Infant death toll hard to conquer; new practices cited

The rate of Sudden Unexpected Infant Death among newborns in the first month of life has stayed the same over two decades, despite safer sleep recommendations, local researchers have found.

“The frequency of SUID in the first month of life is higher than generally recognized, at an average of 444 cases per year in the U.S., of which 66 per year occur on the first day and 130 occur in the first week of life,” said Dr. Joel Bass, chairman of the Newton-Wellesley Hospital Department of Pediatrics. “The thought process behind this is the interventions we made affect the older age group, but not the younger age group.”

SUID is an umbrella term that includes Sudden Infant Death Syndrome (SIDS) — when a baby’s death is unexplained after investigation — and deaths found to result from accidental strangulation or suffocation.

Safe sleep recommendations include putting the baby on its back to sleep rather than face-down, taking objects like stuffed animals out of the crib, and refraining from sleeping with the baby. As a result, the rate of SUID among infants a month to a year old decreased from 1995 to 2002 by nearly 23 percent and then leveled off.

But surprisingly, the rate of these deaths among babies one month and younger remained at 11 per 100,000 between 1995 and 2014 with no change at all, according to a study out this week in the Journal of Pediatrics.

The paper was published by researchers at Newton-Wellesley and MassGeneral Hospital for Children.

According to Bass, there could be several new practices that have contributed to such deaths in newborn babies — including skin-to-skin care, which is when an infant is placed facedown on the mother’s chest as a way to bond and regulate temperature.

But without proper monitoring, it could be dangerous.

“It’s inherently contradictory to safe sleep because they’re not on a bed, and they may be overheated,” Bass said. “You’re in this position (at) 2 in the morning exhausted in bed, and you don’t know the baby has stopped breathing.”

Dr. Tina Gartley, a pediatrician at Newton-Wellesley and co-author on the paper, said pacifiers have also been shown to help reduce SUID, but have been rejected by some mothers who fear it could interfere with breastfeeding.

“I think we should work in many different ways to decrease the incidence of SUID,” Gartley said, “And we as physicians should be sending very clear messages of what is the safest way for babies to sleep.”