LOS ANGELES – In Los Angeles County, Sudden Infant Death Syndrome (SIDS) deaths among infants have declined markedly in the past decade, from 120 deaths per 100,000 births in 1990 to 29.5 deaths per 100,000 births in 1999. “We believe a significant portion of the decline is due to parents heeding the key message that placing infants on their back to sleep poses less of a risk for SIDS,” said Jonathan E. Fielding, M.D., M.P.H., Director of Public Health.
However, based on a new study on infant sleep by the Los Angeles County Department of Health Services (DHS), SIDS rates remain three times higher among African-Americans than other ethnic or racial groups in the county. Not all SIDS deaths can be prevented. However, placing an infant to sleep on his/her stomach is an important risk factor for SIDS; leading national child health organizations targeted this risk factor with the Back To Sleep campaign in 1994 recommending that infants be placed to sleep on their backs. Since the inception of the campaign, the rate of infant mortality due to SIDS in the U.S. declined by 15%. In addition to sleeping position, other modifiable factors associated with SIDS include maternal smoking while pregnant and exposure to environmental smoke.
The new DHS study is the first conducted in a large urban setting that examines infant sleep positions. The study found that only 10% of parents in the county reported placing their infants to sleep on their stomachs. However, 30% of African-American infants were placed to sleep on their stomachs compared to 13% of Asian/Pacific Islander infants, 11% of White infants and 7% of Latino infants. Infant sleep position did not vary significantly by other parent characteristics such as education level or income. “Delivering the ‘back to sleep’ message as well as working to improve overall prenatal care are important objectives to continue reducing SIDS in the county,” said Dr. Fielding. “Every SIDS death is a family tragedy. Clearly, the ‘back to sleep’ message has not reached all parents and efforts to reach African-American parents with this message are critical.”
The county’s Black Infant Health Program works with African- American women during their pregnancy to link them with higher quality prenatal care and after their babies are born to address personal and financial barriers to health care.
“We are working to reduce SIDS rates in the context of improving birth and early infant health outcomes overall,” said Cynthia Harding, Director of the County’s Maternal, Child and Adolescent Health programs. “For example, the African-American community experiences higher rates of low birth weight and lower rates of breastfeeding in addition to the low rates of placing infants on their backs to sleep. Addressing all of these important risk factors will improve infant health overall.”
The results of the survey are based on information provided by parents (or legal guardians) on a random countywide sample of 2,174 children birth through five years of age. Parents were asked in what sleeping position they placed their children from birth to six months of age (back, stomach, or side).
The findings are subject to several limitations: data on infant sleep position were based on parent recollection; parents may have given responses that they perceived to be socially desirable; and, the survey was limited to households with telephones.
The Los Angeles County Health Survey is a population-based telephone survey of approximately 8,000 households in the County, examining health and health- related issues for adults and children. Field Research Corporation conducted the survey for DHS with support from the California Department of Health Services and the Los Angeles County Department of Public Social Services. The survey was repeated in September 1999 through April 2000 and previously in 1997.
Public Health is committed to protecting and improving the health of the nearly 10 million residents of Los Angeles County. Through a variety of programs, community partnerships and services, Public Health oversees environmental health, disease control and community and family health. Public Health comprises more than 3,800 employees and has an annual budget exceeding $465 million.