Back to Sleep campaign renews efforts to reduce the risk of Sudden Infant Death Syndrome in the African American community

The Back to Sleep campaign marks its tenth anniversary this October with renewed efforts to reduce the risk of Sudden Infant Death Syndrome (SIDS) in the African American community by reminding parents and caregivers to always place infants on their backs to sleep.

The Back to Sleep campaign is sponsored by the National Institute of Child Health and Human Development of the National Institutes of Health.

Since the campaign began 10 years ago, the SIDS rate for African Americans has declined dramatically, as it has for the total population. Still, the SIDS rate for African Americans is twice that of whites.

During October, which is also SIDS Awareness Month, the Back to Sleep campaign will run public service announcements on radio stations around the country and display ads on buses in the Washington, D.C., area to remind African American parents, grandparents, and caregivers about reducing the risk of SIDS.

Despite the dramatic decline in SIDS over the last decade, SIDS still claims the lives of roughly 2,500 infants each year. SIDS is the sudden, unexplained death of an infant in the first year of life. The causes of SIDS are still unclear and it is not yet possible to predict which infants might die of SIDS. However, it is possible to reduce factors known to increase SIDS risk:

• Always place a baby to sleep on his or her back—even at naptime
• Don’t smoke around a baby
• Don’t smoke if you’re pregnant
• Place a baby on a firm mattress, such as in a safety-approved crib
• Remove soft, fluffy bedding and stuffed toys from a baby’s sleep areas
• Keep blankets and other coverings away from a baby’s nose and mouth
• Don’t put too many layers of clothing or blankets on a baby
• Make sure everyone who cares for a baby knows that infants should be placed to sleep on their backs and knows the other ways to reduce SIDS risk

NICHD’s Back to Sleep campaign recommends that, unless there’s a medical reason not to, infants should be placed on their backs to sleep, on a firm mattress with no blankets or fluffy bedding under or over them. If a blanket is used, it should be placed no higher than a baby’s chest and be tucked in under the crib mattress. The baby’s sleep area should be free of pillows and stuffed toys, and the temperature in the baby’s room should be kept at a level that feels comfortable for an adult.

“We’ve made great progress over the last decade in cutting the SIDS rate for African American infants by almost 50 percent, but we need to reinforce our efforts,” said Duane Alexander, M.D., Director of the NICHD.

The recommendation to place infants to sleep on their backs resulted from years of careful research sparked by the observation that infants in other countries who were placed to sleep on their backs were less likely to die of SIDS. Research on European infants, funded by the NICHD, provided further evidence that placing infants to sleep on their backs reduced their risk of SIDS. Finally, a large study that took place in Chicago confirmed that the practice of placing infants to sleep on their backs helped reduce SIDS risk. The studies were needed to confirm that placing infants to sleep on their backs did not increase the risk for any other health problems. At the time the studies were undertaken, many health care providers feared that infants placed to sleep on their backs might choke on vomit if they happened to spit up during the night.

The research resulted in a 1992 recommendation from the American Academy of Pediatrics (AAP) that infants not be placed on their stomachs to sleep. Based on information from additional studies, the AAP later revised its recommendation to say that, unless there was a medical reason not to, that all infants be placed to sleep on their backs.

Over the last decade, research supported by the NICHD has yielded other findings on the benefits of back sleeping for infants and additional information on risk factors for SIDS. These findings include:

• Infants who sleep on their backs have fewer fevers and ear infections
• Infants who share a bed with other children or who sleep on soft bedding are at a higher risk of SIDS than are other infants
• Infants accustomed to sleeping on their backs who are then placed to sleep on their stomachs or sides are at an increased risk for SIDS—greater than the increased SIDS risk of infants always placed on their stomachs or sides

In 1994, the NICHD formed a coalition of national organizations to launch the Back to Sleep campaign. Since the start of the NICHD-led campaign that year, the SIDS rates for both groups have declined by about 50 percent, but a significant disparity still remains.

Last year, the NICHD joined forces with three national African American women's organizations in a program to reduce the risk of SIDS among African American infants. The leadership and members of the National Coalition of 100 Black Women, Inc.; the Women in the NAACP; and Alpha Kappa Alpha Sorority, Inc. held three summits with the NICHD to learn how to conduct SIDS risk reduction training and outreach activities in communities around the country.

“The summits were a springboard for sharing vital information with a network of community leaders who will help us end a historical trend that unnecessarily has African American infants at higher risk of SIDS," said Yvonne T. Maddox, Ph.D., Deputy Director of the NICHD, who forged the collaboration with the three African American organizations.