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November 25, 2019

 Sudden infant death syndrome, SIDS, is a sad and serious disease that we still know very little about. One risk factor that has been nailed down scientifically is sleeping prone as an infant. Dr. John Kattwinkel at the University of Virginia developed the Back To Sleep program that significantly reduced SIDS issues nationally.

In the Journal Pediatrics this month, Dr. Hirai and colleagues looked at socioeconomic demographics and guideline adherence in the US.

They looked at 4 sleep practices:
1) back to sleep position
2) separate approved sleep surface
3) room sharing without bed sharing
4) no soft objects or loose bedding

Results: "Most mothers reported usually placing their infants to sleep on their backs (78.0%), followed by room-sharing without bed-sharing (57.1%). Fewer reported avoiding soft bedding (42.4%) and using a separate approved sleep surface (31.8%)." Low socioeconomic status was associated with the highest risk of not adhering to guidelines. (Hirai et. al. 2019)

The US ranks 33rd in the world for Infant mortality which is not good for a rich country. The medical community needs to do a better job of educating all but especially low income American mothers about the risks of placing a newborn infant in any position other than supine and in an approved crib/bassinet without any soft or loose bedding. Many lives can be saved by this simple measure.

The other major issue is co-sleeping. When a mother sleeps in the same bed as an infant, there is a small but serious risk of roll over smothering. A subset of mothers believe that this sleeping method is more beneficial to the child's temperament which may or may not be true. However, what is true is the risk of abject death during co-sleeping.

Be aware and help all mothers know the risks,

Dr. M

Hirai Pediatrics Article