Sudden Infant Death syndrome is the label given to infant deaths that, after an autopsy, a thorough examination of the scene, and a review of the infant’s medical history, no other cause of death is found. It is the leading cause of infant death in the country (responsible for more than 2,000 infant deaths in 2010, the most recent year for which information is available).
While this is a decrease from 120 deaths per 100,000 live births to 56 from 1992 to 2001, the rate is still extremely high, and in some ways, rather unnecessary since we do know that there are ways to reduce the risk – not exposing babies to secondhand smoke, keeping the crib free and clear of potential breathing obstructions, and putting babies on their backs to sleep is the most important.
The last risk factor (the sleeping position of the baby) has received a great deal of attention through the “Back to Sleep” campaign, which was initiated 20 years ago. However, a new study has found that about one-third of parents who delivered a full-term baby, and about 30 percent of parents with pre-term infants, are ignoring the advisory and placing their infants on their sides or stomachs to sleep.
“This is very worrisome given the rate of SIDS, which has been stagnant over several years,” Dr. Sunah Hwang, the study’s lead author and neonatologist at Boston Children’s Hospital and South Shore Hospital, told NBC News.
Studies have indicated that part of the reason may be parents’ concerns over whether or not their baby will choke on spit-up in their sleep.
“I tell parents that their child has a normal airway and a normal nervous system, and so they have a mechanism to prevent the vomit from going into the lungs,” Dr. Ari Brown, a pediatrician in Austin, Texas, and an official spokesperson for the American Academy of Pediatrics, who did not participate in the study, told NBC News.
Another possibility is that exhausted parents, who just want a good night’s sleep, may sometimes risk tummy sleeping as well, simply because their baby sleeps more soundly in that position.
“At least 50 percent of my moms have admitted to tummy sleeping or side-sleeping their infants on occasion,” infant massage therapist and doula, Robin Rizzuto of New York City, told NBC News. “I repeatedly tell my clients that the American Academy of Pediatrics recommends ‘back to sleep’ for optimal infant safety, but you don’t know how hard it is to tell this to a weeping, sleep-deprived mom.”
And when you’re talking about preterm infants – those that are born before 37 weeks gestation – the rate of parents sleeping their infants on sides or stomachs is downright scary since these infants are at an even higher risk of SIDS.
“I was very surprised and somewhat disheartened,” Hwang said, adding that these parents should be even more educated because their babies spent as many as three or four months in a NICU unit. This should have given doctors, nurses and parents all plenty of time to discuss safe sleeping practices.
Allison and Rob Massoud of Avon, Massachusetts – parents of twins Charlotte and Sophia, who were born 12 weeks early – heard the message after the two-hour discharge class and months of listening to the reminders from hospital staff. When they brought the girls home, they made it a conscious effort to place them on their backs. Even now, when they can turn over, they are placed on their backs to sleep.
“They can turn on their own now, but I’m still afraid to put them on their bellies, even though Sophia might sleep better that way,” Allison Massoud told NBC News. “She moves around much at night, while Charlotte sleeps just fine on her back.”
But the NICU doesn’t always follow the “Back to Sleep” rule (mostly due to tubing and machines that are hooked up to the baby) Brown says. And this may be why some parents of preemies are confused.
“When I walk into the NICU, many babies are sleeping on their stomachs, and they can do that because there are monitors and oxygen support,” Brown said. “But the baby may get used to sleeping in that position, and the parent may be used to seeing that.”
NICU’s better modeling the practice of putting babies on their backs to sleep once they reach 34 weeks gestational age may help parents get more used to seeing that, Brown and Hwang say. And more attention on communicating safe sleeping practices to non-Hispanic blacks, young mothers, single mothers, mothers without insurance, and those that are less educated (all who have higher than average rates of side and tummy sleeping), could have some big and positive effects, Hwang says.
“The teachings that doctors and nurses do and the messages from the health community may not be effectively reaching these underserved women,” Hwang said.
“Maybe we need a celebrity to remind people why this is so important,” Brown said.
Related Articles:
I have been a pediatric therapist for 24 years and due to the back to sleep campaign we have seen so many infants with problems because now parents are afraid to put children on their stomachs. The increase in plageocephaly/torticollis, brachiocephaly, tongue tied babies and other issues including autism is a huge problem because children are not getting the stretching and weight-bearing needed on their stomachs or the calming and self-regulating skills needed. The whole reason placing children on their backs to sleep helps prevent SIDS is that the baby is in an aroused and heightened state because they are not in a comfortable position, therefore, not sleeping soundly. It is ok for infants to sleep on their bellies during the day and when napping when the parents are awake. In fact, it is advised. It is also advised to make sure children have tummy time during the day for play.