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October 2005

We are happy to release the second edition of "iNCite", our monthly feature focusing on the health and well-being of women and young children in North Carolina. For those receiving "iNCite" for the first time, our goal is to provide you - members of the health community, government agencies, community groups and individuals - with information to take into your personal and professional lives. We urge you to incorporate featured material in your newsletters, presentations, online resources and discussion groups.

Good Night? Infant Deaths and Sleep

On October 10, the American Academy of Pediatrics (AAP) released updated recommendations regarding Sudden Infant Death Syndrome (SIDS), the leading cause of death for infants one to twelve months of age. Two of the more significant recommendations discourage bed sharing and promote back-only (and not side) infant sleep positioning.

AAP officials had previously permitted, but did not actively promote, side sleeping. The updated guidelines call for back-only infant sleep positioning for night time and naps.

This is the first time since 2000 that revised recommendations have been released and comes at a time when SIDS deaths in North Carolina have begun to plateau, following nearly a decade of decline. Each year, approximately 100 North Carolina families experience the sudden and unexpected death of an infant.

A large percentage of SIDS deaths can be attributed to several modifiable risk factors related to a baby's sleep position and sleep environment. A safe sleep environment is free of excess bedding, bumper pads, pillows, stuffed animals and tobacco smoke. Additionally, a safe sleep environment is one in which a baby sleeps in his own crib or bassinette, away from the potential hazards of sleeping with parents or siblings.

The latest AAP recommendations underscore the importance of placing babies alone in a crib, bassinet or cradle for sleep. Officials also encourage placement of the baby's crib in the parent's room, which studies have linked to SIDS risk reduction benefits.

Placing the baby in a separate, safe sleep environment in close proximity to parents allows for convenient contact while helping to avoid the dangers resulting from sharing the same bed. This provides easy access for bonding and breastfeeding which is beneficial to a baby's physical and emotional development.

In addition to SIDS, bed sharing can result in accidental suffocation, strangulation, entrapment and rollovers (crushing). Recently, North Carolina has seen an alarming increase in overall accidental infant deaths associated with bed sharing and unsafe sleep environments. These deaths are preventable!

Although a majority of North Carolina babies are being put to sleep on their backs (69% in 2003), officials believe part of the decline in SIDS deaths in recent years is due to a shift in coding SIDS cases to other causes of unexpected or accidental infant deaths, many related to the sleep environment.


How is a SIDS diagnosis determined?
A SIDS diagnosis is one of exclusion in which the medical examiner rules out all other causes of death based on autopsy findings, a death scene investigation and review of the baby's clinical history.

What help is available for families experiencing a SIDS death?
The North Carolina SIDS Program (919-715-8430) provides support, answers to questions and has trained SIDS counselors who can offer a helping hand and link family members with others who can provide grief support.

What is "tummy time"? How long should it last?
"Tummy time" is when newborns and infants spend supervised time on their stomachs while awake to play and exercise. "Tummy time" aids in muscle development and tone, and helps prevent flattening of the head which can result from pressure on the back of the head from time spent in car seats, cribs, swings and carriers. It is recommended that newborns be introduced to "tummy time" for five minutes during awake periods, but this can be increased as a baby grows and becomes stronger.

Click here for more information on SIDS.

Click here to view and order educational materials promoting Back to Sleep and other SIDS risk reduction messages. (link to BTS section of the catalog)

Opens in new window Click here to view the American Academy of Pediatrics statement.

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Last updated: October 2005


At a glance
SIDS in 2004

Total number of NC SIDS deaths


8.6 deaths per 10,000 live births

NC Caucasian SIDS rate
6.5 deaths per 10,000 live births

NC Minority SIDS rate 14.1 deaths per 10,000 live births

National SIDS Death Rate
5.5 deaths per 10,000 live births

SIDS death between 2-4 months of age

N.C. State Center for Health Statistics & CDC

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