"Back to sleep" just may not be sufficient

Arizona researchers who studied infant death records in that state have concluded that sleep-associated events-not sudden infant death syndrome (SIDS) alone, but suffocation and asphyxiation during sleep as well-are the number-one cause of death in infancy. What's more, those researchers say, three quarters of such deaths are preventable.

In a paper presented at the Pediatric Academic Societies 2005 Annual Meeting in May in Washington D.C., meeting, researchers from the Maricopa [Ariz.] Medical Center examined the records of the state's Child Fatality Review Program for 1999 and 2001. They focused on 109 records of infants who died in their sleep-from SIDS, suffocation, or asphyxiation. Of these fatalities, 72% had been sleeping in a "high-risk" position (i.e., not on their back), or with such hazards as soft bedding, quilts, pillows, and beds shared with other children or adults. And although the AAP's Back to Sleep campaign includes education for parents and caregivers on both sleep position and sleep environment, the study's findings suggests that the time has come to reframe the campaign to provide equal emphasis on both variables. For Arizona, at least, says pediatrician Anu Partap, MD, lead researcher, SIDS and sleep environment hazards together are the leading cause of infant death, and well-understood safe sleeping measures could have prevented most of them.

Getting the safe sleep message across may be even more important in particular among African American parents and parents on Medicaid. The study found that the rate of death from potentially preventable sleep-associated causes was five times higher among African American infants and 1.5 times higher in Medicaid families than among the general population. Outreach to those populations, says Partap, is vital.

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