The Epidemiology of Sitting Devices and Infant Deaths :

Although AAP guidelines discourage infants sleeping in various sitting devices such as car safety seats (CSSs), and strollers, infants can still be found sound asleep in these products., How dangerous are they? Liaw et al (10.1542/peds.2018-2576) evaluated a decade’s worth of data from the National Center for Fatality Review and Prevention.  They looked at differences between infants who died in a sitting device or not, in terms of who the primary caregiver was at the time of death, the setting, whether bed-sharing was also occurring and other factors that can help distinguish a sitting death from one in which the infant is found lying down.  11,779 infant sleep-related deaths are analyzed with 348 of these (3%) occurring in sitting devices. The sad news is that 2/3 of the deaths occurred while infants were in CSSs but 90% of the time these seats were not being used properly. In addition, just over half of the sitting device deaths occurring at the infant’s home.  Most notably the authors found that sitting device deaths were more apt to occur under the care of a babysitter or childcare provider rather than a parent.  There is a lot more data to be reviewed in this worrisome study that should have you asking during health maintenance visits about sitting devices and whether they are used by your patients.  The findings in this study will not sit well with you and in turn your patients with the hope that knowing about the findings in this study will discourage more families from using these devices because they feel they are safe for a baby to sleep in—when this study suggests just the opposite.  Link to it and learn more.