Sudden Unexpected Infant Death Fact Sheet

• THERE ARE APPROXIMATELY 3,700 infant deaths in the U.S. each year from Sudden Unexpected Infant Death (SUID), which includes Sudden Infant Death Syndrome (SIDS), Accidental Suffocation and Strangulation in Bed (ASSB), and other unknown causes during the first 12 months of life, such as metabolic disorders or neurological conditions.
• SIDS IS THE leading cause of death in children between one month and one year of age. It is thought to be a multifactorial syndrome, associated with both physical and sleep environment factors. These may include brain and motor functions, low birth weight, respiratory infection, sleep positioning, bed sharing, and exposure to second-hand smoke, among others.
• EVIDENCE-BASED MEASURES that reduce the risk of SIDS and are recommended by the American Academy of Pediatrics (AAP) include positioning babies to sleep on their backs on their own firm sleep surface, one free of loose bedding, pillows, toys or other objects. The AAP also recommends breastfeeding/human milk feeding for the first six months and introducing a pacifier during the first year, after breastfeeding has been established.
• AAP GUIDELINES were at the core of the Back to Sleep (now Safe to Sleep ®) public health campaign launched in 1994 by the National Institute of Child and Human Development (NICHD) with a coalition of organizations and agencies, including First Candle. This resulted in a 50% drop in sleep-related infant deaths, although the decline has largely leveled off in recent years.
• HOWEVER, DESPITE AN overall SUID decline, there is a greater risk level across racial and ethnic populations. The CDC reports that from 2016 – 2020 SUID deaths per 100,000 live births were highest among non-Hispanic American Indian/Alaska Native infants (213.50), non-Hispanic Black infants (191.4), and non-Hispanic Native Hawaiian/Other Pacific Islander infants (164.5). Mortality rates were lowest among non-Hispanic White infants (83.6), Hispanic infants (56.4), and non-Hispanic Asian infants (22.6).
• RESEARCH STUDIES HAVE identified societal factors that affect SUID risk, including social determinants of health (SDH) and institutional racism. These factors can affect the access to and quality of prenatal and postpartum health care, as well as maternal health, infant prematurity and low birth weight.
• RESEARCH, INCLUDING First Candle’s qualitative 2021 study, suggests that cultural/racial differences are affecting families’ adoption of the AAP safe infant sleep guidelines. These indications are prompting more study of approaches that may constructively mitigate SUID risk and recognize the impact of holistic – family, community, society — approaches to reducing infant sleep-related deaths.