SIDS risk factors vary for older and younger babies, report suggests

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Bed-sharing remains a risk factor for SIDS and other sleep-related causes of infant deaths, with younger infants at a more increased risk, a new study suggests.

Sudden Infant Death Syndrome and accidental suffocation/strangulation is blamed for over 4,000 infant deaths each year. A new study’s analysis of sleep environment shows how these risks can vary during infant’s first year.

The study, published July 14 in the journal Pediatrics, shows that the risk factors that contribute to SIDS vary with a baby’s age. The majority of infants younger than 4 months old who died while sleeping were bed sharing, whereas older infants who died were more likely to be found on their stomachs with blankets, or other items, around them, said study co-author Dr. Jeffrey Colvin, a pediatrician at Children’s Mercy Hospital in Missouri.

SIDS and unintentional injuries such as suffocation occur in 81 out of every 100,000 live births, according to the National Center for Health Statistics. According to the study, the majority of infants who died from SIDS — 69 percent — were bed-sharing when they died.

A larger proportion of younger infants (ages 0 to 3 months) were bed-sharing compared with older infants, 74 percent vs. 59 percent, according to the study.

Advocates of bed-sharing say the soothing and bonding benefits can be made safe by eliminating soft, loose bedding from the bed. However, the study challenges this argument.

“So many of the deaths that we saw in this study were in the context of bed sharing, yet, at least according to the (state review teams that provided the data) there were no other objects in the bed that would have made an additional risk,” said Jeffrey Colvin, a pediatrician at Children’s Mercy Hospitals and Clinics in Kansas City, Mo. “What we’re learning is that not only is it unsafe and a big risk factor for SIDS and other sleep-related deaths, but it’s impossible to make bed sharing safe.”

Older infants (4 months to 12 months) were more likely to have objects in their sleep area at the time of death. They were also more likely to be found face-down, even though they were placed in their bed on their back or side.

Infants begin rolling from back to stomach around 4 months of age.

While experts advise infants do not need to be repositioned on their backs if they roll into the prone position, parents are reminded to keep the sides of cribs and bassinets clear of any objects.

Colvin and colleagues found:

• In all deaths, 35% of all infants were placed to sleep on their side or stomach: 37% of younger infants; 29% of older.

• 38% of all infants were found on their stomach: 42% of older infants; 37% of younger.

• One or more “dangerous” objects (i.e., pillows, blankets, bumper pads, stuffed toys, clothing, cords) was found in the sleep environment in 33% of the deaths.