Most Sudden Unexpected Infant Deaths Are Linked to Unsafe Sleeping Areas: Study

CPSC has been targeting unsafe infant sleeping arrangements, initiating a ban on inclined infant sleepers and crib bumpers last year. However, it continues to be the most common cause of unexpected infant deaths.

Most infants who die unexpectedly before their first birthday were sharing a bed with parent or sibling, and many were placed in an unsafe sleeping position, according to the findings of a new study.

Researchers from the U.S. Centers for Disease Control and Prevention (CDC) indicate that more than half of sudden unexpected infant death (SUID) cases were linked to a baby’s sleeping environment, including where they slept, what position they were placed in to sleep, and if they were sleeping with another individual, according to findings of a new study published this month in the medical journal Pediatrics.

The study examined SUID data from 2011 and 2020 reported to the CDC’s SUID Case Registry. The data included infant death reports from 23 states that were due to SUID, sudden infant death syndrome (SIDS), unintentional sleep-related asphyxia, suffocation, strangulation, cardiac or respiratory arrest, or other unknown causes.

SUID Linked to Sleeping Arrangements

According to the data, 59.5% of infants who suddenly died before one year old were sleeping with someone else when they died. Researchers also identified multiple unsafe sleeping practices among at least 76% of all SUID cases.

Approximately 8,192 SUID cases occurred during the study period, and researchers analyzed of those 7,595 cases, after excluding those with missing or unknown data. The data revealed that over half of the infants that died shared sleeping surfaces with others, with 68.2% sharing beds with an adult, and 75.9% sleeping in an adult bed when they died.

Among infants who co-slept with others, over 73% were under three months old, and nearly 80% were sleeping in an adult bed. Nearly 70% shared beds with one or more adults, 21.9% slept with adults and other children, and 7.6% slept with other children.

Soft bedding around the sleeping area was reported in 68.3% of those cases, among several other contributing factors that made their sleeping environment unsafe. At least 31% were sleeping on a surface with soft bedding or loose objects nearby, slept outside of a crib or bassinet, and were placed on their side or stomach.

Researchers found 87.2% of SUID involving bed sharing were supervised by a parent at time of death, and 16.3% were supervised by someone impaired by drugs or alcohol. They also found 18.6% of co-sleeping infant homes did not have a crib.

Households with multiple infants had more instances of bed sharing compared to those with only one baby, according to the findings. Among those cases, 73.1% slept in the same bed, and 25.8% were placed on an unsafe sleeping surface and in an unsafe sleeping position.

The findings suggest shared sleeping surfaces, sleeping on the side or back, and sleeping on soft bedding or in anything other than a crib may be linked to SUID. Researchers indicate the findings can help educate parents and caregivers on safe sleeping practices for babies, which may help prevent SUID cases.

Ban on Inclined Infant Sleepers and Crib Bumpers

Federal regulators have been warning that unsafe sleeping arrangements, often in the form of padding placed in the crib or inclined sleeping devices, are a high risk to young children in recent years.

The U.S. Consumer Product Safety Commission (CPSC) banned inclined infant sleepers and crib bumpers from the market in August 2023, after they were linked to a number of infant deaths caused by suffocation and asphyxiation.

The ban established safety standards to address hazards posed by millions of infant sleep products following years of reports involving infants dying after they rolled over and became trapped against the fabric.

The relatively new rules banned sleep products intended for infants under five months of age from exceeding an elevation of 10 degrees. They also banned padded crib bumpers, vinyl bumper guards, and vertical slat crib covers with fabric or material that cover or block access to the crib’s side opening, and required compliance testing for infant sleep products currently on the market.