Study: Blacks Uninformed Of SIDS Risks
Infants Sleeping On Stomachs At Most Risk
A new government-funded study found that infants who sleep on their stomachs have an increased risk of sudden infant death syndrome -- and there's a racial gap in parents' knowledge of risk factors.
Previously, researchers had relied largely on overseas studies for making the recommendation that infants be placed on their backs to sleep to reduce their risk for SIDS.
The study, published in the October issue of Pediatrics, found that infants placed to sleep on their stomachs were at more than twice the risk for SIDS as were infants sleeping in other positions.
The research was supported by the National Institute of Child Health and Human Development, the National Institute on Deafness and other Communication Disorders, and the Centers for Disease Control and Prevention.
In all, the researchers examined the records of 260 infants from the ages of birth to 1 year who had died of SIDS in Chicago between November 1993 and April 1996. Of these, 75 percent were black, 13 percent were Hispanic, and another 12 percent were white.
In their study, the researchers used the NICHD definition of SIDS: "the sudden death of an infant under 1 year of age, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history."
The results support the 1992 and 1996 recommendations by the American Academy of Pediatrics that infants be placed to sleep on their backs to reduce the risk of SIDS.
The study found that blacks at that time were less likely than whites to have been informed by health care personnel to avoid placing infants to sleep on their stomachs. Forty-three percent of black parents usually placed their babies sleep on their stomachs, compared to 12 percent for the other groups, the study found.
Most of the SIDS deaths occurred within the first four months of life, with most of these occurring between the first month and the third month. And consistent with other studies, most of the SIDS infants had died in the fall or winter -- 64 percent.
"Racial and ethnic disparities in infant mortality have been among the most persistent in our society," said Dr. James Marks, director of the CDC's chronic disease program. "This study suggests that at least some of the disparity can be eliminated by wide use of the supine [back] sleeping position among African-American infants."
In the study, 64 percent of mothers in the control group said that a doctor or nurse had advised them after delivery about infant sleeping position. The most common recommendation was that infants be placed to sleep on their sides, consistent with recommendations at that time. The next most common recommendation was that infants be placed to sleep on their stomachs. The study authors theorized that, at the time, many health care professionals feared that infants placed to sleep on their backs might choke on vomit if they happened to spit up during the night.
However, only 46 percent of those whose infants had died of SIDS said they had received advice from health care professionals on how to place their infants for sleep. For both the SIDS infants and controls, a greater proportion of blacks (25 percent) than whites (7 percent) said they had been advised to place their infants to sleep on their stomachs.
"Our study highlights the need for health care professionals to inform parents of all racial and ethnic backgrounds about the importance of placing their infants to sleep on their backs," said the study's lead investigator, Dr. Fern Hauck, now with the Department of Family Medicine at the University of Virginia Health System in Charlottesville.
In 1992, the American Academy of Pediatrics recommended that infants not be placed to sleep on their stomachs. The AAP revised this recommendation in 1996, to say that placement on the back is the preferred sleeping position for all healthy infants.
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