Placing an infant on his back when sleeping may save his life, according to new data

Sudden and unexpected infant deaths will claim the lives of approximately 3,400 infants in the United States in 2024. Despite decades of public health efforts to raise awareness of the importance of safe sleep, these cases remain a leading cause of death during infancy.

A new report issued by the US Centers for Disease Control and Control found that about three-quarters of deaths studied between 2020 and 2024 were linked to factors related to unsafe sleep. This means that there are steps that parents and caregivers can take to reduce these risks.

The first of these steps: knowing what a safe sleeping environment looks like. To reduce the risk of infant death, Dr. Leana Wen, a certified health expert with Ofoq News, explained the steps that parents should take.

Wayne, an emergency physician and assistant clinical professor at George Washington University, previously served as Baltimore City Health Commissioner, and is the mother of two young children. Ofoq News: What is the conclusion of the new Centers for Disease Control report regarding sudden and unexpected deaths of infants?

Dr. Leana Wen: Sudden unexpected infant death, or SUID, is a general term used to describe the sudden and unexpected death of an infant under one year old. It includes: In this report, the agency analyzed 4,861 sudden and unexpected infant deaths that occurred between 2020 and 2024, in 31 states and jurisdictions that participate in the CDC’s case registry.

This register provides detailed information about the circumstances surrounding deaths, which is not available in death certificates. 73% of deaths were classified as being related to factors related to unsafe sleep.

When looking at specific characteristics of the sleep environment, we find that: These categories overlap, which means that a single infant may be exposed to several of these risk factors. Significant disparities also emerged between ethnic groups.

Black infants accounted for 38% of recorded deaths. The agency noted that sudden and unexpected infant death disproportionately affects infants who are dark-skinned, American Indian or Alaska Native.

These disparities have complex causes, which may include differences in access to the resources needed to regularly implement safe sleep practices. Ofoq News: What are the specifications of a safe sleeping environment for an infant?

Wayne: The American Academy of Pediatrics recommends: The Academy also recommends room sharing without bed sharing, ideally for a minimum of six months. This means that the child's bed or cradle should be next to the parents' bed, which makes it easier to feed and soothe him, but the child should sleep on a separate surface.

Infants should always be placed on their backs to sleep. As for tummy time, it is important for developing strength and motor skills, and only when the infant is awake and under direct supervision.

Once the infant is able to turn from his back to his stomach and back on his own, the parents do not need to change his position during sleep, but should continue to place him on his back at the beginning of each sleep period. Ofoq News: Why does soft bedding and sharing a bed with an infant pose a danger to him?

Wayne: In their first months, babies cannot move their heads and bodies easily if something gets in the way of their breathing. Soft bedding poses a particular risk, because the pillow, blanket, or other object may cover the infant's nose and mouth, and he may not be able to change his position to regain his ability to breathe.

Sharing a sleeping surface adds additional risks: The infant may also get stuck between the mattress and the wall, headboard or other object. Therefore, adult beds are not safe sleeping surfaces for infants.

Sofas and chairs with armrests may be more dangerous, as the infant could get stuck between the pillows or between the sleeping person and a piece of furniture. Centers for Disease Control data illustrates these risks.

Of the 919 deaths, investigators determined suffocation related to unsafe sleeping factors was a cause, with 74% of cases involving airway obstruction due to soft bedding. About a quarter of these cases were related to what is known as “compression,” that is, the obstruction of the infant’s airway due to another person or animal, while 8% of the cases involved the infant being trapped between different objects.

Some deaths involved more than one mechanism of suffocation. Ofoq News: Are there other steps that parents and caregivers can take to reduce the risk of infant death?

Wayne: The most important step is to adhere to safe sleep practices every time your baby sleeps. Parents should also avoid smoking and using nicotine during pregnancy, and protect the infant from passive smoking after birth, as cigarette smoke increases the risk of sudden infant death syndrome.

Alcohol, marijuana, opioids, and illicit drugs should be avoided during pregnancy and after birth, because they may increase risks and interfere with caregivers' ability to wake up and respond to the infant. The American Academy of Pediatrics recommends breastfeeding and providing a pacifier for naps and bedtime, in addition to pregnant women receiving regular medical care, and infants receiving recommended vaccinations.

Ofoq News: If an infant falls asleep in a car seat, stroller, swing, or infant carrier, what should parents do? Wayne: Car seats are essential for protecting infants while on the move, but they are not intended for sleeping outside the car.

If the baby sleeps in it or in a stroller or infant carrier, there is no need to worry, but he should be moved when he reaches a suitable surface designated for infant sleeping. In the first months, the infant's control of his head and neck is limited, and a forward-bent head position on an inclined surface or while sitting may impede breathing.

You should also be careful with hammocks, because the product is intended for infants does not mean that it is safe for sleeping without supervision. A solid, flat, non-sloping surface that meets infant sleep safety standards remains the safest option.

Ofoq News: What about parents who are tired, so they put the infant in their bed to feed him or calm him down? Wayne: This is an important practical issue, because night feeding occurs at a time when parents are tired.

Adherence to safe sleeping practices can be facilitated by placing the infant's bed or cradle next to the parents' bed. After feeding or calming him, he should be returned to his separate sleeping place before the parents go back to sleep.

If a parent accidentally falls asleep while feeding the infant in bed, he must return him to his bed or cradle immediately after waking up. Pillows, blankets, and other soft items should also be kept away from the infant while feeding him, in case the parents nap.