PIP: The speed of decline of the US infant mortality rate diminished markedly to 2.7% (10.6 deaths) in 1984, and the likelihood that the goal of an infant mortality rate of 9 will be reached by 1990 is less likely. A definite change that took place not long before the rate of decline flattened out was the reduction by the Reagan Administration in the funding of several programs for children, mothers of young children, and pregnant women. Many observers think these cutbacks have contributed significantly to the change in the infant mortality rate trend by weakening national policies for the care and protection of pregnant women. Senior officials of the Department of Health and Human Services deny the connection. They point instead to such factors as the high rate of teenage pregnancy, the use ot tobacco, alcohol, and drugs by many pregnant women, and the complex racial mixture of the US population. They also cite the possibility that high technology medicine merely postpones the death of some infants who earlier would have appeared in the statistics relating to naturally aborted pregnancies. The Administration has declined a proposal to study the effect of the cutbacks. The infant mortality rate is officially defined as deaths (per 1000 live births) in the 1st year of life. Neonatal deaths, involving babies less than 28 days old, account for 70% of infant deaths, and 2/3 of neonatal toll is attributable to low birth weight. The risk of low birth weight is increased both among black mothers and among women who give birth when they are younger than 16 or older than 35. It is also higher for women who have poor prenatal care or none, whose diet is inadequate, and who gain less than 20 pounds during pregnancy. Smoking, abuse of drugs, and excessive consumption of alcohol are factors as are stress, frequent childbearing, and previous miscarriages. The postneonatal infant mortality rate (deaths from 28 days through 12 months) is less substantially correlated with low birth weight but is heavily influenced by environmental circumstances that contribute to accidents and contagious diseases. The postneonatal rate is high among populations that have low socioeconomic status, poor sanitation, unsafe housing, and limited water supply. The period of sharpest decline in the infant mortality rate was the decade of the 1970s. Many influences were at work. These include: the expansion of social support programs; a decrease in the proportion of unwanted childbearing through the provision of easier access to family planning and abortion services; the development of nutritional supplements specifically for pregnant women, and dramatic advances in medical technology for the care of infants. To reach the goal of an infant mortality rate of 9/1000 by 1990 requires the implementation of public policies that include assured access to comprehensive perinatal care, guaranteed maternity leaves, job protection during the leave, and cash benefits equal to a significant portion of wages during the leave.