Infant Suffocation Deaths on the Rise

We all know as mothers that we want to keep our babies as safe as possible. The bed is one place that needs special attention. Today, the rates of infant mortality that are due to accidental suffocation and strangulation in bed have quadrupled since the year 1984, adding to the already horrifying statistics of SIDS that occur in the crib.

While the rate of sudden infant death syndrome (SIDS) has declined since 1984, the rate of sudden unexpected infant deaths has remained stagnant, as shown in a new study that will be published in the February edition of Pediatrics. The seeming contradictions in declines and increases in the deaths of infants are likely due to the changes in the way such tragedies that are investigated and classified, said Carrie K. Shapiro-Mendoza, Ph.D., a researcher from the CDC. She credits that very impressive decline in the cases of SIDS to a national “back to sleep” campaign that, among other things, urges that parents put their babies on their backs when it is time for bed.

The reason for the dramatic increase in the accidental suffocation and strangulation deaths in bed or ASSB, is not known for sure at this time. Researcher Shapiro-Mendoza says, “It’s probably due to poor bedding, blankets in cribs, sleeping with parents or siblings, or bad habits. Or infants getting wedged between the mattress and the wall.” Also, despite the urgings from the American Academy of Pediatrics and the CDC, many of the parents still put their infants to bed on their stomachs instead of their backs, which can lead to suffocation.

The decline in the rates of SIDS has been offset by the increase in other sudden unexplained infant deaths, a new category that is called SUIDs. ASSB death, which is a subgroup of SUIDs, is said to be a leading cause of infant mortality. SUIDs, include all of the deaths attributed to accidental strangulation and suffocation, SIDS, and all unknown causes.

Shapiro-Mendoza said that infant deaths that are attributed to ASSB increased from 2.8 to 12.5 deaths for every 100,000 births between the years of 1984 and 2004. She also stated that such deaths increased dramatically between the years 1996 and 2004, which is a 14 percent average annual increase, a period in which mortality attributed to a decline in SIDS. These ASSB deaths are potentially preventable. She states that a “comprehensive” investigation of the site of death is critical in determining the exact cause of death. Often, the autopsy findings won’t be able to tell the difference between strangulation and physiological causes such as defects of the heart.

All mysterious infant deaths used to be classified as SIDS cases, she said, adding that the medical examiners and coroners need to be much more careful when diagnosing the cause of death to help scientists fight infant mortality.

Shapiro-Mendoza stated, “A death scene investigation, an autopsy, and a review of medical records are essential to correctly classify these deaths.” She adds that it is very unlikely that comprehensive investigations are the rule. She also said that most grandparents still advise to put the baby’s on their stomachs, but that is bad advice.

Seema Csukas, M.D., who is the director of child health promotion at Children’s HealthCare of Atlanta, says that the medical community has “gotten better at defining what is SIDS and what isn’t SIDS. Some of these may be genetic, caused by heart problems. The strangulation-suffocation deaths shouldn’t be increasing.”

Coroners and others are beginning to understand that many of the cases of SIDS should be classified as suffocations, according to Bradley Thach, M.D., from the Washington School of Medicine. He has stated that sudden unexpected infant death is a broader category, which includes true SIDS as well as other cases such as accidental suffocation. We know now that there are several causes of sudden death and some of the causes can be found only by post-mortem tests.

It is also becoming more recognized that if you put your infants face down in their beds they are more likely to suffocate.

Here are some tips for parents for reducing infant deaths:

• Do not sleep with your infants or allow other to.
• Make sure that your infants are put to bed on their backs and not on their stomachs.
• Infants should sleep on a mattress that is hard. Soft bedding can lead to suffocation.
• Remove any stuffed toys or heavy blankets from the sleep area.
• Consider using single-piece sleep attire, sometime called an onesie, that would keep the baby warm without any covers or blankets.
• Clear everything from around the crib. Infants have been strangled on cords from blinds.
• The slats on cribs should not be far enough apart for the infants to stick their head through.
• Use thin bumper pads instead of the thick fluffy ones.
• Instead of asking other mothers or grandmothers for advice, consult your doctor. The times have changed and so has the advice.
• Be aware that cribs that are bought at garage sales or one that you have stored in the attack might not meet current guidelines of the Consumer Product Safety Commission.
• Putting infants to bed on their sides is also dangerous; it is very easy for them to roll onto their stomachs.
• It is not advised to smoke around infants.
• Make sure that caregivers know what you do about putting your infant or baby to bed. Many do not know, even at established day-care centers.
• Pacifiers are O.K. to use when placing a baby down to sleep, but they should not be left in the crib after they fall asleep.