Rates of sudden unexpected infant death (SUID) among Black infants rose in 2020, making them nearly three times as high as for White infants, according to a new study.
Researchers from the Centers for Disease Control and Prevention (CDC) said the COVID-19 pandemic may have exacerbated existing economic disparities and other social determinants of health.
“These factors affect family vulnerability and may have increased unsafe sleep practices (e.g. bedsharing), thereby increasing the occurrence of SIDS (sudden infant death syndrome) and other sudden unexpected infant deaths (SUID),” they wrote in “Sudden Unexpected Infant Deaths: 2015–2020,” (Shapiro-Mendoza CK, et al. Pediatrics. March 13, 2023).
The team analyzed birth and death data and found that from 2017-’20, the SUID rate did not increase significantly. Looking at a breakdown by race, Black infants were the only group to see an increase from 2019 to 2020. The SUID rate for Black infants in 2020 was the highest for the four-year period at 214 per 100,000 infants. The 2020 SUID rates per 100,000 infants for other races were 205 for American Indian/Alaska Native, 76 for White, 59 for Hispanic and 23 for Asian infants.
“The COVID-19 pandemic disproportionately affected communities of color compared to Non-Hispanic White families through exacerbation of crowded housing, food insecurity, unemployment, limited health care access, altered child care, and social or emotional health stressors,” authors wrote. “Infants from these communities were also vulnerable to these effects.”
They stressed the importance of clinicians educating families on safe sleep and helping them reduce barriers.
Several pediatricians including authors of the AAP’s policy on safe sleep for infants, wrote a related commentary in which they said noted that compared to many other countries, families in the U.S. have limited access to lactation assistance, home visiting programs, maternal mental health support and guaranteed paid family leave. The pandemic also made access to support more difficult.
“These latest data about SUID rates during the first year of the COVID-19 pandemic reflect our societal failures,” authors wrote. “ … All infants deserve a better start in life than we in the US are providing to them now.”
The CDC study also looked SIDS, which accounted for about 41% of SUID cases in 2020. They found a 15% increase in the SIDS rate from 2019 to 2020, following a decline since 2015. However, they said few of the cases had evidence of a COVID-19 infection, and the increase is likely due to a change in diagnostics.
- AAP policy Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment
- AAP technical report Evidence Base for 2022 Updated Recommendations for a Safe Infant Sleeping Environment to Reduce the Risk of Sleep-Related Infant Deaths
- Information for parents from HealthyChildren.org on safe sleep
- Safe to Sleep campaign
- Information on Sudden Unexpected Infant Death Syndrome from the CDC