The success of the public health campaign “Back-to-Sleep,” which encouraged parents to place infants to sleep on their back and avoid potential suffocation hazards such as soft bedding in cribs, is only one factor in lower rates of sudden infant death syndrome (SIDS), according to a report published online ahead of print December 2 in Pediatrics. 

Lead author Richard Goldstein, MD, and colleagues analyzed data on infant mortality from 1983 to 2012, finding an overall decrease of 71% in deaths attributed to SIDS. Positive trends in other factors, which have been associated with susceptibility to SIDS, may have contributed to the decrease. These include better prenatal and neonatal care, greater rates of breast feeding, and lower rates of smoking during pregnancy and teen pregnancy. For instance, rates of pregnant women who smoked decreased from 16% in 1987 to 10% in 2011. In addition, the Back-to-Sleep campaign began at the same time as a substantial increase in the use of postnatal steroids, which reduce respiratory distress and are especially a factor for premature babies at higher risk of SIDS.

“While we continue to stress safe sleep environments, we should also move forward in improving overall maternal and infant health and in researching the underlying biology that may well also influence SIDS,” Dr. Goldstein said.

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