Oct. 7, 2002 -- Black babies are more than twice as likely to die from Sudden Infant Death Syndrome (SIDS) than white babies, and a new study suggests that how the infants are put to sleep might be the critical difference behind the racial disparity.
Researchers studied all of the SIDS deaths reported in Chicago between November 1993 and April 1996 and found infants who were placed to sleep on their stomachs had twice the risk of SIDS as those who slept in other positions. About a third of the deaths could be attributed to putting the child to sleep on his or her stomach.
Of the 260 SIDS deaths, 75% of the victims were black, and researchers found that black parents were more than three times as likely to put their babies to sleep on their stomachs compared with other ethnic or racial groups.
Their findings appear in the October issue of Pediatrics.
"This is the largest, most comprehensive study of SIDS risk in an urban, high-risk setting," said Duane Alexander, MD, director of the National Institute of Child Health and Development (NICHD), which supported the research, in a news release. "Other studies have linked sleeping on the stomach with Sudden Infant Death Syndrome, but the Chicago Infant Mortality Study makes the strongest case to date."
In 1992, the American Academy of Pediatrics introduced the idea that infants not be placed on their stomachs. In 1996 the group revised its recommendations to say that placing sleeping infants on their backs is the preferred position for all healthy babies.
"Back to Sleep," a national public health campaign, was launched in 1994 by the NICHD and national coalitions to educate parents, family members, healthcare providers, and other caregivers about back sleeping. Officials say the campaign has reduced SIDS deaths by 50%.
But researchers say this study shows that the message about putting babies to sleep on their backs isn't reaching everyone.
"Our study highlights the need for healthcare professionals to inform all parents of all racial and ethnic backgrounds about the importance of placing their infants to sleep on their backs," said researcher Fern R. Hauck, MD, MS, who is with the department of family medicine at the University of Virginia Health System in Charlottesville.
Only 46% of the parents whose child had died of SIDS said they received advice from healthcare providers on how to place their infants for sleep. In addition, 25% of blacks said they had been advised to place their babies to sleep on their stomach, compared with 7% of whites who said they received similar advice.
The researchers say that at the time many healthcare providers may have feared infants who were put to sleep on their backs might face a choking risk if they spit up during the night. Those fears later proved unfounded.
The study also confirmed the results of previous research that shows the SIDS risk is greatest in the first four months of life, and SIDS deaths are more likely to occur in the fall and winter months.
Researchers say healthcare providers need to make a better effort to reinforce the "back to sleep" recommendations to parents and caregivers immediately after birth and at each medical encounter thereafter. -->