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Sleeping on the Back Lowers Risk of Sudden Infant Death Syndrome

First Posted: May 05, 2014 05:51 AM EDT
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A new study highlights that less than 50 percent babies are made to sleep on their backs despite doctors' advice as it cuts the risk of sudden infant death syndrome.

Since 1994 parents have been urged to place babies on their backs while sleeping to cut the rate of sudden infant death syndrome (SIDS).  But the new study learns that most caregivers have not taken this seriously and the health care providers have failed to educate the parents.

The researchers found in their survey that in a few states the rate of supine sleeping (sleeping on the back) is no more than 50 percent. Just two-third of the parents take the message seriously and place the babies in this position for sleeping. Among preterm infants the rate of supine sleeping is much lower.

The Sudden Infant Death Syndrome also known as cot death is sudden, unexpected and unexplained death of the infant.  Even a healthy baby can be a victim of SIDS. In the U.S. this is the third leading cause of infant mortality but since 1988 deaths caused by SIDS have dropped. SIDS is especially higher for those infants whose mothers smoke during pregnancy.  

 According to the Centers for Disease Control and Prevention, every year, nearly 4000 infants die suddenly and half of the deaths are due to the sudden unexpected infants deaths (SUID).  In 2010, over 2,000 babies died from SIDS.

"Given that supine sleep positioning significantly reduces an infant's risk for SIDS, it is worrisome that only two-thirds of full-term infants born in the U.S. are being placed back-to-sleep," said lead author Sunah S. Hwang, MD, MPH, FAAP, a neonatologist at Boston Children's Hospital. "More concerning is that adherence to safe sleep positioning is even lower for preterm infants who are at even greater risk for SIDS compared to term infants."

Though the exact cause for SIDS continues to remain a mystery, studies over the years have revealed that proper and safe sleeping practices like supine sleeping position cuts the risk of infant deaths in the first year of life.  In the 1990s the 'Back-to-Sleep' campaign dropped the rate of SIDS by 50 percent and since 2001 the rate hasn't changed much.

For this study the researchers evaluated the data taken from the Pregnancy Risk Assessment Monitoring System (PRAMS) in order to compare the rate of supine sleeping, after being discharged from hospitals, among preterms and term infants. This included a survey in which the mothers reported the position they put their infants to sleep i.e. stomach, back or side. Based on the responses received, researchers created groups that included supine (back) and non-supine (combination of sleeping positions).

The study included 392,397 infants born in 36 states, which had response rates of 70 percent or more in 2000-2011. The supine sleeping was analyzed in a few gestation age categories mainly 27 weeks or less, 28-33 weeks, 34-36 weeks and 37-42 weeks.

They noticed that the preterm and term infants had suboptimal rates of supine sleep position after being discharged from the hospital.  The rate of supine sleeping varied widely by state as Alabama had the lowest rate at 50 percent and Wisconsin had the highest rate of supine sleeping with 81 percent.

Infants with gestation age of less than 28 weeks had the lowest rate of supine sleep position with 60 percent. 

"Given the concerning data about inadequate adherence to safe sleep practices for all infants and in particular for preterm infants, we need to better engage families about adhering to safe sleep practices at the individual, community, hospital and public health levels," Dr. Hwang concluded.

The finding was presented at the Pediatric Academic Societies annual meeting in Vancouver.  

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