Safe Sleep Does Not Just Mean “Back to Sleep”: The Sleep Environment Also Matters :

We have published quite a bit on the safe sleep environment both before and after the AAP published its safe sleep policy (10.1542/peds.2016-2938). Yet we have not taken a recent national look at infant deaths due to unsafe sleep factors leading to suffocation.  Lambert et al. (10.1542/peds.2018-3408) compiled data from the national Sudden Unexpected infant Death (SUID) Case Registry from 2011-2014 and pulled out the cases that were noted to be due to suffocation from unsafe sleep factors.  Sadly 14% of SUID cases during the four years studied were due to explainable suffocation attributable to unsafe sleep environments.  For example, 69% of the infants suffocated did so because of soft bedding most often found because the infant was placed in an adult bed (49%) and not crib, in a prone position (82%) and/or with blankets blocking the airway (34%). 19% of deaths were due to a parent laying on top of their infant again in an adult bed (71%) with overlay occurring due to the mother’s position on top of the infant (47%).  Finally wedging of the baby (12%) occurred most often because the baby became wedged between mattress and wall (48%).  Do you discuss the sleep environment with the parents of your newest patients? If ever there was a reason why, you’ll find it after reading this study. After you’ve read this article, make sure parents are aware of the findings so they safety-proof their infants sleep environment and in doing so perhaps get the high number of SUID cases due to suffocation down to where they no longer occur.  That would certainly make for pleasant dreams for baby, parent, and pediatrician.