What is a neonatal death?

A neonatal death (also called a newborn death) is when a baby dies during the first 28 days of life. Most neonatal deaths happen in the first week after birth.

Neonatal death is different from stillbirth. A stillbirth is when the baby dies at any time between 20 weeks of pregnancy and the due date of birth.

More than 3 million neonatal deaths happen worldwide every year – about 2 in every 5 deaths of children under 5 occur in the first 28 days after birth.

Neonatal death is rare in Australia, and rates are falling – there are now about 1,600 neonatal deaths per year.

What are the causes of a neonatal death?

It’s not always known why a baby dies. However, the risk of neonatal death may be greater if a baby is born prematurely, is low birthweight, or has birth defects.

Prematurity and low birthweight cause about 1 in 4 neonatal deaths. Premature babies can develop life-threatening complications such as breathing problems, bleeding on the brain, infections and problems in their intestines (necrotising enterocolitis).

Low birthweight – if the baby weighs less than 2.5kg at birth – can also cause serious health problems such as difficulty breathing and feeding.

The most common birth defects that cause neonatal death include heart defects, lung defects, genetic conditions and brain conditions such as neural tube defect or anencephaly.

Sometimes a neonatal death may be caused by problems during the pregnancy, such as pre-eclampsia; problems with the placenta; infections; or lack of oxygen during the birth. It can also be caused by complications during the labour - for example, if the baby didn’t get enough oxygen.

What happens after a neonatal death?

If your baby dies, you might want to spend some time with them. You should take as long as you like. Some parents create memories of the baby by taking photos, handprints or footprints.

When you are ready to say goodbye, the hospital or a funeral director will take your baby to a funeral home. There will then be a burial or cremation.

By law, you must register both the birth and the death with Births, Deaths and Marriages in your state or territory.

In Australia, not all neonatal deaths are investigated by conducting an autopsy. An autopsy is an examination to try to work out why the baby has died. It is done by a trained pathologist. You can decide how detailed you would like the autopsy to be – whether it involves just examining the baby or removing organs to test why the death has happened.

An autopsy cannot be done without the parents’ consent and it is up to you whether to agree to an autopsy after a neonatal death. The only time when an autopsy may be carried out without consent is if the case is referred to a coroner. This might happen if the death occurred in suspicious circumstances or if it was something to do with the healthcare the baby received.

Sometimes no cause of death can be found, even after an autopsy. It’s a good idea to discuss the benefits and downsides of an autopsy with a doctor, midwife or social worker. They will guide you through what needs to be done and will answer any questions you might have.

Learn more here about what happens after a neonatal death and what changes might occur to your body.

Where to find help

The death of a newborn baby can be devastating, both for the parents and for the whole family. So it’s important to get as much support as possible to help you through this difficult time.

Your doctor, midwife, maternal child health nurse or social worker will be able to guide you through what happens after the baby has died.

Sands Australia provides information and support for anyone who has experienced stillbirth or newborn death. You can speak to someone 24 hours a day on their helpline, 1300 072 637.

Red Nose Grief and Loss has information and resources. You can call their helpline 24 hours a day on 1300 308 307.

Lifeline supports anyone having a personal crisis – call 13 11 14 or chat online.

You can call Pregnancy, Birth and Baby on 1800 882 436 to talk to a maternal child health nurse.