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Study: Most infants who died unexpectedly had multiple unsafe sleep practices

February 20, 2024

About 60% of sudden unexpected infant death (SUID) cases involve sharing a sleep surface, and most SUID cases involve multiple unsafe sleep practices, according to a new study.

“Our findings support comprehensive safe sleep counseling for every family at every encounter beyond just asking where an infant is sleeping,” authors wrote in “Characteristics of Sudden Unexpected Infant Deaths on Shared and Nonshared Sleep Surfaces” (Erck Lambert AB, et al. Pediatrics. Feb. 20, 2024).

There are about 3,400 SUID cases in the U.S. each year, according to the study. To reduce the risk, the AAP calls for infants to be placed to sleep on their back on a firm, flat sleep surface with no soft objects or loose bedding. Infants should not share a sleeping surface with anyone.

A team including researchers from the Centers for Disease Control and Prevention (CDC) analyzed data on 7,595 SUID cases in 23 U.S. jurisdictions from 2011-2020. Results showed three in five infants were sharing a bed, couch or chair when they died. These infants were more likely than non-sharing infants to be under 4 months of age, Black, in a multiple birth or publicly insured. Those sharing surfaces had higher rates of sleeping on their back, sleeping in an adult bed or chair/couch and exposure to maternal cigarette smoking during pregnancy.

About 82% of infants who were surface sharing and 68% of those who were not surface sharing had at least two additional unsafe sleep factors. Most of the infants were under a parent’s supervision.

“Thus, it is critical for healthcare providers to appropriately model and discuss planned and actual infant sleep practices during prenatal visits, birth hospitalization, and postnatal and well-child visits,” authors wrote. “Engaging parents in discussions about their sleep practices and helping them make decisions to address their concerns and also reduce SUID risk is valuable.”



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