232010 Safe infant sleep initiatives and evidence based on death reviews

Tuesday, November 9, 2010 : 10:50 AM - 11:10 AM

Mary Overpeck, MPH, DrPH , Michigan Public Health Institute, National Center for Child Death Review, Santa Fe, NM
Heather Dykstra, MPA , Michigan Public Health Institute, National Center for Child Death Review, Okemos, MI
Theresa Covington, MPH , National Center for Child Death Review, Michigan Public Health Institute, Washington, DC
Patricia Schnitzer, PhD , School of Nursing, University of Missouri - Columbia, Columbia, MO
Initiatives to reduce infant deaths in the sleep-related environment address different aspects of risks. Most initiatives target asphyxia and strangulations while some support reduction of risk associated with infant vulnerability characteristics. Initiatives from the National Institutes of Health “Back to Sleep” campaign, National “Crib for Kids”, Consumer Product Safety Commission, and Home Safety Council are described. Recommendations based on emerging knowledge of risks of sudden unexpected infant death (SUID), from the American Academy of Pediatrics Policy Statements are described, including those for infants born with developmental delay, prematurity, low birth weight, and birth defects. Evidence to support safe sleep initiatives is often based on child death review (CDR) results. CDR data on the sleep-related circumstances of more than 3000 SUID cases occurring in 2005-2007 show: More than half were on adult beds (41%) or couches and chairs (12%); 25% were in cribs. Almost half occur while sharing a sleeping surface with others. Only 25% were found on their back when discovered although the sleep position was unknown in about 30% of cases, indicating a need for better death scene investigations. Death was attributed by medical examiners and coroners to SIDS in 27% of cases, asphyxia in 24%, and unknown or undetermined cause in 31% of cases, indicating a need for improved autopsies and medical histories.

Learning Areas:
Communication and informatics

Learning Objectives:
1. Identify current Infant Safe Sleep Initiatives in the United States 2. Describe results of Child Death Reviews in 2005-2007on circumstances of sleep-related circumstances of more than 3000 sudden unexpected infant deaths. 3. Explain implications of Child Death Review results for need of improved death scene investigations, autopsies, and medical histories for reporting of medical examiners and coroners on causes of death.

Keywords: Maternal and Child Health, Injury Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a senior research scientist responsible for research on sudden unexpected infant deaths using the multi-state database of the National Center for Child Death Review. I also have strong experience in childhood injury risks and prevention.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.