A lead author of the AAP policy on safe sleep is decrying federal government cuts to the Safe to Sleep campaign, especially in light of recent increases in sudden unexpected infant deaths (SUID).
The Trump administration’s recent federal government cuts include the National Institute of Child Health and Human Development (NICHD) office responsible for the Safe to Sleep campaign, which launched in 1994 to address sleep-related infant deaths.
“This was out of the blue,” said Rachel Y. Moon, M.D., FAAP, a lead author of the AAP policy statement Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment. “I received an email from NICHD staff on April 1 that the office of communications had been shut down, and thus the Safe to Sleep campaign terminated. It’s devastating that this happened so suddenly and only a few months after we learned that these deaths are increasing.”
Dr. Moon, the Harrison Distinguished Professor of Pediatrics at the University of Virginia Health Children’s Hospital, studies factors affecting sudden infant death syndrome (SIDS) and other sleep-related deaths.
The Safe to Sleep program’s origins can be traced back to the 1992 AAP Task Force on SIDS, which recommended that babies be placed on their back for sleep.
“It was clear that there needed to be a national public health campaign to be sure that parents and health care professionals were aware of this new recommendation, and the AAP worked with NICHD and several nonprofit organizations to launch the Back to Sleep campaign in 1994,” Dr. Moon said. “In the first few years after the campaign was launched, the rate of SIDS dropped by 50%.”
The Back to Sleep campaign was expanded and renamed Safe to Sleep in 2012 to address not only SIDS, but other sleep-related infant deaths.
While sharp declines in SUID have been seen since the campaign launched, the SUID rate has been increasing since the beginning of 2020, according to the Centers for Disease Control and Prevention.
A recent study showed that from 2020-’22, the SUID mortality rate rose 12% in children younger than 1 year — from 89.9 to 100.5 deaths per 100,000 live births.
“This was during the pandemic, and we believe that it was likely due to the fact that parents had fewer opportunities to learn about safe sleep from health care providers, federal programs, etc.,” Dr. Moon said. “If we do not continue to publicize the importance of safe sleep and people do not hear it from multiple places, they will more likely think that it is not important, they won’t do it and more babies will die.”
Safe to Sleep program materials remain available on the NICHD website, though it is unknown how long they may be posted. Several partner organizations, including the AAP, are continuing to promote the campaign, though the loss of federal backing likely will have consequences.
“The AAP is taking the lead role in Safe to Sleep, but they certainly don’t have the resources that NICHD had to continue this robust campaign,” Dr. Moon said. “I suspect that other organizations dedicated to SUID prevention will have to do more.”
Dr. Moon also expressed concerns over the recently proposed federal budget, which calls for the elimination of CDC registries that monitor infant deaths.
“That too will be devastating if we have no sense of whether these deaths are increasing or not,” Dr. Moon said.
The 2022 AAP policy statement recommends that infants always sleep on their back on a separate, flat and firm sleep surface without any bumpers or loose bedding. It also recommends room-sharing without bed-sharing and emphasizes that devices such as car seats, strollers, swings, infant carriers and infant slings should not be used for routine sleeping.
The AAP supported the Safe Sleep for Babies Act, which bans manufacturing and distributing crib bumpers and inclined sleepers.
Resources
- Information for parents from HealthyChildren.org on how to keep a sleeping baby safe and baby products to avoid
- AAP policy statement 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 from the U.S. Consumer Product Safety Commission on safe sleep spaces for babies
