Lower decline than expected

Background

National programmes to reduce sudden infant deaths led to a sharp decline in SIDS deaths in the United States in the 1990s. This is mainly due to the “Back-to-Sleep” campaign, which was used to encourage parents to let babies sleep on their backs. In addition, fewer cases of SIDS were diagnosed between 1990 and 2001 because other diagnoses were also used. These include “death from unknown cause” and “ASSB” (Accidental Suffocation and Strangulation in Bed). Renaming all causes of sudden infant death syndrome to “sudden, unexpected infant death” may make it easier to monitor cases in the future.

Methodology

This US scientific study examined how national and state-specific SUID rates have changed between 1990 and 2015. The data was extracted from a compressed national cause of death statistic. SUID was defined as the death of a baby under the age of one. All SUID causes were included in the work (SIDS, death from unknown cause, ASSB). The study authors examined both national and individual state data.

Key Findings

• Between 1990 and 2015, the overall US SUID rate (based on 100,000 live births) dropped from 154.6 (1990) to 92.4 (2015).
• Between 1999 and 2015, the overall decline was only 7%, indicating an increased need for information.
• SIDS was the most commonly diagnosed cause, followed by “death from unknown cause” and ASSB.
• ASSB even increased by 183.8%, which can be attributed to the child sleeping in the parental bed (co-sleeping).
• The study authors recommend national programmes for safe sleep.
• States showing a strong decline in SUID can serve as role models for other states.
• The study results suggest that state-run safe sleep programmes should be supplemented or redesigned.

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 soother 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

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