Babies still put at risk for sudden death: study
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Monday, March 26, 2012
By Genevra Pittman
NEW YORK (Reuters Health) - Parents changed how they put their infants to sleep after a campaign to prevent sudden infant death, but babies who died in the years afterward were still put at risk unnecessarily, suggests a new study from San Diego.
Sudden infant death syndrome, or SIDS, kills about 2,500 babies each year in the United States, most often those who are between two and four months old.
Babies who are put to bed on their stomach or side, especially with blankets and pillows, or those who share a bed with their parents are known to be at extra risk of SIDS -- also known as "crib death."
So doctors and public health officials have tried to get the message out that infants should be put to sleep on their back on a firm sleep surface, starting in 1994 with the nationwide "Back-to-Sleep" campaign. But there are other important ways to prevent infant death that shouldn't be minimized, researchers said.
"Far and away the safest sleep environment for a baby is to be placed in a crib with a well-fitting mattress, the mattress is firm, there are no soft objects in the bed -- no bumper pads, no blankets, no overstuffed toys -- and the baby in the crib is sleeping alone," said Dr. Henry Krous, from the University of California, San Diego School of Medicine.
"When caretakers put an infant down to sleep, they shouldn't just think about putting a baby on its back, they should think about these other risk factors," said Krous, who worked on the new study.
He and his colleagues compared the cases of all babies who came through the San Diego medical examiner's office with SIDS as the cause of death between 1991 and 2008, a total of 568 infants.
They found that fewer babies died suddenly after the word got out about dangerous sleeping positions: about one in 750 babies were killed by SIDS in 1991, compared to one in 1,600 in 2008. Most of that drop, however, came in the decade after the campaign started, and the number of babies dying has evened out in recent years, the researchers reported Monday in Pediatrics.
The study team also noticed there were still preventable risks involved in most recent SIDS cases.
The number of infants who'd been put to sleep on their stomach, for example, fell from 85 percent before the campaign to 30 percent afterward, but the number found deceased in an adult bed increased from 23 percent to 45 percent.
"The piece that I think is extraordinary is the continued issue of infants sleeping in bed with someone else, sleeping on adult surfaces," said Dr. Debra Weese-Mayer, a pediatrician at the Northwestern University Feinberg School of Medicine in Chicago who wasn't involved in the new study.
"People are getting part of the message, but not all of it," she told Reuters Health. "That tells me that we need to be more clear with the recommendations."
Most of the babies who died since 1991 had at least one innate risk for SIDS, such as being a boy or African American or being born prematurely. Infants were also more at risk if their moms smoked or drank alcohol.
In addition to avoiding risks like exposure to cigarette smoke, Krous told Reuters Health that "the best of both worlds" is to let the baby sleep on a separate surface immediately next to the parents' bed. Keeping mom and baby close promotes breastfeeding, but avoiding bed-sharing cuts the risk of SIDS, he explained.
Weese-Mayer said she thinks preventable risks haven't been eliminated for multiple reasons: because some parents never learn about the dangers of stomach sleeping or sharing beds -- and because others know the risks, but choose alternative sleeping positions anyway.
"What's sad is, because the (decreased number of deaths) has suggested to people that SIDS is going away, it decreases the public visibility of SIDS, and there couldn't be anything farther from the truth -- it's not going away," she said.
Krous agreed that the findings show there's still a lot of work doctors can do when it comes to educating new parents about preventing infant death.
"It's distressing that despite these educational efforts, SIDS rates have plateaued and we still have babies that are at unnecessary higher risk for sudden infant death," he said. SOURCE: Pediatrics, online March 26, 2012.
NEW YORK (Reuters Health) - Parents changed how they put their infants to sleep after a campaign to prevent sudden infant death, but babies who died in the years afterward were still put at risk unnecessarily, suggests a new study from San Diego.
Sudden infant death syndrome, or SIDS, kills about 2,500 babies each year in the United States, most often those who are between two and four months old.
Babies who are put to bed on their stomach or side, especially with blankets and pillows, or those who share a bed with their parents are known to be at extra risk of SIDS -- also known as "crib death."
So doctors and public health officials have tried to get the message out that infants should be put to sleep on their back on a firm sleep surface, starting in 1994 with the nationwide "Back-to-Sleep" campaign. But there are other important ways to prevent infant death that shouldn't be minimized, researchers said.
"Far and away the safest sleep environment for a baby is to be placed in a crib with a well-fitting mattress, the mattress is firm, there are no soft objects in the bed -- no bumper pads, no blankets, no overstuffed toys -- and the baby in the crib is sleeping alone," said Dr. Henry Krous, from the University of California, San Diego School of Medicine.
"When caretakers put an infant down to sleep, they shouldn't just think about putting a baby on its back, they should think about these other risk factors," said Krous, who worked on the new study.
He and his colleagues compared the cases of all babies who came through the San Diego medical examiner's office with SIDS as the cause of death between 1991 and 2008, a total of 568 infants.
They found that fewer babies died suddenly after the word got out about dangerous sleeping positions: about one in 750 babies were killed by SIDS in 1991, compared to one in 1,600 in 2008. Most of that drop, however, came in the decade after the campaign started, and the number of babies dying has evened out in recent years, the researchers reported Monday in Pediatrics.
The study team also noticed there were still preventable risks involved in most recent SIDS cases.
The number of infants who'd been put to sleep on their stomach, for example, fell from 85 percent before the campaign to 30 percent afterward, but the number found deceased in an adult bed increased from 23 percent to 45 percent.
"The piece that I think is extraordinary is the continued issue of infants sleeping in bed with someone else, sleeping on adult surfaces," said Dr. Debra Weese-Mayer, a pediatrician at the Northwestern University Feinberg School of Medicine in Chicago who wasn't involved in the new study.
"People are getting part of the message, but not all of it," she told Reuters Health. "That tells me that we need to be more clear with the recommendations."
Most of the babies who died since 1991 had at least one innate risk for SIDS, such as being a boy or African American or being born prematurely. Infants were also more at risk if their moms smoked or drank alcohol.
In addition to avoiding risks like exposure to cigarette smoke, Krous told Reuters Health that "the best of both worlds" is to let the baby sleep on a separate surface immediately next to the parents' bed. Keeping mom and baby close promotes breastfeeding, but avoiding bed-sharing cuts the risk of SIDS, he explained.
Weese-Mayer said she thinks preventable risks haven't been eliminated for multiple reasons: because some parents never learn about the dangers of stomach sleeping or sharing beds -- and because others know the risks, but choose alternative sleeping positions anyway.
"What's sad is, because the (decreased number of deaths) has suggested to people that SIDS is going away, it decreases the public visibility of SIDS, and there couldn't be anything farther from the truth -- it's not going away," she said.
Krous agreed that the findings show there's still a lot of work doctors can do when it comes to educating new parents about preventing infant death.
"It's distressing that despite these educational efforts, SIDS rates have plateaued and we still have babies that are at unnecessary higher risk for sudden infant death," he said. SOURCE: Pediatrics, online March 26, 2012.
Reuters Health
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