SIDS (sudden infant death syndrome,) also known as “crib death,” continues to be a baffling and tragic problem for many families in the United States. According to the Centers for Disease Control and Prevention (CDC,) around 3,700 SIDS deaths were reported among infants less than 1 year old that had no immediately obvious cause.
And in some states, the toll is heavier than others, health officials report.
"Despite continued updates and refinements to the American Academy of Pediatrics' (AAP) safe sleep recommendations, declines in SIDS have slowed since 1999," said lead researcher Alexa Erck Lambert.
"Our analysis also found that trends in SIDS vary by state," she added. "Although some states have experienced notable declines, wide variations in SIDS rates by state still exist."
While SIDS has declined in several states, it has increased in others.
The greatest declines in SIDS rates were seen in California, Colorado, the District of Columbia, Florida, Kansas, Missouri, New York, Oregon, Washington and Wisconsin.
On the other hand, the highest SIDS rates were found in Alaska, Arkansas, Alabama, Kentucky and Louisiana. Significant increases in SIDS cases were also seen in these states between 2000-2002 and 2013-2015.
The rate of SIDS cases dropped about 7 percent from 1999 to 2015. From 1990 to 1998, however, these deaths fell nearly 45 percent, the study authors reported.
The researchers can't say why there are state differences or why the number of SIDS cases has flattened.
"The reasons for the trends are outside the scope of this study and impossible to tease out from vital statistics data," Erck Lambert said. "Our goal was to illuminate the trends and state variation."
One child health specialist, Rebecca Carlin, a pediatrician at Children’s Health Center Hospital in Washington, D.C., believes there may be several factors contributing to the higher SIDS risks in certain states such as cigarette smoking, cultural differences and SIDS education availability.
"All five of the states with the highest and increasing SIDS rates also have some of the highest rates of smoking, whereas only one of the nine states with the biggest fall in SIDS rates had as high a rate of tobacco use," she said.
In addition, laws that cover training childcare providers on infant safety vary from state to state, as do rates of health insurance coverage, said Carlin, who co-authored an editorial that accompanied the study.
"There are also racial differences in SIDS rates, with American Indian and Alaskan Native and non-Hispanic African American infants having the highest rates, and Hispanic American and Asian American infants having the lowest rates," she said.
Moreover, some states have home-visiting programs and other initiatives that have been helpful in educating parents on safe sleep, Carlin added.
"In the U.S. as a whole, but particularly in states where the number of SIDS deaths are increasing, we need to invest in programs to effectively decrease smoking and substance use, increase prenatal care and promote safe sleep environments in order to better protect infants," she said.
The Back to Sleep campaign has been updated over the years and is now called the Safe Sleep campaign. Although SIDS is not preventable, there are ways for parents and caregivers to reduce the risk of SIDS and other sleep-related causes of infant death. Many of these actions aim to create the safest possible sleep environment for baby.
The AAP offers these Safe Sleep recommendations:
Always place your baby on his or her back for every sleep time.
Always use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep.
The baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing).
Keep soft objects or loose bedding out of the crib. This includes pillows, blankets, and bumper pads.
Wedges and positioners should not be used.
Pregnant woman should receive regular prenatal care.
Don’t smoke during pregnancy or after birth.
Breastfeeding is recommended.
Offer a pacifier at nap time and bedtime.
Avoid covering the infant’s head or overheating.
Do not use home monitors or commercial devices marketed to reduce the risk of SIDS.
Infants should receive all recommended vaccinations.
Supervised, awake tummy time is recommended daily to facilitate development and minimize the occurrence of positional plagiocephaly (flat heads).
The report was published online in the journal Pediatrics.
Story sources: Steven Reinberg, https://consumer.healthday.com/kids-health-information-23/sudden-infant-death-syndrome-sids-news-643/babies-face-higher-sids-risk-in-certain-states-731009.html