 1.4 deaths per 1,000 live births in 2023 (see Table 22 of our accompanying dataset). Achieving the ambition in 2023 would have required at least 238 fewer neonatal deaths of infants born at 24 weeks or over, so that the total did not exceed 561.

The stillbirth ambition in England is 2.6 stillbirths per 1,000 births. As shown in Figure 2, there were 3.9 stillbirths per 1,000 births in 2023 (see Table 21 of our accompanying dataset). Achieving the ambition in 2023 would have required at least 765 fewer stillbirths, so that the total did not exceed 1,465.

Figure 2: Stillbirth and neonatal death rates remain broadly stable

Stillbirths and neonatal mortality rates, England, 2010 to 2023

Notes:

1. Stillbirth data in this chart refer to stillborn babies born at 24 weeks and over.

2. Neonatal death data in this chart refer to babies who were born alive at 24 weeks and over, and died within 28 days of birth.

In Wales, the stillbirth rate was 4.0 deaths per 1,000 births (see Table 25 of our accompanying dataset). The neonatal mortality rates were 2.6 per 1,000 live births for infants of all gestations, and 1.4 per 1,000 live births for infants born at 24 weeks or over (see Table 26 of our accompanying dataset).

Gestational age

After reaching a low of 2.5 deaths per 1,000 live births in England and Wales in 2014, the overall neonatal mortality rate (infants that lived for less than 28 days) increased to 3.0 deaths per 1,000 live births in 2023 (see Table 1 of our accompanying dataset).

The neonatal mortality rate is higher among infants of shorter gestational ages, as premature birth increases the risk of serious health complications. In 2023, infants born between 37 and 41 completed weeks of gestation had a neonatal mortality rate of 0.5 deaths per 1,000 live births. Infants born before 24 weeks' gestation had a neonatal mortality rate of 782.2 deaths per 1,000 live births.

Although representing only 0.1% of live births, infants born before 24 weeks gestation accounted for 37.4% of neonatal deaths in 2023.

Figure 3: Neonatal mortality differs by gestational age

Change over time in neonatal mortality rates since 2010 by gestational ages, England and Wales, 2010 to 2022

The improvement in overall neonatal mortality rate since 2010 has not been consistent between gestational age groups. It decreased by 37.5% for infants born between 37 and 41 weeks' gestation, but only by 6.6% for infants born before 24 weeks' gestation.

Cause of death

Congenital malformations, deformations and chromosomal abnormalities continued to be the leading cause of death in 2023 among children aged 28 days to 15 years (19.9%), followed by neoplasms (15.6%) (see Table 8 of our accompanying dataset).

For neonatal deaths, 51.7% were accounted for by immaturity-related conditions, with congenital anomalies and antepartum infections together accounting for another 40.2%.

In 2023, coronavirus (COVID-19) appeared on 25 (1.7%) death certificates of children aged 28 days to 15 years, decreasing from 44 (2.7%) in 2022. Of these 25 death certificates, 11 cited COVID-19 as the underlying cause of death.

Some mortality statistics on deaths due to and involving COVID-19 may differ because they are based on the number of deaths registered in a reference period, rather than when they occurred.

Birthweight

Low birthweight infants, weighing less than 2,500 grammes (g), had an infant mortality rate of 30.3 deaths per 1,000 live births in 2023. Normal birthweight infants, weighing 2,500g or over, had an infant mortality rate of 0.8 deaths per 1,000 live births. These rates remain consistent with recent years (see Table 9 of our accompanying dataset).

Ethnicity

In 2023, infants from the Black ethnic group continued to have the highest rate of infant mortality, followed by the Asian ethnic group (see Table 18 of our accompanying dataset). Both groups' infant mortality rates have decreased since 2022 (Figure 4). The ethnic groups presented in this release can be divided into sub-categories, where infant mortality rates vary further. However, information is presented using high-level groupings because small numbers of births and deaths in some ethnic groups can cause larger fluctuations over time.

Maternal age

Infants born to mothers aged under 20 years or aged 40 years and over consistently have a higher mortality risk than infants born to mothers aged in their twenties or thirties (Figure 5).

In 2023, there were 7.0 infant deaths per 1,000 live births to mothers aged under 20 years, and 5.3 infant deaths per 1,000 live births to mothers aged 40 years and over.

Where mothers are aged between 20 and 39 years, this risk is consistently lower. In 2023, infants born to mothers aged 30 to 39 years had the lowest risk of infant mortality, at 3.4 deaths per 1,000 live births (see Table 10 of our accompanying dataset).

Deprivation

In 2023, higher levels of deprivation continued to be associated with higher infant mortality rates. Infants from the 10% most-deprived Lower level Super Output Areas (LSOAs) in England had higher infant mortality rates (6.1 deaths per 1,000 live births) compared with infants from the 10% least-deprived LSOAs (2.6 deaths per 1,000 live births). More information is available in Table 21 of our accompanying dataset).

Infants in England and Wales whose parents' highest socio-economic classification was "routine occupations", had higher mortality rates compared with infants with a parent from higher managerial, administrative and professional occupations (see Table 12 of our accompanying dataset, and Section 7 of the National Statistics socio-economic classification (NS-SEC), for class definitions).

Equivalent trends in Wales are more difficult to assess, as there are fewer infant deaths and therefore more fluctuations in the figures.

Other known risk factors

There are a range of other risk factors associated with infant mortality, such as maternal health behaviours, that we are unable to assess from the data we currently have available. More information is available in the Child health in 2030 in England report (PDF, 1.05MB) from the Royal College of Paediatrics and Child Health (RCPCH).

Child

Aged 1 to 15 years.

Child mortality rate

The number of child deaths, per 100,000 population.

Early neonatal

Aged under seven days.

Infant

Aged under one year.

Infant mortality rate

The number of infant deaths, per 1,000 live births.

Neonatal

Aged under 28 days.

Perinatal death

Either a stillbirth or early neonatal death.

Postneonatal

Aged 28 days to 1 year.

Stillbirth

Born after 24 or more weeks completed gestation without, at any time, breathing or showing signs of life.

Child and infant mortality data are based on deaths occurring in 2023. In normal circumstances, deaths of all ages are typically registered within five days. In the case of infant deaths, this delay can be much longer if the death requires coroner investigation. Consequently, our annual death cohort for infant deaths occurring in 2023 includes infant deaths registered before 1 October 2024.

Coronavirus (COVID-19) and child and infant mortality statistics

Linking infant deaths to their birth registration and birth notification improves our understanding of the main characteristics of the infant and the infant's parents. Before 2020, over 95% of infant deaths were successfully linked to their birth registration and birth notification.

In 2020, during the coronavirus (COVID-19) pandemic, the linkage rate fell to 90.5%. Birth registrations and infant death registrations may have been delayed, reducing the likelihood of infant death registrations being linked with a birth registration and notification.

The linkage rate recovered to over 95% from 2021 onwards. In 2023, 97.0% of infant deaths were successfully linked to their birth registration and birth notification. More information can be found in our User guide to child and infant mortality statistics.

Strengths and limitations

Quality

More information on the strengths, limitations and accuracy of the data is available in our Child and infant mortality statistics quality and methodology information (QMI) report.

Our User guide to child and infant mortality statistics provides further information on data quality, legislation, and the procedures relating to mortality and cause of death coding. It also includes a full glossary of terms.

Accredited official statistics

These accredited official statistics were independently reviewed by the Office for Statistics Regulation in 2012. They comply with the standards of trustworthiness, quality and value in the Code of Practice for Statistics and should be labelled "Accredited official statistics".

For more information on accredited official statistics, read the Office for Statistics Regulation guidance.