SIDS: International Trends in Sudden Infant Death Syndrome

Fern R. Hauck, M.D., M.S., Kawai Tanabe, M.P.H.

Abstract

Purpose:

The aim of this paper is to compare international trends in sudden infant death syndrome (SIDS) and postneonatal mortality (PNM) since the introduction of SIDS risk reduction and safe sleep campaigns, offer possible explanations for differences, and to provide recommendations to improve consistency in classifying and reporting infant SUDI deaths internationally.

Methods:

SIDS and postneonatal mortality rates were obtained for 15 countries from 1990 through the year for which most recent data were available.

Results:

SIDS rates have declined in all countries, with reductions well over 50% for most countries. These declines are attributed to SIDS risk reduction campaigns, which achieved success primarily in reducing rates of prone sleeping among infants. The largest declines generally occurred in the first few years after initiation of national

campaigns, and there are concerning indications that these rates have reached plateaus in many countries.

Conclusions and Recommendations:

Diagnostic accuracy is essential to monitor and compare trends in SIDS and other sudden unexpected infant deaths. This requires establishing sudden infant death definitions and diagnostic categories that are agreed

upon widely. National and local campaigns need to be re-energized to continue the early successes made in reducing SIDS incidence. Finally, data collection needs to be easy to access and this would best be accomplished by national vital statistics agencies posting data in a uniform way on their websites.

<http://www.ispid.org/fileadmin/user_upload/textfiles/articles/CPR17_Hauck_SIDS_Trends.pdf>

SIDS: Louisiana: co-sleep death statistics

Loresha Wilson Mar. 5, 2011

There's probably nothing sweeter than the image of a baby drifting off to sleep — be it in your arms or lying next to you. But these innocent moments can turn tragic when you fall asleep with the baby.
Local authorities say that's likely what happened to four babies who died in Shreveport homes in February. The infants, ages 22 days to 8 months, were found unconscious and not breathing after falling asleep next to someone.
The exact cause of each death has yet to be determined, but Caddo Parish Coroner Dr. Todd Thoma says all appear to be instances of co-sleeping. It ultimately resulted in suffocation.
However, detailed investigations are under way in all the deaths.
"This is an unfortunate problem in our community," Thoma said. "It occurs when the infant sleeps in the same bed as their parents. Whether the infant is moved, or the parent rolls over on the baby, it still results in positional asphyxia."
The first baby was found about 2 a.m. Feb. 16 at a residence in the 3500 block of Sumner Street, according to police reports. About two hours later, officers responded to the 1400 block of West 58th Street, where an 8-month-old was found deceased. The third baby died the morning of Feb. 23 at a residence in the 3100 block of West Caperton Street. And about 4 a.m. Feb. 26, a 2-month-old was found dead in the 1400 block of Claiborne Avenue, according to reports.
Criminal charges in these cases are rare, occurring most often when the parent at fault is under the influence of drugs or alcohol. When substance abuse is not involved, the deaths are often ruled accidental by police or local district attorney's offices.
"And at this time, we do no suspect foul play," said Sgt. Bill Goodin, spokesman for Shreveport police.
Louisiana has the highest infant mortality rate in the nation — nearly twice the national average, according to Louisiana Department of Health and Hospitals.
One reason this is happening is that some mistakes are being made when it comes to the environment in which children are sleeping. The term "infant mortality" refers to all infant deaths before age one, excluding miscarriages and abortions.
Louisiana had an average of 71 infants die from SIDS, or Sudden Infant Death Syndrome, from 2003 to 2005, according to statistics provided by the Department of Health and Hospitals. During the same three years, the state had an average of 17 infants die of suffocation
http://www.shreveporttimes.com/article/20110305/NEWS01/103050323/1060/news01/Shreveport-sees-4-possible-co-sleeping-infant-deaths

SIDS: Missourii: Buchanan County has higher rate of child abuse deaths

Kim Norvell St. Joseph News-Press

January 28, 2011

As with any age, infants can die at any moment. Sometimes from natural causes, other times from accidents. But when a child dies as a result of serious physical injury, the public collectively becomes concerned.

“The type (of infant death) we have way too many of is abuse,” said Joyce Estes, executive director of the Northwest Missouri Children’s Advocacy Center. “We are higher than other areas of Missouri, definitely.”

According to the 2009 Missouri Kids Count study, Buchanan County had a higher rate per 100,000 child deaths (not necessarily criminal in nature), ages 1 to 14, than the rest of the state; the county also had a higher rate per 1,000 child abuse and neglect cases.

In 2010, three infants were victims of homicides that were criminal in nature, which included neglect and abuse. In January, an investigation into the death of an almost 2-year-old boy was launched by the St. Joseph Police Department. Charges have yet to be filed, but police believe his death was not from natural causes.

While there is no specific cause as to why infants are victims of child abuse, the trend seems to indicate the tragic deaths happen when a single mom is forced to trust her child with another caregiver, said Robin Hammond, executive director of the St. Joseph Youth Alliance. The national trend indicates that infant deaths as a result of trauma happen when a father is left alone with the child; in St. Joseph it’s typically the boyfriend of the child’s mother, Ms. Hammond said.

Ms. Estes said typically, infant deaths related to neglect will be the fault of the mother, while infant deaths related to abuse will be that of the father or male figure. Typically these deaths are also related to drug or alcohol abuse, which is also high in St. Joseph, Ms. Estes said.

Usually, the incidents that result in death are severe and garner media attention, said Joey Thompson, circuit manager for the Missouri Department of Social Services in Buchanan County. However, Ms. Thompson said most cases of infant deaths are the result of natural causes, such as Sudden Infant Death Syndrome. It is rare for infant deaths to be caused by serious physical abuse, she said.

Of the 2,000 calls of suspected child abuse that Andrew and Buchanan County receive per year, only one or two are investigated as a death that is criminal in nature, Ms. Thompson said.

“It’s all preventable, none of it’s necessary,” she said. “Our agency is very threatening because we make determinations on children’s safety, but most of the work we do is to prevent further abuse and reduce the risk of abuse.”

There is a need for resources for victims of child abuse under 6 years old, said Jennifer Soper, chairwoman of the Crisis Nursery Committee. She said the need grew a few years ago from a community response to “previous child abuse and unfortunate deaths.” She said currently there are gaps in services where infants and toddlers can stay if they are victims of abuse, which the Crisis Nursery hopes to address. The nursery will be housed at the Noyes Home for Children, which provides services for children ages 6 to 18. There is no timeline as to when the service will be completed.

Those who believe their child may be a victim of abuse can contact the Missouri Department of Social Services, St. Joseph Youth Alliance, Northwest Missouri Children’s Advocacy Center, Noyes Home for Children or their local law enforcement.

Kim Norvell can be reached at kim.norvell@newspressnow.com.

http://www.newspressnow.com/localnews/26658544/detail.html

SIDS: Action urged on cot deaths

DAVID KILLICK   |   December 17, 2010
A CORONER has lashed the Health Department for failing to act on her recommendations which she says would cut the number of cot deaths in the state.

Coroner Olivia McTaggart says she is still waiting for a response and for action on recommendations she made two years ago.
In the meantime 15 babies had died in unexplained circumstances. Many of the deaths may have been preventable, she said.
In coronial findings released yesterday, Ms McTaggart found a three-month-old baby boy died after being placed on his right side in his cot on April 16 last year.
She found his death was because of Sudden Infant Death Syndrome.
Ms McTaggart said she had made detailed recommendations after inquests into the deaths of four infants two years ago, including for the appointment of a full-time SIDS educator, but had not received a response despite repeated requests.
"Since the beginning of 2008 alone, 15 Tasmanian infants under the age of 12 months have died suddenly," she said.
"It appears that in a high proportion of this number preventable risk factors have been present.
"Such factors include co-sleeping with an adult, incorrect infant sleeping position and bedding and parental drug or alcohol sedation.
"I again urge that the Department of Health and Human Services consider implementing as a matter of priority a strategy to reduce the incidence of sudden infant death."
The department's director of children's services, Mark Byrne, said the department would consider the recommendations.
"The importance of safe sleeping is discussed by maternity unit staff and child health nurses with all new parents," he said.
"The blue book [personal health record] given to all parents requires nurses to discuss safe sleeping including the risks associated with Sudden Infant Death Syndrome at least four times with parents in the first four months of a baby's life."
The advice was based on guidelines accepted nationally.
He said the department was developing a DVD to help nurses and other health professionals reinforce the safe sleeping message.
SAFE SLEEPING:
1. Put babies on their backs to sleep. Do not sleep babies on their tummies or sides.
2. Parents should not smoke before or after the birth of a baby.
3. Sleep babies with faces uncovered. Use a light blanket tucked in securely or a safe infant sleeping bag. Do not put a hat on a baby to sleep.
4. Have a safe cot, safe mattress, safe bedding and safe sleeping environment for a baby day and night. Keep quilts, doonas, duvets, pillows and cot bumpers and fluffy toys out of the cot.
5. Do not sleep with the baby.
6. It is preferable to sleep babies in their own cots next to the parents' bed for the first six to 12 months.
http://www.themercury.com.au/article/2010/12/17/193901_tasmania-news.html

SIDS: CDC Life expectancy tables.

By Tracy Agnew
Americans lost about 1/10 of a year in life expectancy in 2008, The Centers for Disease Control’s National Center for Health Statistics released its report on the 2008 numbers last week.
The news for infants was particularly good in the 2008 numbers. The preliminary infant mortality rate fell to an all-time low — 6.59 infant deaths per 1,000 live births. Birth defects were the leading cause of infant death in 2008, followed by disorders related to preterm birth and low birth weight. Sudden infant death syndrome was the third leading cause.
The numbers are based on 99 percent of death certificates reported from all 50 states, the District of Columbia and U.S. territories.
http://www.suffolknewsherald.com/2010/12/18/american-life-expectancy-declines/

SIDS: Surge in SIDS on New Year's Day

Jessica Grogan, MDNews.com: December 22, 2010

Researchers at the University of California, San Diego discovered a 33% rise in the number of sudden infant death syndrome (SIDS) cases on New Year’s Day.

The study, lead by David P. Phillips, examined 129,090 SIDS cases from 1973 to 2006. Researchers used the following three nationwide data sets: the Fatality Analysis Reporting System, computerized death certificates, and the linked birth and infant death data set.
While it isn’t a proven fact, authors of the study believe the rise in SIDS cases on New Year’s Day is a result of alcohol overindulgence by parents or other caregivers. There are a few facts, however, that support this theory, according to researchers.
Phillips and his team identified an increased rate of SIDS on weekends, the day after the Fourth of July and the day after April 20 — a celebratory day for those who smoke marijuana. Past research has also shown that the rate of SIDS is abnormally high if the child’s mother drinks alcohol. Intoxication can make simple tasks difficult; including caring for an infant.
While SIDS has decreased since 1994, it continues to be the leading cause of death for children between the ages of one month and one year.
http://www.mdnews.com/news/2010_12/surge-in-sids-on-new-year's-day

SIDS: Binge Drinking

LEE BOWMAN - Scripps Howard News Service   December 22, 2010
The percentage of people drinking alcohol is the highest it has been since the mid-1980s, and binge drinking has also risen sharply.
A recent report from researchers at the University of Texas School of Public Health looked at two national health surveys of adults (18 and older) in 1991-92 and 2001-02 by the National Institute on Alcohol Abuse and Alcoholism and found that more people overall were drinking at the start of the millennium. More recent data were not available to the researchers.
"The reasons for the uptick vary and may involve complex social and demographic changes to the population, but the findings are clear: More people are consuming alcohol than in the early '90s," said Dr. Raul Caetano, dean of the university's Southwestern School of Medical Professions.
"Drinking" was defined during both survey periods as having consumed at least 12 drinks with at least 0.6 ounces of any kind of alcohol within the past year. Anyone who had consumed less than that much alcohol or said they never drank was classified as a nondrinker.
By that definition, drinking was up 5 percent to 7 percent during that decade among men of all ethnic groups, so that 64 percent of white men, 60 percent of Hispanic men and 53 percent of black men were drinking. Among women, the rate rose by 8 percent to 9 percent, to 47 percent of whites, 32 percent of Hispanics and 30 percent of blacks.
Those numbers seem to fit closely with a mid-summer Gallup survey that found 67 percent of adults drank any alcohol at all, versus totally abstaining. That was the highest drinking rate since 1985.
The government surveys showed binge drinking --having more than five drinks in one day -- increased among all ethnic groups and genders, but particularly among men. The share of white men who consumed five drinks a day at least once a week rose from 9 percent to 14 percent, and there was a similar increase among Hispanic men. Among women, whites are also more likely than other ethnic groups to binge drink.
Caetano said the trends toward riskier drinking behavior suggest more individuals are problem drinkers who may require treatment, and he noted that the patterns are likely made worse by recession and other factors.
The surveys and many other studies show that for people who aren't addicted to alcohol, drinking tends to decline with age.
Statistics on alcohol-related injuries and deaths from traffic accidents, crime and risky sexual activity all point to the dangers of immoderate behavior.
The National Institute on Alcohol Abuse and Alcoholism notes that two or three times more people die in alcohol-related traffic accidents around Christmas and New Year's Day than during other times of the year.
Another study points to another sort of threat from drinking holidays -- infant sleeping deaths.
Researchers at the University of California, San Diego, analyzed more than 129,000 deaths attributed to sudden infant death syndrome between 1976 and 2006 and found that the deaths spike by 33 percent on New Year's Day.
The team, led by sociologist David Phillips, noted that the increase is well above an increase in SIDS deaths during the winter that has long been noted.
They also note that other research has found that the incidence of SIDS -- along with alcohol consumption -- rises on weekends and that babies of mothers who drink are more than twice as likely to die from SIDS as those whose mothers abstain.
Phillips said the large databases don't give enough detail about each death to determine just how alcohol use was related to the babies' deaths. "But we know that when people are under the influence of alcohol, their judgments are impaired and they are not as good at performing tasks, and this would include caretaking," Phillips said.
Medical examiners and infant death review boards around the country are increasingly finding that alcohol- or drug-impaired parents are more likely to place their babies in an unsafe sleep setting rather than putting them safely on their backs alone in a crib.
Investigators are finding that babies often die when parents or other family members roll over on them in their sleep in a bed, sofa or other setting, or become entrapped by heavy adult bedding. Infant death researchers at the Centers for Disease Control and Prevention and elsewhere are working to better count those deaths and understand the circumstances that led to them.
(Contact Lee Bowman at BowmanL(at)shns.com.)

http://www.therepublic.com/view/story/medical122210/medical122210/

SIDS: Crib deaths spike on New Year's

December 21, 2010 CBC News

Parents and caregivers are encouraged to place infants on their backs at night and nap time. (U.S. Consumer Product Safety Commission)
Babies are more likely to die of sudden infant death syndrome on New Year's than other days of the year, a new study suggests.
The reasons are not clear but researchers suspect that parents who celebrate the new year with heavy drinking aren't being attentive enough to their children and how they're put to bed.
The researchers examined a large U.S. database to explore connections between alcohol and SIDS — the sudden, unexpected death of an apparently healthy infant under one year of age.
The spike in deaths is beyond the normal winter increase in SIDS, sociologist David Phillips of the University of California, San Diego, and his co-authors report in this week's issue of the journal Addiction. They analyzed a database of 129,090 deaths from SIDS from 1973 to 2006 and 295,151 other infant deaths in those years.
The study doesn't give actual figures for the New Year's Day deaths from SIDS but said the number was about a third higher than would be expected on any other winter day.
To see if parental sleeping-in might be a factor rather than intoxication, the researchers checked for shifts in deaths when clocks are set back an hour in the fall. No rise in SIDS was found then.
The study doesn't show alcohol consumption is a cause of SID, but the findings raise concerns, Phillips said. Drunk parents could be doing something or not doing something that puts babies at risk, he suggested.

Impaired judgment?

"We know that when people are under the influence of alcohol their judgments are impaired and they are not as good at performing tasks," Phillips said in a release. "This would include caretaking."
Single-day jumps in cribs deaths occurred on July 5, the day after Independence Day.
Back to Sleep campaigns that recommend parents and caregivers place infants to sleep on their backs at night and nap time have been successful, the researchers noted.
"A similar campaign might now be implemented: There should be increased efforts to inform caretakers that alcohol impairs parental capacity and might be a risk factor for SIDS," the study's authors wrote.
The Public Health Agency of Canada also advises parents to lower risk of SIDS by:

• Not smoking around the baby.
• Avoiding dressing the baby in too many clothes or adding too many covers to prevent overheating.
• Providing a safe crib environment that has no toys or loose bedding.

A second study by Phillips that analyzed mortality rates for the U.S. population found people are more likely to die during the Christmas season.
The analysis of U.S. death certificates between 1979 and 2004 found that in the two weeks starting with Christmas there were 42,325 natural deaths above the usual seasonal winter increase.
Again, the reasons are unknown. Possible explanations for the spike in deaths include overcrowding in emergency departments, winter travel, cold weather and substance abuse, the researchers said.

 http://www.cbc.ca/health/story/2010/12/21/sids-death-rates.html#ixzz19QaaYmZ8

SIDS: New Years Day is dangerous to your baby's health

By Mary Forgione, Los Angeles Times

December 23, 2010, 9:54 a.m.

Babies who die from SIDS are 33% more likely to die on New Year's Day than any other day of the year, a new study finds. Researchers say alcohol use the night before by parents or caretakers may play a role in SIDS deaths.
The study from UC San Diego examined 129,090 cases of SIDS, or sudden infant death syndrome, between 1973 and 2006 by using data from the Fatality Analysis Reporting System. It suggests that caregivers who drink alcohol may not be following "safe sleep" recommendations, such as placing infants on their backs to sleep. Here's a news release that explains the findings recently published in the journal Addiction.
No one knows what causes SIDS. It remains the leading cause of deaths in babies between the ages of 1 month and 1 year. This Los Angeles Times story provides some of the latest thinking on SIDS.
Still, progress has been made. The overall rates of SIDS has dropped more than 50% since 1994, when medical experts urged parents to place babies on their backs while sleeping. Read more here from the Eunice Kennedy Shriver National Institute of Child Health & Human Development about the Back to Sleep campaign. And the American SIDS Institute provides more information here too.
http://www.latimes.com/health/boostershots/la-heb-sids-alcohol-study-20101223,0,5171736.story

SIDS: Wisconsin

New research out on the causes of child deaths in Wisconsin. Between 2007 and 2008, 1,556 children died in the state.

More startling: experts say 25% of those deaths could have been prevented.

Now county leaders state-wide are making an effort to spread the word about the risks and most importantly, prevention.

"When you're raising kids there's so many things to think of and it's easy to overlook little things," Eau Claire mom Norah Airth-Kindree said.

Parents say these days there are an endless amount of things to worry about when it comes to their kids' safety.

"You gotta keep them safe and keep them smart," another Eau Claire mom added.

"I think it's scary to read all about when accidents happen and when it turns out that it's stupidity basically that could have been prevented," dad of two Oystein Vollstad said.

A new report from Children's Health Alliance of Wisconsin, the Injury Research Center and the state Department of Health Services shows the five leading causes of preventable death were motor vehicle and other crashes, asphyxia and sudden infant death syndrome, homicide, drowning and poisoning.

In 2008, Clark County put together a team that looks at the causes of child deaths throughout the county. It works to educate the public on how to prevent more of those deaths from happening.

"Of the deaths we've reviewed a lot of times it's supervisory neglect that can result in a child death, typically neglect is a big issue," Clark County Detective Kerry Kirn said.

The report shows more than half of children who died were boys, two-thirds of the children were less than one year old, and the victims were primarily white.
Scary statistics for any parent to hear.

"It's one thing to be a laid back parent, which there's a lot to be said for and that's really good, but I think you also need to be really vigilant constantly," mom of two Peggy Vollstad explained.

"Just to take the time to pay attention to the small little things," Airth-Kindree said.

County leaders say they'll continue to work to teach parents and the public ways they can keep more children safe.

"The ultimate goal is to keep kids alive,” Kirn said.

http://www.weau.com/news/headlines/Research_shows_25_of_child_deaths_in_Wisconsin_could_have_been_prevented_110888094.html

SIDS: Montana

 Kevin Maki:  November 30, 2010

MISSOULA, Mont. -- Last year 17 babies in Montana died from either suffocation or Sudden Infant Death Syndrome. SIDS is the unexpected death of an apparently healthy infant during sleep.

It's the leading cause of death for infants between the ages of one month and a year. Scientists are still researching the causes, but a new grant might help make a difference in preventing deaths.
The Missoula City County Health Department has been awarded a foundation grant of one year for $4,300. It will mostly boost SIDS education among our most vulnerable.
Nursing supervisor Kate Siegrist says that would be "group homes, shelthers and other agencies that work with high risk families." A public health nurse will help educate parents about safe sleeping patterns.
They recommend placing an infant on its back when it naps or goes to sleep for the night. The baby should be in a simple, unadorned crib with a hard mattress.
The baby shouldn't have too many clothes. The infant shouldn't sleep with stuffed animals or pillows. Taylor Wood is a young mother with two kids.
She says, "when you're a new mom you get really tired so you sleep really deeply, and it's easy to roll over on a baby." Taylor has learned a lot about SIDS from the public health department.
Nurse Dianne Grutsch says placing a baby on its back has reduced the SIDS incidence by 50%.

http://www.nbcmontana.com/news/25965411/detail.html

SIDS: Bed Sharing Among Black Infants and Sudden Infant Death Syndrome: Interactions With Other Known Risk Factors

Objective
Bed sharing has been associated with sudden infant death syndrome (SIDS) and may contribute to the racial disparity seen in infant mortality. It is unclear how bed sharing interacts with other factors to impact SIDS risk. We aimed to measure the effects of bed sharing on risk of SIDS in blacks and to determine whether the risk is modified by other characteristics of the sleep environment.
Methods
Characteristics of 195 black infants who died of SIDS were compared with matched controls. The moderating influence of known SIDS risk factors on the effect of bed sharing on risk of SIDS was examined using logistic regression.
Results
Almost half (47.4%) of the study population bed shared during the last/reference sleep (58% cases and 37% controls). Bed sharing was associated with 2 times greater risk of SIDS compared with not bed sharing. The deleterious effect of bed sharing was more pronounced with a soft sleep surface, pillow use, maternal smoking, and younger infant age. However, bed sharing was still associated with an increased risk of SIDS, even when the infant was not using a pillow or sleeping on a firm surface. The strongest predictors of SIDS among bed-sharing infants were soft sleep surface, nonuse of a pacifier, and maternal smoking during pregnancy.
Conclusions
Bed sharing is a common practice among black infants. It is associated with a clear and strong increased risk of SIDS, which is even greater when combined with other known risk factors for SIDS. This practice likely contributes to the excess incidence of SIDS among blacks, and culturally competent education methods must be developed to target this high-risk group.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B94TX-51FPWXP-7&_user=10&_coverDate=12%2F31%2F2010&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=163e6d677f1f9da57f4161d4c6b87aeb&searchtype=a

SIDS: Texas Infant Sleep Practices

Sudden Infant Death Syndrome (SIDS) is the third leading cause of death to infants in the United States and Texas. SIDS accounts for approximately 10% of all infant deaths in Texas. According to the American Academy of Pediatrics, infant sleep practices, such as choice of infant sleep surfaces and sleep position, have been identified as risk factors associated with SIDS. In 2009, the Texas Department of State Health Services conducted a study to collect data on infant sleep practices in Texas. Approximately 51% of women giving birth during this time period were Hispanic, 33% White, 11% Black and 5% were of other racial/ethnic background. Additionally, 6% were younger than 20 years old, 54% were between 20 to 29 years, and almost 40% were 30 years of age and older. Approximately 30% of study participants were college graduates, 64% were married, and 46% of those with a reported annual income, made at least $35,000 or more a year. Of the women who reported their place of birth, 68% were born in the United States. Additionally, 12% of the women lived in a county along the Texas/Mexico border.
<http://www.dshs.state.tx.us/mch/pdf/TISS%20Fact%20Sheet.pdf>

SIDS: New SIDS Law to Take Effect in Pennsylvania

SIDS is the number one cause of death in babies, but before the end of the year, new parents in Pennsylvania will be better prepared to prevent this type of tragedy.  A  new law requires all hospitals to educate new mothers about infant safe sleep practices.
More than 80 babies died in Pennsylvania in 2008, due to Sudden Infant Death Syndrome, but  the number of  SIDS deaths has dropped 50 percent since the start of the Back to Sleep campaign in 1994.
Most parents,   grandparents and other caregivers should know by now that you must place a baby on his or her back to sleep and keep   blankets, bumper pads and stuffed animals out of the crib.  According to Blair County Respiratory Disease Director Betsy Hurst, "an empty crib is a good crib and every parent will be taught that now."
The Society has been teaching that lesson for years and it sounds simple enough.  But Blair County Coroner Patty Ross said,  not enough people have been following those guidelines.   She was called to three preventable baby deaths this year, including this one.  "It was a baby in a crib with netting and soft  toys and bumper pads and actually the sheet had wrapped around the baby's head, " Ross said.
The coroner says co-sleeping ---basically putting your baby in bed or on a couch with you is also a dangerous practice.  This year, Ross investigated the deaths of two babies who suffocated in this way.
Ross added, "I'm sure there's times that people have slept with their children nothing has ever happened, but when they have  to see me when I have to share their story, when I have to investigate their home and I have to help bury their babies, it makes a difference".
Ross and Hurst hope that under the new law,   more parents and grandparents learn and use  safe sleep practices so that more babies get to celebrate their first birthdays.
Hospitals across the state are required  to begin this new SIDS education program by mid-December.
Unsafe cribs are also a danger to babies.   To get a free safe crib, call the Blair County Respiratory Disease Society at 814-944-8222.
http://wearecentralpa.com/fulltext-healthcast/?nxd_id=225066

SIDS: Antenatal and intrapartum factors associated with sudden infant death syndrome in the New Zealand Cot Death Study.

J Paediatr Child Health. 1995 Oct;31(5):473-8.

Stewart AJ, Williams SM, Mitchell EA, Taylor BJ, Ford RP, Allen EM.

Department of Nursing and Midwifery, Otago Polytechnic, Dunedin, New Zealand.

Abstract

OBJECTIVE: To describe the relationship between antenatal and intrapartum factors and sudden infant death syndrome (SIDS).
METHODOLOGY: The New Zealand Cot Death Study was a 3 year case-control study, with 485 infants who died from SIDS in the postneonatal period and 1800 randomly selected control infants. Data were obtained from obstetric records, parental interview and community nursing records.
RESULTS: This study confirms many of the antenatal and intrapartum risk factors for SIDS noted in studies from both the southern and northern hemispheres. After controlling for potential confounders, such as occupational group and marital status, significant inverse effects were noted for interpregnancy interval, birthweight and gestation. Other factors that retained a significantly increased risk of SIDS were: increasing parity, bacteriological evidence of urinary tract infection (UTI) (adjusted odds ratio 1.73, 95% CI 1.10-2.73); smoking antenatally (AdjOR 2.14, 95% CI 1.61-2.84); less than six antenatal checks attended (AdjOR 1.84, 95% CI 1.19-2.84); second stage of labour less than 16 min (AdjOR 2.06, 95% CI 1.35-3.14) and multiple birth (AdjOR 3.23, 95% CI 1.70-6.02). No interaction was observed between maternal haemoglobin and antenatal smoking. Interactions were tested for and not found between antenatal smoking and three antenatal risk factors (UTI, short second stage of labour and number of antenatal appointments). The only significant interaction between these three factors and three modifiable postnatal risk factors (prone sleeping, bed sharing and bottle feeding) was between bed sharing and fewer antenatal appointments. The risk of SIDS associated with bed sharing was greater among those whose mothers had fewer antenatal appointments.
CONCLUSIONS: Although many of the previously identified antenatal and intrapartum risk factors for SIDS are confirmed, the risks of SIDS associated with obstetric factors are in general considerably lower than the risks associated with the four modifiable postnatal risk factors.
http://www.ncbi.nlm.nih.gov/pubmed/8554873

SIDS: Risk factors for sudden infant death syndrome following the prevention campaign in New Zealand: a prospective study.

Pediatrics. 1997 Nov;100(5):835-40.

Mitchell EA, Tuohy PG, Brunt JM, Thompson JM, Clements MS, Stewart AW, Ford RP, Taylor BJ.

Department of Paediatrics, University of Auckland, Auckland, New Zealand.

Abstract

OBJECTIVES: To identify the risk factors for sudden infant death syndrome (SIDS) following a national campaign to prevent SIDS.
METHODS: For 2 years (October 1, 1991 through September 30, 1993) data were collected by community child health nurses on all infants born in New Zealand at initial contact and at 2 months.
RESULTS: There were 232 SIDS cases in the postneonatal age group (2.0/1000 live births) and these were compared with 1200 randomly selected control subjects. Information was available for 127 cases (54.7%) and 922 (76.8%) of controls. The previously identified modifiable risk factors were examined. The prevalence of prone sleeping position of the infant was very low (0.7% at initial contact and 3. 0% at 2 months), but was still associated with an increased risk of SIDS. In addition, the side sleeping position was also found to have an increased risk of SIDS compared with the supine sleeping position (at 2 months: adjusted odds ratio (OR) = 6.57; 95% confidence interval (CI) = 1.71, 25.23). Maternal smoking was found to be the major risk factor for SIDS. Bed sharing was also associated with an increased risk of SIDS. There was an interaction between maternal smoking and bed sharing on the risk of SIDS. Compared with infants not exposed to either bed sharing or maternal smoking, the adjusted OR for infants of mothers who smoked was 5.01 (95% CI = 2.01, 12.46) for bed sharing at the initial contact and 5.02 (95% CI = 1.05, 24. 05) for bed sharing at 2 months. In this study breastfeeding was not associated with a statistically significant reduction in the risk of SIDS. The other risk factors for SIDS identified were: unmarried mother, leaving school at a younger age, young mother, greater number of previous pregnancies, late attendance for antenatal care, smoking in pregnancy, male infant, Maori ethnicity, low birth weight, and shorter gestation.
CONCLUSIONS: After adjustment for potential confounders, prone and side sleeping positions, maternal smoking, and the joint exposure to bed sharing and maternal smoking were associated with statistically significant increased risk of SIDS. A change from the side to the supine sleeping position could result in a substantial reduction in SIDS. Maternal smoking is common in New Zealand and with the reduction in the prevalence of prone sleeping position is now the major risk factor in this country. However, smoking behavior has been difficult to change. Bed sharing is also a major factor but appears only to be a risk to infants of mothers who smoke. Addressing bed sharing among mothers who smoke could reduce SIDS by at least one third. Breastfeeding did not appear to offer a statistically significant reduction in SIDS risk after adjustment of potential confounders, but as breastfeeding rates are comparatively good in New Zealand, this result should be interpreted with caution as the power of this study to detect a benefit is small.
http://www.ncbi.nlm.nih.gov/pubmed/9346984

SIDS: Changes in the timing of SIDS deaths in 1989 and 1999: indirect evidence of low homicide prevalence among reported cases.

Paediatr Perinat Epidemiol. 2006 Jan;20(1):2-13.

Pollack HA.

University of Chicago School of Social Science Administration, Chicago, IL 60637, USA. haroldp@uchicago.edu

Abstract

An unknown proportion of cases diagnosed as sudden infant death syndrome (SIDS) are misdiagnosed, and in some cases are homicides. Because recent SIDS prevention measures were unlikely to reduce homicides, changes in the reported timing of SIDS cases provide an indirect measure of covert homicides in this group. This paper uses United States vital statistics microdata to explore these questions. The sample includes all reported infant deaths to singletons with birthweight > 500 g in the 1989 and 1999 US birth cohorts. Deaths attributed to SIDS (n = 7708), homicide (n = 597), or object inhalation and mechanical suffocation (n = 860) are specifically examined. If reported SIDS cases were a mixture of 'true' cases and misdiagnosed homicides, it is hypothesised that the age-at-death distribution of SIDS deaths would have changed to reflect greater prevalence of misdiagnosed homicide. We find that the age-at-death distribution of reported SIDS cases was virtually unchanged in the two cohorts, showing no increase during periods of infancy when relative homicide risk is most pronounced. One cannot reject the hypothesis that the timing was drawn from the same distribution (chi2(52)= 62.2, P = 0.157). Analogous results hold for infants born in circumstances associated with high homicide risk (chi2(50) = 61.5, P = 0.12). The stable age-at-death distribution of reported SIDS cases between 1989 and 1999 suggests that covert homicides are a small fraction of reported SIDS cases.
http://www.ncbi.nlm.nih.gov/pubmed/16420336

SIDS: Sudden unexpected death and covert homicide in infancy.

Arch Dis Child. 2004 May;89(5):443-7.

Levene S, Bacon CJ.

Foundation for the Study of Infant Deaths, Artillery House, 11-19 Artillery Row, London SW1p 1RT, UK.

Abstract

It is impossible to be certain, but it is estimated that each year in England and Wales there may be about 30-40 infant deaths from covert homicide, which represents about 10% of the current annual total of sudden unexpected deaths in infancy. This paper reviews the features that have been suggested as possible indicators of covert homicide, describes the difficulties in its identification and the need for better evidence, and emphasises the importance of thorough medical investigation of all sudden infant deaths.
http://www.ncbi.nlm.nih.gov/pubmed/15102637

SIDS: Diagnosis of SIDS to be reviewed in North Carolina

 LISA HAMMERSLY - The Charlotte Observer

With the goal of educating families and saving babies' lives, North Carolina's new chief medical examiner is going to re-examine how the state diagnoses the unexpected deaths of sleeping infants.
Dr. Deborah Radisch says she plans to consult with path ologists statewide about how the medical-examiner system should handle the deaths that are now usually labeled sudden infant death syndrome.
She also wants to discuss a federal project under way in five states that aims to better investigate and diagnose these deaths. Those states are finding they record fewercases of SIDS, and more often label the deaths suffocation, cause unknown, neglect or even homicide. 

It's the first time since she took office in late June that Radisch has said she'll study SIDS deaths and related cases. She expects to start after she finishes hiring her staff.
The hope is to "establish consistency in diagnosis of all infant deaths that come through the medical examiner's system," Radisch said in an interview this week. "We want to continue to encourage families to be aware of preventive measures such as safe-sleep practices."
A Charlotte Observer series in June showed that N.C. medical examiners often have applied the SIDS ruling tobabies even when evidence showed they might have suffocated. They were often found sleeping in unsafe situations: with adults on beds or couches, for example, or facedown among pillows and fluffy blankets.
The investigation found that two-thirds of SIDS autopsies in North Carolina between 2004 and 2008 listed risks that raised the possibility of suffocation. The newspaper also found that law enforcement agencies were sometimes frustrated by the SIDS ruling if they thought the case involved neglect or - rarely - homicide. A SIDS ruling, they said, made successful prosecution of infant deaths almost impossible.
About 100 North Carolina infants each year die from SIDS. After years of research, those deaths are still a medical mystery. The label means that doctors don't know why a baby died and that the death was unpreventable. In North Carolina, SIDS also is considered a natural manner of death.
Advocates of safe-sleep practices for infants worry that SIDS diagnoses can be misleading. They want parents to understand that the risk of SIDS goes down when babies are put to sleep on their backs, alone in their cribs, without blankets or pillows that could suffocate them.
Georgia's medical-examiner system is taking part in the federal project coordinated by the Centers for Disease Control and Prevention in Atlanta.
Beoncia Loveless, a medical investigator with the Georgia system, says some people think of the SIDS label as merely an issue of semantics. "But it's important, if you're trying to get a message out to the community," she says. People once thought SIDS deaths "were unpreventable. But many appear to be preventable. It changes your message."
Although doctors still don't know what makes some infants vulnerable to dying in their sleep, they do know that sleep conditions are related, Loveless said. "The chances of that death go up significantly if the baby is in an unsafe environment."
Loveless said that in Georgia, very few sleep-related deaths are labeled SIDS. The term is reserved for a baby that dies unexpectedly in a safe-sleep situation.
Radisch says she won't start the process of examining infant deaths and other issues until she has a full staff, and she's still working to fill three open jobs forforensic pathologists in her Chapel Hill office. She says the pool of qualified applicants is small - about 40 graduate each year, and about 30 pass board examinations. Several states and jurisdictions are trying to hire.
The medical examiner's office is charged with investigating suspicious, unusual or unnatural deaths. North Carolina's Office of the Chief Medical Examiner oversees about 11,000 cases per year and about 4,500 autopsies.
http://www.newsobserver.com/2010/11/07/786502/diagnosis-of-sids-to-be-reviewed.html#ixzz15dTIqqsJ

SIDS: Kansas statistics of child mortality

 October 25, 2010

TOPEKA, Kan. -- In its annual report, the Kansas State Child Death Review Board released statistics of child deaths from 2008, and the board made a number of recommendations to try to reduce some of the preventable deaths in the report.

The board broke the deaths out into six catergories: natural-except sudden infant death syndrome (SIDS) - 316 deaths; Natural-SIDS - 49 deaths; Unintentional injury (motor vehicle crash, drowning, strangulation, etc.) - 79 deaths; Homicide (including gang-related and child-abuse) - 26 deaths; Suicide - 9 deaths; and Undetermined - 23 deaths.

The recommendations the review board included: comprehensive and thorough investigations and autopsies, working partnerships with various for public education purposes, improving women's/maternal health to lower infant mortality, comprehensive laws regarding ATVs, prohibiting unattended children in vehicles, and adjustments to laws allowing children to drive on a farm permit.

In the natural deaths category, the report notes that 64 percent of the deaths were from infants less than 29 days old, 40 percent were due to prematurity and 22 percent were from congenital malformation.

In 2008, the report said 85 percent of the SIDS deaths in Kansas occurred in the first four months of life. In 82 percent of the SIDS cases, the report said mechanical asphyxia or suffocation caused by overlay could not be ruled out because the infants were placed to sleep in an unsafe environment, like in a bed, on a couch or recliner or on their abdomen. Of the infants who died from SIDS, 24 percent of those who died were placed in a crib to sleep and 37 percent were placed on their back.

The report noted that the violence-related deaths were the most alarming of the deaths. The statistics showed 50 percent of homicides came from abuse cases and most of those deaths came from children under the age of 4 and died from abusive head trauma. The report also noted 61 percent were killed by someone other than their biological parent, including 38 percent being killed by the mother's boyfriend who was left to care for the child.

The majority of the suicide deaths, the report said, were from teens ages 16 and 17, who died from asphyxia and that 33 percent had previously attempted suicide or had suicidal tendencies before their death, the report said. The board noted 44 percent of the suicides came after a recent breakup or argument with a significant other and 77 percent had some type of family discord.

Most of the unintentional deaths were from motor vehicle crashes, the report said, and accounted for 65 percent of the total unintentional injury deaths. In breaking down the unintentional death numbers, 48 percent of the deaths involved inattentive or inexperienced teen drivers. Four of the five children killed in ATV wrecks in ATVs were under the age of 13

http://www.kctv5.com/news/25503225/detail.html