Between August 2019 and July 2024, there were 369 more deaths during the winter periods of December to March than during the non-winter months. The analysis found that child mortality was on average 6.5% higher in winter. This figure fluctuated across the five years, from just 0.8% in 2021–22 during the height of the COVID-19 pandemic to 11% in 2022–23.
Winter mortality varied between age groups. Infant deaths were 5.3% higher during the colder months, while deaths among children aged 1–9 years were 16.8% higher. In contrast, the difference for older children aged 10–17 years was much smaller, at 1.3%.
The analysis also revealed disparities across different ethnic groups. There were 11.5% more deaths of children from Asian or Asian British backgrounds in winter compared to non-winter months, and the increase was 10.2% among Black or Black British children. The figures were lower for children from mixed ethnic backgrounds (5.8%) and White children (5.3%).
Deprivation played an important role, with 7.2% more deaths in winter among children living in the most deprived areas of England compared to a 2.2% in the least deprived areas. Regional variation was also observed, ranging from an 11% rise in the North East to 2.2% in the East Midlands.
The leading cause of winter mortality was infection, with 70.4% more infection-related deaths occurring in winter than in non-winter periods. By contrast, traumatic causes around birth, known as intrapartum events, were less common during the colder months.
Sylvia Stoianova, Deputy Director of the National Child Mortality Database, said: "These findings highlight the stark seasonal pressures on children’s health, with winter bringing a clear increase in preventable deaths. By understanding the role of infection, deprivation and ethnicity, we can better target support and interventions to protect the most vulnerable children."
The lowest levels of winter mortality were seen in the two pandemic years, when child mortality overall fell. Previous NCMD research has already highlighted the impact of SARS-CoV-2 and wider infection-related deaths in children.
These new findings reinforce the importance of preventing and managing infections in children, particularly those with underlying health conditions and vulnerabilities. The NCMD’s earlier thematic report on infection-related deaths remains highly relevant for shaping government and healthcare strategies aimed at reducing winter mortality.
NCMD report