INCREASE IN MACOMB COUNTY
INFANT DEATHS DUE TO SUFFOCATION

Macomb County has seen an alarming increase in infant deaths due to suffocation during sleep. The Macomb County Health Department wants to do everything they can to reverse this trend. In September 2002, they launched their " Safe Sleep Macomb" campaign which includes educational materials, presentations and public awareness displays.

Dana Camphous-Peterson, Chairperson, Health & Environmental Services Committee, Macomb County Board of Commissioners is concerned. "Babies in Macomb County are dying from preventable causes. We need to make sure that every household knows how to safely place their baby to sleep." The Health Department campaign aims to do just that. The educational material explains to parents and caregivers how to create a safe sleeping environment for their babies. Guidelines for cribs, how to position the baby and what the baby should wear are included in the materials.

In 1992, the American Academy of Pediatrics started recommending that babies be put to sleep on their backs. Since then the death rate from Sudden Infant Death Syndrome (SIDS) has decreased by more than 40%. The Health Department campaign expands the "back to sleep" concept to include other information on how to prevent babies from being htmhyxiated while they sleep.

Information for parents and caregivers is as follows:

• Babies should be placed on their back to sleep. Babies are nose breathers so when they sleep on their tummy it's hard to get air.
  

• Babies need their own crib with a firm mattress and tight-fitting sheets. The crib should have no broken or missing hardware or slats. Slats should be no more than a soda can width apart.
  

• There should be nothing in the sleep area such as pillows, stuffed animals, quilts or bumper pads. If a baby's face becomes pushed up against these soft objects they may not be strong enough to free themselves.
  

• Babies should be dressed appropriately for the temperature in their room so they won't need any covers. Over bundling babies does not help them sleep safe.
  

• Babies should sleep alone in their crib. They should never sleep on a couch, waterbed or anything soft. They should never sleep in bed with other children, adults or pets.
  

American Academy of Pediatrics Revises
SIDS Prevention Recommendations

The American Academy of Pediatrics (AAP) addresses several issues that have become relevant since they last published a statement in 2000. Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment and New Variables to Consider in Reducing Risk.

The AAP no longer recognizes side sleeping as a reasonable alternative to fully supine (lying on back) sleeping. Studies have found that the side sleep position is unstable and increases the chances of the infant rolling onto his or her stomach. Every caregiver should use the back sleep position during every sleep period.

Bed sharing is not recommended during sleep. Infant’s maybe brought into bed for nursing or comforting, but should be returned to his or her own crib or bassinet when the parent is ready to return to sleep. However, there is growing evidence that room sharing (infant sleeping in a crib in parent’s bedroom) is associated with reduced risk of SIDS. The AAP recommends a separate but proximate sleeping environment.

Research now indicates an association between pacifier use and a reduced risk of SIDS, which is why the revised statement recommends the use of pacifiers at nap time and bedtime throughout the first year of life. The evidence that pacifier use inhibits breastfeeding or causes later dental complications is not compelling enough to discredit the recommendation. However, it is recommended that pacifier introduction for breastfed infants be delayed until one month of age to ensure that breastfeeding is firmly established. In addition, if the infant refuses the pacifier, it should not be forced. There is a slight increased risk of ear infections associated with pacifier use, but the incidence of ear infection is generally lower in the first year of life, especially the first six months, when the risk of SIDS is the highest.

Consistently Identified As Risk Factors for SIDS

* Prone (lying on stomach) sleep position
* Late or no prenatal care
* Sleeping on a soft surface
* Young maternal age
* Maternal smoking during pregnancy
* Pre-term birth and/or low birth weight
* Overheating

Consistently higher rates of SIDS are found in Black and American Indian/Alaska Native children – two to three times the national average.


The policy recommendations include:

Back to Sleep
Infants should be placed for sleep in a supine (wholly on back position) for every sleep.

Use a Firm Sleep Surface
A firm crib mattress, covered by a sheet, is the recommended sleeping surface.

Keep Soft Objects and Loose Bedding Out of the Crib
Pillows, quilts, comforters, sheepskins, stuffed toys and other soft objects should be kept out of an infant’s sleeping environment.

Do Not Smoke During Pregnancy
Also, avoiding an infant’s exposure to second-hand smoke is advisable for numerous reasons in addition to SIDS risk.

A Separate But Proximate Sleeping Environment is Recommended
A sleeping environment such as a separate crib in the parent’s bedroom. Bed sharing during sleep is not recommended.

Consider Offering a Pacifier at Nap Time and Bedtime
The pacifier should be used when placing infant down for sleep and not be reinserted once the infant falls asleep.

Avoid Overheating
The infant should be lightly clothed for sleep, and the bedroom temperature should be kept comfortable for a lightly clothed adult.

Avoid Commercial Devices marketed to Reduce the Risk of SIDS
Although various devices have been developed to maintain sleep position or reduce the risk of re-breathing, none have been tested sufficiently to show efficacy or safety.

Do not Use Home Monitors As a Strategy to Reduce the Risk of SIDS
There is no evidence that use of such home monitors decreases the risk of SIDS.

Avoid Development of Positional Plagiocephaly (Flat Back of Head)
Encourage “tummy time”.

Avoid Having the Infant Spend Excessive Time in Car-Seat Carriers and “Bouncers”
Place the infant to sleep with the head to one side for a week and then changing to the other.

Assure that others caring for the infant (childcare provider, relative, friend, and babysitter etc.) are aware of these recommendations.

Click here to print the Safe Sleep Brochure Side 1

Click here to print the Safe Sleep Brochure Side 2

Infant Safe Sleep Month in Michigan

How much do you know about infant safe sleep?

Infant Safe Sleep Poster

Back To Top