Why has no substantial progress been made in preventing sleep-related infant deaths?

Approximately 3700 infants (aged 1 year) have died each year in the past 15 years, most of whom died before age 6 months. No recent breakthrough has occurred for this public health issue, which kills a surprisingly large number of society’s most vulnerable—typically healthy infants. After the 1992 American Academy of Pediatrics recommendation regarding sleep position and the National Institutes of Health–led Back to Sleep campaign, infant deaths significantly declined; however, since the late 1990s, the decline in sleep-related infant deaths has plateaued. In 2015, there were 3684 sudden unexpected infant deaths (SUIDs), a total that is essentially unchanged from the 3716 SUIDs in 1999. By comparison, childhood deaths from motor vehicle crashes decreased dramatically in this same period. With the recent decline in deaths from crashes,SUIDs now claim as many lives as all deaths from crashes in infants, children, and teenagers combined (aged <20 years) (Figure). How can we begin to make real gains and prevent these tragic deaths?

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