New study and AAP commentary support First Candle’s community-driven safe sleep program.

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Today, the Centers for Disease Control (CDC) released a study on the rate of Sudden Unexpected Infant Death (SUID) during the pandemic (2019-2020).

The rate of SUID overall remained the same from previous years but the rate among Black infants increased.  The rates of SUID for infants born to Black families is now 2.3 times higher than the overall rate and 2.8 times higher than white babies.

While the CDC study notes that there are shifting diagnostic criteria and COVID-related challenges, it acknowledges that these disparate rates can’t be attributed to this and are more likely reflective of  poverty levels, lack of access to prenatal and well-child care, and education regarding safe sleep and other practices, including the feeding of human milk, which can reduce the risk of SUID, and social norms related to these practices that vary between communities.

This is what First Candle has recognized since our Community Listening Sessions that we conducted in 2019 through the support of a grant from the W.K. Kellogg Foundation.  In 2020 we produced a white paper highlighting how socio-economic challenges and structural racism contribute to the lack of access to safe sleep and breastfeeding information along with a family’s lived experiences, cultural beliefs and social norms surrounding bed sharing. We concluded that existing education campaigns that do not take into account how the message is delivered and by whom are ineffective.

It was from this research that we launched our community-led Let’s Talk Community Chat program, a partnership with local organizations, doulas and fathers to educate them on safe sleep practices, breastfeeding and the proper use of infant products and deployed them into their communities on a monthly basis to talk to all members of a family, meeting them where they’re at in regards to their existing beliefs and challenges. The program was piloted in Harlem last year and has been so successful we have received grants and private donations to expand into Atlanta and Philadelphia this year.

While the study itself is illuminating, it’s the commentary by our colleagues at American Academy of Pediatric Pediatrics (AAP) that we find most encouraging.  They acknowledge that the higher rates for SUID among Black families is due to lack of support in the United States for new parents “including but not limited to lactation assistance to increase human milk feeding rates, home visiting programs to support families in their home and help identify and address unsafe sleep conditions, and support for maternal mental health, particularly in the postpartum period. Our lack of guaranteed paid family leave means that parents may be forced to stop human milk feeding before they would like, parents are more desperate for nighttime sleep and thus, may turn to less safe sleep practices, and infants are often cared for by a variety of caregivers, not all of whom are adequately educated on safe sleep practices.”

We are happy that the AAP is clearly stating that new strategies must be explored to address the inequities in the rates of SUID.  It is what we at First Candle have been addressing for over five years now – as a country we must do better providing support for all families, acknowledging that safe sleep messaging is not a “one-size fits all,” respecting the cultural norms and real-life challenges each family faces and shining a light on the part structural racism has played in supporting and educating families.

We look forward to taking our community-led education program to locations around the country.  We know that providing assistance to these local organizations, listening to the specific challenges within each community and allowing them to lead the way on safe sleep education, breastfeeding and other supports families need will finally change the trajectory of SUID.