Dr. Kyran Quinlan and colleagues at Rush issue an urgent call for prevention strategies for sleep-related infant deaths in his viewpoint, "Protecting Infants From Sleep-Related Deaths" published in the June 18 online issue of JAMA Pediatrics.
"Approximately 3,700 sudden unexpected infant deaths occur each year," said Quinlan, associate professor and division director of general pediatrics at Rush University Medical Center. "These infant deaths all occur before the child's first birthday, with 90 percent occurring within six months."
While infant deaths from sudden infant death syndrome and suffocation significantly declined following the 1992 American Academy of Pediatrics recommendation regarding sleep position and the National Institutes of Health-led Back to Sleep campaign, the number of sleep-related deaths has now plateaued for nearly 20 years. Leading to a decrease in infant deaths, the campaign included safe sleep practices such as place the baby on his or her back to sleep, use a firm and flat sleep surface separate designed for infants, and not to place soft objects or loose bedding in the infant's sleep area.
"The number of sudden unexpected infant deaths in 2015 has essentially remained unchanged from the 3,716 sudden unexpected infant deaths in 1999," Quinlan said. "From a public health standpoint, the true risk of sudden unexpected infant death is probably underestimated by parents because these deaths are rarely reported publicly. When the true risk is underestimated, some parents may be less likely to adopt safe sleep recommendations to protect their infants."
Currently, sudden unexpected infant death is estimated to take as many lives as all deaths from car crashes in infants, children and teenagers combined, according to an analysis of national health data.
A total of 3,684 infants died suddenly and unexpectedly in 2015, more than nine times as many as the 404 drivers aged 18 years who died in crashes the same year, according to the National Center for Statistics and Analysis in the federal Department of Transportation.
Surveillance system needed
"There is a need to create a national surveillance system and to support innovation to find what works to promote safe sleep effectively," Quinlan said.
The CDC is building a sudden unexpected infant death case registry to serve as such a surveillance system. So far, the case registry includes 16 states and two jurisdictions, and is beginning to provide rich and detailed information about the circumstances for each sudden unexpected infant death. To date, the case registry covers just 30 percent of all sudden unexpected infant death.
"If this registry expanded across all states, the system could provide details to show how many of the deaths were associated with unsafe sleep from those with other causes," Quinlan said. "Efforts to expand such a system should be a public health priority."
"The road is ahead is clear. First we must correct the current misperception of the risk, invest in the national surveillance system, and support innovation to find what works to promote safe sleep effectively."
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Kyran P. Quinlan et al. Protecting Infants From Sleep-Related Deaths, JAMA Pediatrics (2018). DOI: 10.1001/jamapediatrics.2018.0879