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We are pleased to bring you the 13th edition of Fast Facts. This is a brief report on
local data that we believe you will find useful in both understanding and improving the
health of our community. Our goal is to keep it brief and instructive and to provide
opportunities for all persons to positively impact the issue. Please feel free to forward to colleagues, board members and others in the community.
October is Sudden Infant Death Syndrome (SIDS) awareness month and that is the topic of this month's Fast Facts report. Special thanks to Connie Kerrigan with Parkview Health and Jill Leal with Tobacco Free Allen County for their assistance in compiling this report.
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Overview
SIDS is defined as the sudden death of an infant under 1 year of age, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history. However, it is often called a "diagnosis of exclusion," meaning it is the diagnosis that is given when everything else has been ruled out. In 1992, the American Academy of Pediatrics recommended that babies sleep on their backs to prevent accidental deaths. As the number of babies sleeping on their backs has increased, SIDS cases have decreased as demonstrated below.[i] However, the decrease in the rate of deaths has plateaued at about 50%.
Unfortunately, despite the robust back to sleep campaign, about a quarter of parents in the U.S. say they don't put their babies on their backs to sleep, and among blacks, it's about half. According to statistics, black babies die of SIDS at a rate twice that of whites. More and more many SIDS deaths are now believed to be accidents caused by unsafe sleep practices. And some are questioning whether the term SIDS remains relevant at all [i].
Unfortunately we are also seeing an increase in bed sharing with infants: Nearly 14 percent of adults, mostly mothers, surveyed in 2010 said their infants usually shared a bed, either with parents or another child, instead of sleeping alone in a crib. That was up from about 7 percent in 1993, and the increase was mainly among blacks and Hispanics.[ii] We know that there are certain circumstances that increase the risk of SIDS and positional asphyxia including premature birth, parents' smoking and sleeping on soft surfaces with pillows and blankets. Many doctors think bed-sharing is risky because sleeping parents could roll onto infants, or they could get tangled in loose bedding - especially when alcohol and/or drugs or severe fatigue is involved. Research studies continue to suggest that breastfeeding and pacifier use may reduce the risk of SIDS.[iii]
It is also important to note that about one in five SIDS deaths occur while an infant is in the care of someone other than a parent. Many of these deaths occur when babies who are used to sleeping on their backs at home are then placed to sleep on their tummies by another caregiver.[iv] Smoking is an important risk factor for SIDS. Babies of mothers who smoked during pregnancy have twice the risk of SIDS than infants of nonsmoking mothers.
[i] http://www.npr.org/2011/07/15/137859024/rethinking-sids-many-deaths-no-longer-a-mystery
[ii] http://www.chron.com/news/medical/article/More-babies-share-parents-beds-despite-SIDS-risks-4857151.php?cmpid=healthhcat
[iii] http://www.medicinenet.com/sids/page3.htm#what_are_the_risk_factors_for_sids
[iv] http://www.healthychildcare.org/pdf/sidsparentsafesleep.pdf
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Local Data
Allen County numbers for infant deaths due to SIDS or Unsafe Sleeping
2008
| 2009
| 2010
| 2011 | 2012
| 2013
| 7
| 4
| 6
| 5
| 3
| 2
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Impact
Studies have shown that the loss of a child, especially a sudden loss, is among the most traumatic, devastating losses for any individual or couple to experience. It affects the family for the rest of their lives.[i] SIDS parents often cry, feel ill or depressed, or have other emotional responses months or even years after the baby's death. Other family members are also affected; surviving children may feel especially guilty about having resented all the attention lavished on the new baby.
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What You Can Do
As a health care provider:
- Keep informed in best practices for safe sleeping. (http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2285.full.pdf+html)
- Counsel patients early in their pregnancy about the risks associated with unsafe sleeping.
- Refer pregnant women to the Indiana Tobacco Quitline, which offers pregnant smokers behavioral support. The Indiana Tobacco Quitline uses evidence-based treatment practices to help pregnant smokers quit and stay quit. The treatment plan is tailored to meet the woman's needs and offers additional postpartum contact to prevent relapse. This program is free for all Hoosiers; Call 1-800-QuitNow to enroll.
- Reiterate at every visit the need to follow safe sleeping practices.
As a parent/grandparent [i]:
- Don't smoke or expose yourself to others' smoke while you are pregnant and after the baby is born. Alcohol and drug use can also increase your baby's risk for SIDS.
- Always place babies to sleep on their backs during naps and at nighttime.
- Avoid letting the baby get too hot. Dress the baby lightly for sleep. Set the room temperature in a range that is comfortable for a lightly clothed adult.
- The safest place for your baby to sleep is in the room where you sleep, but not in your bed. Place the baby's crib or bassinet near your bed (within arm's reach). This makes it easier to breastfeed and to bond with your baby. The crib or bassinet should be free from toys, soft bedding, blankets, and pillows. Don't place babies to sleep on adult beds, chairs, sofas, waterbeds, pillows, or cushions.
- You can reduce your baby's risk of dying from SIDS by talking to those who care for your baby, including child care providers, babysitters, family, and friends, about placing your baby to sleep on his back during naps and at night.
As a funder or public official:
- Support government-sponsored campaigns emphasizing that placing babies to sleep on their backs on a firm mattress and not in a bed shared with others is the safest sleep practice.
- Support smoking cessation campaigns and resources targeted toward new mothers and fathers.
[i] http://www.chron.com/news/medical/article/More-babies-share-parents-beds-despite-SIDS-risks-4857151.php?cmpid=healthhcat |
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Resources
Classes for New Parents:
Video:
Tobacco Cessation and Counseling:
Grieving Families:
Erin's House for Grieving Children: offers grief support and education to children, teens and their families who have suffered the death of a loved one. Contact them at (260) 423-2466 or visit www.erinshouse.org.
First Candle: Provides a 24-hour hotline where persons who have experienced a stillbirth or death of a baby due to Sudden Infant Death Syndrome (SIDS) or Sudden Unexpected Infant Death (SUID) are connected to grief counselors. Also provides information and advice to parents, professionals, and other interested persons on keeping babies healthy and safe during pregnancy and through the first year of life. Contact them at (800) 221-7437 or visit www.firstcandle.org.
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Fast Facts is a collaboration of the Fort Wayne-Allen County Department of Health and
United Way of Allen County 2-1-1
Questions?
Contact Deborah McMahan, MD or John Silcox
c/o Fort Wayne-Allen County Department of Health
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