Each year, there are about 3,500 sudden unexpected infant deaths in the United States, making SUIDs the leading cause of death among children 1 month to 1 year old.

According to the Atlanta-based Centers for Disease Control and Prevention, the three commonly reported types of SUID include the following:

  • Sudden infant death syndrome (SIDS)
  • Unknown cause
  • Accidental suffocation and strangulation in bed

In 2019, there were about 1,250 deaths from SIDS, about 1,180 deaths from unknown causes, and about 960 deaths from accidental suffocation and strangulation in bed.

Despite the Safe to Sleep campaign by the National Institutes of Health that began in 1994, infant deaths from accidental suffocation and strangulation — caused by having toys, blankets and pillows in the baby’s bed — have continued to rise. In 1990, for example, there were 3.44 ASSB deaths for every 100,000 live births. In 2019, that number was 25.5 per 100,000.

A recent study published in the journal Pediatrics analyzed the deaths of nearly 5,000 babies who died suddenly between 2011 and 2017 and found that nearly 75% were caused by airway obstruction caused by soft bedding or sleeping in an unsafe environment, per the American Academy of Pediatrics’ safe sleep guidelines.

AAP recommends putting a baby to sleep on a firm surface, such as a crib, bassinet, portable crib or play yard that meets the safety standards of the Consumer Product Safety Commission. The crib should have a tight-fitting, firm mattress and fitted sheet designed for that particular product. Nothing else should be in the crib except the baby. A firm surface is a hard surface; it should not indent when the baby is lying on it.

AAP states a baby should never be in the same bed as others unless feeding or being comforted.

“Place your baby back in his or her own sleep space when you are ready to go to sleep. If there is any possibility that you might fall asleep, make sure there are no pillows, sheets, blankets, or any other items that could cover your baby’s face, head, and neck, or overheat your baby. As soon as you wake up, be sure to move the baby to his or her own bed,” the policy states.

“These deaths are still happening — and they happen to well-meaning parents,” Dr. Rachel Moon, who chairs the American Academy of Pediatrics task force on SIDS and authored the AAP policy statement, told CNN.

“We have remained at the same rate of sleep-related deaths since around 1998,” she added. “And the rate in the US is much higher than that in most developed — and even some not-so-developed countries.”

In addition to placing an infant on its back on a firm surface with no bedding, AAP recommends parents:

Use caution when a product claims to reduce the risk of SIDS. Wedges, positioners, special mattresses and specialized sleep surfaces have not been shown to reduce the risk of SIDS, according to the AAP.

Do not rely on home heart or breathing monitors to reduce the risk of SIDS. If you have questions about using these monitors for other health conditions, talk with your pediatrician.

There isn’t enough research on bedside or in-bed sleepers. The AAP can’t recommend for or against these products because there have been no studies that have looked at their effect on SIDS or if they increase the risk of injury and death from suffocation.

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