Sudden unexpected infant death rates show sharp rise

Sudden infant death syndrome has jumped significantly in the past two decades, according to a new report published in JAMA Pediatrics.  

This finding emerged from investigators’ study of infant mortality in the United States from 1999 to 2022. Using Centers for Disease Control and Prevention records, pediatric researchers from the Virginia Commonwealth University School of Medicine and the University of Washington School of Medicine analyzed 23 years of data.  

UW Medicine pediatrician Dr. Fred Rivara, a study co-author, said the team found that overall infant mortality decreased by 24%, which tracked with their expectations. 

What they did not expect were the upward trends for Sudden Unexpected Infant Death or SUID, which includes Sudden Infant Death Syndrome. Sudden unexpected infant death had jumped by 11.8%. 

Sudden unexpected infant death is the term used to describe the sudden and unexpected death of an infant under one year old. SUID is an umbrella term that includes deaths with known causes, such as accidents or injuries, and deaths with unknown causes.    

Both mortality rates and SUID rates jumped, especially viewed on the basis of racial and ethnic demographics, the researchers found. 

For example, SUID rates for Native Hawaiian and Pacific Islander and Black infants were three times higher than that for white infants.  

Mortality rates overall were higher among infants from diverse communities, the researchers found.  For example, mortality rates for Black infants were two to four times higher than that of white infants. The same mortality-rate trend was seen among Pacific Islander/Native Hawaiian infants. 

In discussing the increase in SUID across all racial groups, Rivara and his colleagues identified potential contributing factors: the COVID-19 pandemic, other respiratory illnesses, maternal opioid use — which dramatically increases the incidence of SUID — and social media misinformation recommending unsafe sleeping practices for infants. 

Tobacco use also increases risk, as well as maternal stress from housing issues, food shortages or work, he added.  

To sum up ways to try to reduce the risk of sudden unexpected infant death, Rivara advised not sleeping next to infants and not smoking around them. He also reminds parents and other care givers to make sure babies sleep on their backs. 

The American Academy of Pediatrics recommends these protocols to reduce the risk of sleep-related infant death: 

• Place infants on their backs for sleep in their own sleep space with no other people.  
• Use a crib, bassinet or portable play yard with a firm, flat mattress and a fitted sheet. Avoid sleep on a couch or armchair or in a seating device, like a swing or car safety seat (except while riding in the car).  
• Keep loose blankets, pillows, stuffed toys, bumpers and other soft items out of the sleep space.  
• Breastfeed if possible and avoid smoking. 

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