Caution:

This site includes information about child deaths, which some readers may find distressing. If you need support, free and confidential help is available

We wish to convey our sincere condolences to the families and friends of the infants, children and young people in NSW who have died. It is our foremost responsibility to learn from these deaths and to use that knowledge to make a difference.

Working together to reduce preventable child deaths in NSW through
  1. research
  2. insight
  3. data
  4. collaboration
  5. action
insight data collaboration action

Natural causes

Background

Between 2022 and 2023, 632 children and young people in NSW died from natural causes – 346 in 2022 and 286 in 2023.

Infants under 1 year accounted for 395 deaths (63%).

Natural cause deaths result from disease, illness, or complications of early development. The main classifications include:

  • perinatal conditions related to pregnancy, birth, or the neonatal period
  • congenital malformations and chromosomal abnormalities
  • infectious and parasitic diseases, including viral meningitis, meningococcal and other bacterial diseases
  • cancers (neoplasms), including leukaemia and malignant brain or soft-tissue tumours
  • respiratory diseases such as influenza and pneumonia
  • nervous system diseases, including encephalitis and cerebral palsy
  • endocrine, nutritional, and metabolic conditions such as diabetes and cystic fibrosis.

Findings collected

2009-2023

Page last updated

5 November 2025

2-year period (2022-2023)

15-year period (2009-2023)

Leading causes of deaths for infants <1 year

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Leading causes of death for children 1-17 years

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Factors

Across 15 years (2009-2023), certain groups remain at higher risk of death from natural causes: 

  • Male children
  • Aboriginal and Torres Strait Islander children 
  • Children in areas of greatest socio-economic disadvantage 

Steps toward prevention

Observations

The following issues were identified through recent reviews of natural cause deaths.

In 2022 and 2023, 6 children in NSW died from COVID-19 infection – 3 aged 0–2 years and 3 aged 13–17 years.

'Vaccine-preventable’ refers to the reduced risk of infection following immunisation, which can vary with age, immune response and virus strain. 

In 2022 and 2023, 4 children died from vaccine-preventable diseases listed on the NSW Immunisation Schedule.

Between 2009 and 2023, 32 children died from vaccine-preventable diseases, mostly pneumococcal infection (18 deaths). 

As of September 2024, 93.9% of children aged 5 in NSW were fully immunised, helping keep infection-related deaths low. 

In 2016, the CDRT released a report commissioned from the National Centre for Immunisation Research and Surveillance (NCIRS) on child deaths in NSW from 2005 to 2014, focussing on recommendations to prevent or reduce deaths from vaccine preventable diseases (VPDs).

Sepsis is a life-threatening condition where the body’s response to infection causes injury to its own tissues and organs. It can result from bacterial, viral or fungal infection. 

In 2022 and 2023, 9 children died from sepsis – a threefold increase compared with 2020 and 2021. Another 11 children had sepsis recorded as a direct or antecedent cause, and 3 as a contributing condition. 6 deaths were due to Streptococcus group A infection. 

In 2025, NSW Health updated the REACH program and Paediatric Observation Charts to improve early recognition and parental engagement. We continue to monitor sepsis-related deaths and the impact of these initiatives. 

In 2022 and 2023, 11 children in NSW died where asthma was directly related to the cause of death. All had a pre-existing diagnosis and experienced a sudden onset of symptoms before death. 

Read our detailed discussion in Chapter 9 of our Biennial Report 2022-2023

Previous research

Between 2016 and 2019, we examined infant deaths from severe perinatal brain injury, including hypoxic-ischaemic encephalopathy.

A 2021 case review of 101 deaths found no single cause, but multiple, interrelated factors.

Common themes included:

  • fetal growth restriction and decreased fetal movements
  • fetal heart-rate monitoring
  • newborn deterioration
  • use of oxytocin to induce labour
  • instrumental vaginal birth
  • critical incident investigation

A summary of these findings was published in the Biennial Report of the Deaths of Children in New South Wales: 2020 and 2021.

Read more in the Biennial Report 2020-2021

Current research

What we aim to understand

This follow-up review builds on the CDRT’s earlier study of perinatal deaths from severe brain injury in NSW.

It aims to understand the key contributory factors in these infant deaths, evaluate the adequacy of existing clinical practice guidelines and policies, identify prevention opportunities and make recommendations to prevent similar deaths in the future.

What the research involves

The study includes:

  • a cohort review to analyse cases and identify patterns
  • a validation exercise to confirm findings and ensure accuracy
  • a review of relevant policies, guidelines, and clinical practices to assess adequacy, adherence, and any changes since the initial study.

Why it matters

By identifying what has changed, and what still needs to improve, this review will help inform recommendations that strengthen perinatal care and safety for infants and their families across NSW.