WASHINGTON — "He's growing great, by the way," Dr. Norma Kreilein said of the underweight baby suckling on a pacifier in his mother's arms.
"I thought so," said Angel Riggle, as her husband changed their other son's diaper during a pediatric checkup in November. "It's good to see the numbers."
"Sleeping good?"
"Oh, yeah, he wakes up every three hours to eat."
The baby, Matthew, and his twin brother, Mark, entered the world Oct. 4, six weeks ahead of schedule. Matthew weighed 3.5 pounds, Mark 4.4.
Matthew had a hole in his heart and a narrowing of his aorta. He was flown by helicopter to an Indianapolis children's hospital.
His mother and brother stayed behind here in southwest Indiana. "It was hard. I felt torn about where you were supposed to be," said Angel, 35, who lives in this small town, the county seat of Daviess County.
Ten days before the birth of the twins, an air quality warning went out in her part of the state. Her husband, Allan Riggle, remembers their older sons being sick and using an allergy spray, and that he had "crud" in his own eyes and lungs.
"I remember there was something going on around the time they were born," said Riggle, 41. "It's been a problem for years. It seems to be getting worse. You definitely see the discoloration coming out of the power plant all the time."
Matt was in the neonatal intensive care unit for 19 days. He underwent heart surgery. It was touch-and-go for his first few weeks.
Kreilein, the Riggles' pediatrician, is convinced the environment played a role in the twins' preterm birth. Not only that, she believes it causes infants to die in her county. Twins, however, are more likely to have birth complications than single babies.
Ten days before the birth of the twins, an air quality warning went out in her part of the state. Her husband, Allan Riggle, remembers their older sons being sick and using an allergy spray, and that he had "crud" in his eyes and lungs.
"I remember there was something going on around the time they were born," said Riggle, 41. "It's been a problem for years. It seems to be getting worse. You definitely see the discoloration coming out of the power plant all the time."
Matthew was in the neonatal intensive care unit for 19 days. He underwent heart surgery. It was touch-and-go for his first few weeks.
Kreilein, the Riggles' pediatrician, is convinced the environment played a role in the twins' preterm birth. Not only that, she believes it causes infants to die in her county. Twins, however, are more likely to have birth complications than single babies.
From Oct. 31 to Nov. 7, a few weeks after the air quality alert, there were seven premature births at the Washington hospital, she said. In an average week, there would be less than one.
"We're basically downwind from some of the largest concentrations of industrial pollution in the country," Kreilein said.
"And there are too many women delivering premature babies and sick babies with no obvious risk factor other than the fact they live here."
Whatever the reason, from 2010 to 2014, this rural county of 32,407 had the highest rate of babies dying of any county in the state, with 10.6 deaths for every 1,000 live births. Health officials were largely taken aback by the news, and are just now trying to get a grip on why it happened.
"In the last few months, this has come to our attention," said Kathy Sullender, public health nurse for the Daviess County Health Department. "We're still in the early stages of digging down and finding out what's going on."
Indiana's infant mortality rate for African-Americans is 2.5 times that of whites. But Daviess County statistics suggest it's not strictly a racial issue. In a county that is 95 percent white, all 28 babies who died between 2010 and 2014 were white.
The leading causes of infant death in Daviess County were birth defects (36 percent) followed by premature birth (27 percent) and sudden unexplained infant death (14 percent), according to the county health department.
In Daviess County, more children died in the postneonatal period (after 28 days) than before. Nationally and statewide, the opposite is true.