Most unexpected infant deaths occur while sharing sleep surface
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Key takeaways:
- Most unexpected infant deaths occur while the infant is sharing a sleep surface.
- Three-quarters of all unexpected deaths involve multiple unsafe factors.
Nearly 60% of sudden unexpected infant deaths occur while the infant is sharing a sleep surface with another person, according to study findings published in Pediatrics.
Sudden infant death syndrome rates have increased in recent years, especially among non-Hispanic Black infants. The AAP recommendations for safe sleep include placing a baby on its back with no other people; using a firm, flat, noninclined sleep surface; and avoiding soft objects and loose bedding in the sleep environment.
“Sharing a sleep surface with an infant is discouraged because it increases the risk of sleep-related sudden unexpected infant death (SUID), including sudden infant death syndrome (SIDS), accidental suffocation and strangulation in bed, and other ill-defined and unknown causes,” the authors of the new study wrote.
“Surface sharing, especially on a couch or armchair, increases risk of unintentional suffocation by soft bedding, wedging or entrapment, and overlay. Moreover, surface sharing in combination with parental smoking and maternal alcohol or drug use greatly increases SIDS risk.”
The researchers studied 7,595 sudden unexpected infant deaths in 23 United States jurisdictions from 2011 to 2020 and found that 59.5% were sharing a sleep surface when they died.
There were multiple unsafe sleep factors present in at least 76% of all SUIDs, and among surface-sharing SUIDs, most were sharing with adults only (68.2%), in an adult bed (75.9%) and with one other person (51.6%). Surface sharing was more common among multiples than singleton infants.
When the researchers compared these deaths with infants who did not share a sleep surface, sharing infants were more often aged 0 to 3 months; non-Hispanic Black; publicly insured; found lying on their back; found in an adult bed, chair or couch; and with a higher number of unsafe sleep factors present.
The researchers noted that most SUIDs involved at least one unsafe factor, regardless of whether they shared a surface. Nonsharing infants were commonly in both an unsafe sleep position and with soft bedding in their sleep environment.
“Thus, surface-sharing in and of itself may not be what caregiver education should focus on,” they wrote. “These results support efforts to provide comprehensive safe sleep messaging and not focus solely on not surface sharing for all families at every encounter.”
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