As most EU countries, Poland also struggles with a year-on-year decline in the number of births. 272,000 children were born in Poland in 2023, which was the lowest recorded number of births in the entire post-war period. This downward trend has intensified especially in the last several years. Between 2010 and 2023, the decrease in the amount of births reached 34%. Per 1,000 population, 7 children were born in 2023, while in 2010, it was 11 children. By comparison, in the post-war period, the average number of births per 1,000 population varied from nearly 29 children in the 1950s to 12 children in the 1990s.

The declining number of births in Poland results from the following factors: the decreasing number of potential mothers (women of childbearing age, i.e. in the 15-49 age group), an increasingly older age at which women give birth to their first child, and a low fertility rate (the average number of children that a woman gives birth to during her lifetime). Changes in the size of the population and age structure entail a steady decline in the number of potential mothers. In Poland, their number has fallen by more than 1 million (to 8.3 million) since 2010. In the context of an aging population, the current share of women who can become potential mothers in the total number of women over the age of 15 is 51% (compared to 56% in 2010). Similar trends are observed in the whole EU, where this percentage has fallen from 54% to 48%. More Polish women, like their European counterparts, decide to give birth to their first child at an older age. In 2023, the average age at which Polish women decided to become mothers was 29, while in the EU (in 2022) it was nearly 30 (more than a decade ago, the average age was almost 27 and 29, respectively). Fewer children are born to women who are in the 20-29 age group, and more to those over 30. The percentage of children born to mothers over the age of 30 was 57% in 2023, which is significantly higher than in 2010 (39%). The percentage of children born to mothers over 40 is also rising steadily (to over 4% in 2023 from less than 2% in 2010). On the other hand, the number of very young girls giving birth has decreased markedly. There were more than 70% fewer births among 15-19-year-olds in 2023 than in 2010, falling from nearly 19,000 to less than 5,000. Births by even younger Polish mothers, i.e. aged 10-14, has remained at the level of 30-60 per year, although a downward trend is observed in their case as well.

In order to ensure a stable demographic development of the country, thus the replacement of generations, there should be on average at least 2.10–2.15 children born to every woman aged 15-49. Declining fertility trends are observed in Poland and on average in the EU. In 2023, 1.16 children were born per Polish female resident, which is one of the lowest fertility rates in the EU (compared to an average of 1.46 children per EU female resident in 2022).

The duration of the pregnancy and whether it is single or multiple is of great importance for both the mother and her baby. According to the definition of the World Health Organization, a pregnancy is considered to be full-term from the 38th week of its duration, while a baby born after the 22nd week but before the completed 37th week is classified as premature. In Poland, 7% of all newborns are premature. Among them, babies born between the 32nd and 36th week of gestation are the most numerous; between 2010 and 2023, their percentage grew from 83% to 85%. Out of the remaining premature babies, about 10% were born between the 28th and 31st week of gestation and about 5% below the 28th week. The vast majority of newborns come from single pregnancies (these babies invariably account for more than 97% of all births). The remaining 3% come from twin and multiple pregnancies.

Between 2010 and 2023, most children in Poland were born in July, followed by January and September. On the other hand, the fewest children were born in February, December and November. The most popular day of the week for parents to welcome their babies into the world is Tuesday and the rarest Sunday. The naming trends in Poland are changing: in 2023, the most popular girl names were Zofia, Zuzanna and Laura, and boy names Nikodem, Antoni and Jan, while in 2010, parents most often named their daughters Julia, Maja and Zuzanna, and sons Jakub, Szymon and Kacper.

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As medicine advances and perinatal care improves, the number of deaths among infants is falling. In Poland, during the 2010-2023 period, the death rate of infants (children up to 12 months of age) per 1,000 live births fell from 5.0 to 3.9. Among them, the death rate of newborns (children up to 28 days old) decreased from 3.5 to 2.6 and of children who lived less than a day from 1.6 to 1.1. The year 2021 was an exception, when, for the first time in years, the number of infant deaths per 1,000 live births increased year-on-year. Similar trends were recorded in most EU countries, which, among other factors, should be linked to the then-ongoing pandemic.

Despite the observed improvement, more infants still die per 1,000 live births in Poland than in most EU countries (both in 2010 and 2022, Poland was the 7th country with the highest infant mortality rate). Annually, out of all Polish children who die in the first year of life, 70% are those who do not live to be one month old, almost half of whom die in their first day of life.

There are many causes of death among infants, but the most common ones are conditions which begin in the perinatal period (they accounted for half of infant deaths in 2010–2023). Congenital defects, deformities and chromosomal abnormalities are considerable causes of death; the percentage of deaths among children suffering from these conditions and under the age of one ranged from 34% to 40% in 2010-2023. Other less common causes of infant deaths include respiratory diseases, cardiovascular diseases and infectious and parasitic diseases.

The older the mother, the higher the risk of infant death. The mortality rate of children born to women aged 45 and over is clearly higher than children whose mothers are younger. In 2010-2023, the number of deaths of infants born to mothers over the age of 45 varied from 3 to 27 infants per 1,000 live births, depending on the year. Among mothers aged 40-44, an average of 8 infants per 1,000 live births died each year, and 7 among the youngest mothers (aged 19 and less).

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In Poland, mandatory vaccination is regulated by the 2008 Act on preventing and combating infections and infectious diseases in humans. Each year, the Chief Sanitary Inspectorate prepares a Preventive Vaccination Program (Vaccination Schedule), which consists of a list of mandatory and recommended vaccinations and describes the rules for their administration. Compulsory vaccinations include those against tuberculosis, hepatitis B, diphtheria, tetanus and pertussis, acute poliomyelitis (polio), Haemophilus influenzae type B (Hib), and measles, mumps and rubella. Due to the specific properties of the immune system of children, most vaccinations are given to those under the age of 2.

Despite the relatively high vaccination coverage of children and adolescents in Poland, the number of evasions from mandatory vaccinations is growing. Over 13 years, the number of children and adolescents (in the 0-19 age group) who have not received mandatory vaccinations increased more than 20-fold. In 2010, 4 people from this age group per 10,000 population were not vaccinated, while in 2023 this number reached 115 people. As regards the youngest children (up to the age of 3), the percentage vaccinated with the primary (basic) dose decreased from nearly 100% in 2010 to just over 90% in 2023. An even higher decline was noted among children receiving a vaccine in two or more doses. Vaccinations that need to be repeated every few years have an average vaccination rate of between 90% and 80%. Booster doses tend to be the least popular, especially those administered at an older age. For instance, by 2023, only 77% of people aged 20 decided to get a booster dose against diphtheria and tetanus (compared to 91% in 2010).

Compared to 2010, the percentage of vaccinations against measles and polio has declined most sharply of all mandatory vaccinations. According to the WHO data, in 2020-2022, the percentage of infants vaccinated with the first dose against measles reached 70-80% (i.e. below the limit of herd immunity) in Poland. Thus, in 2022, Poland ranked last among EU countries in terms of the vaccination coverage against this infectious disease. A year later (in 2023), the percentage of children vaccinated against measles rose to 91% (yet was still lower than in 2010, when the percentage was close to 100%). In the recent years, vaccination rates against polio have also been below or close to the limit of herd immunity; in 2023, the percentage of vaccinations administered against this disease was only 85%, compared to 96% in 2010.

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In Poland, parents of young children increasingly often decide to use available services provided by various childcare institutions. In 2023, 36% of children aged 1-2 were under the care of others than their closest family (compared to only 4% in 2011). A much higher percentage of toddlers from cities remain in the care of childcare institutions than in rural areas (over 50% and 15%, respectively in 2023). Fewer women decide not to return to work after having a child; their number per 10,000 women fell from 48 in 2010 to 31 in 2023. At the same time, the employment rate of women with the youngest child under 5 increased from 66% in 2010 to 74% in 2023.

Care for the youngest children in Poland is regulated by the Act on care for children under the age of 3 (of 4th February 2011), according to which care organised by institutions may take the form of nurseries, kids’ clubs, day carers and nannies. In the 2011-2023 period, the total number of institutions offering childcare services (nurseries, kids clubs, nursery wards) increased almost eightfold (from 700 in 2011 to 5,500 in 2023), and the number of the available places in these institutions increased more than fivefold (from 39,000 to 213,000). For every 100 places in these institutions, nurseries offer their largest number, i.e. an average of 90 places in the years 2011-2023. The remaining places are provided by kids’ clubs (an average of 8 per 100) and nursery wards¹ (an average of 2 places per 100).

1) Nursery wards (additional institutions established e.g. at workplaces or hospitals) are not included in the Act on care for children under the age of 3, but until 2022 they were one of the options that parents could consider. In 2022 nursery wards were no longer included in the Register of Nurseries, which collects data on institutions offering care to the youngest children.

In addition to the care provided by nurseries, nursery wards and kids’ clubs, parents can also use the services offered by day carers and nannies. A day carer’s duties are defined by regulations, according to which he or she should have appropriate education, premises for safe care, and regularly update and develop his or her knowledge and skills. A day carer may care for up to five children (who may come from different families) who are at least 20 weeks old. In Poland, the profession of a day carer is becoming increasingly popular. In the years 2012-2022, their number grew from 30 to over 2,000. Thus, the number of children in their care also increased: from 80 children in 2012 to almost 10,000 in 2022. The institution of a nanny, the least formalised type of care for toddlers, is declining in popularity. The number of nannies reported to the Social Insurance Institution plummeted by a half in the studied period, i.e. from 9,100 in 2012 to 4,700 in 2022.

Poland has one of the lowest percentages of children who spend more than 30 hours a week in childcare institutions in the EU (although the gap between Poland and the EU average narrowed in 2011-2023). In 2023, the percentage of children receiving formal care for more than 30 hours a week was twice as low in Poland as in the EU on average (11% in Poland and 23% in the EU), while in 2011, it was more than five times lower (3% and 16%, respectively). In the case of a shorter stay of a child in the care of formalised institutions, Poland was also among EU countries that have a very low percentage of children under such type of care (in 2023, 1% of children in Poland and 14% on average in the EU).

Small children whose parents decide to use childcare services offered by institutions spend increasingly longer hours per week there (although definitely a lower amount than in the EU on average). In 2023, a child in Poland spent nearly 4.5 hours per week in childcare institutions, compared to more than 11 hours in the EU. In Poland, non- formal childcare, i.e. provided by family members and neighbours, is still more popular than the care provided by relevant institutions. In 2023, children up to the age of 3 spent an average of 7 hours a week in non-formal care. Poland is thus in the top five EU countries where children spend the most time per week in this type of care. Poland exceeded the 2023 EU average of 3.5 hours in this regard.

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