sleeping baby girl

Study Summary

Trends in the mortality of SUID

Sudden Unexpected Infant Death: 1995–2014.


Trends in the Incidence of Sudden Unexpected Infant Death in the Newborn: 1995–2014.

Bass J, Gartley T, Lyczkowski D, Kleinman R

Pediatrics, 2018
In order to reduce the risk of sudden unexpected infant death, the authors of the study are calling for a standardised definition and USA-wide register collating all cases. In addition, further studies are required in order to further narrow down the causes of all forms of unexpected infant death.

Background

The definition of SUID covers:

  • Sudden Infant Death Syndrome (SIDS)
  • Accidental Suffocation and Strangulation in Bed (ASSB)
  • unknown causes of death in infants less than one year of age.

SUID occurs most frequently between one and four months. When SUID occurs within the first six days of life, it is known as Sudden Unexpected Postnatal Collapse (SUPS). In 1992, the American Academy of Pediatrics (AAP) published guidelines for healthy sleeping. In the years that followed, a 25% increase in SIDS was observed during the first month of life. The authors of the study presume that some of the fatal cases previously diagnosed as SIDS have now been divided into different categories (ASSB, ‘death from an unknown cause’ or SUPC). In order to explain this possibility, the authors investigated each SUID case, covering all categories including SUPC. This was an attempt to detect patterns which could explain the increase.

Methodology

In the study, all forms of SUID were compared with the birth/death report in the CDC WONDER online database (1995–2014). This concerned both SUID in neonatal infants (younger than 28 days) and the post-neonatal phase (28–364 days). The annual incidence of SUID in 100,000 births between 1995 and 2014 and the percentage of each SUID due to unsafe sleeping conditions (MSBC – Mechanical Suffocation Bed or Cradle) and ASSB were listed separately for both the neonatal and post-neonatal periods. Furthermore, data was compiled for the number of deaths in the first few hours, in hours one to twenty-three and in days one to six.

Key Findings

  • Between 1995 and 2014 there were 8869 SUID cases in the first month of life, with around 30% occurring within the first six days.
  • Post-neonatal SUID cases fell between 1995 and 2014 from 101 to 78 cases per 100,000 births.
  • The authors of the study propose the development of a standardised definition for identification and analysis.
  • Maternity wards have an important role to play in the teaching of safe sleeping conditions for babies.
  • The use of mobile information (emails, video messages, etc.) shows that this raises awareness among parents of safe sleeping arrangements for their babies.
  • A pacifier can be offered shortly after the birth to help with sleeping.

Recommendations for safe sleep

  • Let babies sleep on their backs
  • Use a firm mattress
  • Breastfeeding is recommended
  • Put babies to sleep in their own cot,
  • but in the parental bedroom
  • Avoid leaving pillows and other soft objects such as stuffed animals in the cot
  • Offer a pacifier while baby is falling asleep
  • No smoking during pregnancy
  • and after childbirth
  • No alcohol and illegal drugs during pregnancy and after childbirth
  • Avoid excessively warm clothing and headgear
  • Ensure that all recommended vaccinations are received
  • Allow babies to lie on their stomachs for controlled periods when awake to aid development
Source: American Academy of Pediatrics – New Safe Sleep Recommendations aap.org

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