Top Papers Of The Month

Unintentional Suffocation Among Infants Is Increasing

Author:
Jessica Tomaszewski, MD
Primary Care Pediatrics, Nemours Children’s Health System, Wilmington, Delaware

Citation:
Tomaszewski J. Unintentional suffocation among infants is increasing [published online April 25, 2018]. Consultant for Pediatricians.

 

 

Gao Y, Schwebel DC, Hu G. Infant mortality due to unintentional suffocation among infants younger than 1 year in the United States, 1999-2015. JAMA Pediatr. 2018;172(4):388-390. doi:10.1001/jamapediatrics.2017.4887.

 

Unintentional suffocation is a largely preventable cause of death in children younger than 1 year. Despite significant efforts to promote safe sleep practices, suffocation still caused 87% of deaths due to unintentional injury in this age group in the United States in 2015.

Gao and colleagues1 examined the recently updated data on mortality from unintentional suffocation from 1999 to 2015. Data were extracted from the Centers for Disease Control and Prevention (CDC) WONDER (Wide-Ranging Online Data for Epidemiologic Research) database with the use of International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes w75 to w84. Rate ratios in mortality for this period were calculated, with special consideration given to specific variables such as sex, race, and urbanization.

The rate of unintentional suffocation death among infants younger than 1 year increased from 12.4 per 100,000 in 1999 to 28.3 per 100,000 in 2015.

The increase in suffocations and strangulations in bed was the primary driver for the overall increase in unintentional mortality from 1999 to 2015. The increase in mortality rate was also noted among all subgroups, including those based on sex, race (white and black), ethnicity (Hispanic and non-Hispanic), and urbanization (urban and rural), without significant variation across groups.

The increase in rates of unintentional suffocation among infants younger than 1 year is disturbing, especially given that the majority of these fatalities are related to strangulation in bed.

“There is insufficient evidence to interpret the mechanism behind our results, especially the 1.27-fold increase in mortality,” the authors wrote. “The observed increase is likely associated with multiple factors, including use of unsafe products and improved differentiation between suffocation and SIDS in death certificate reporting. Regardless of the cause, our data indicate more than 1100 preventable infant deaths occurred in 2015, a statistic that warrants attention and action.”1

Despite education from primary care providers and campaigns by the CDC2, unsafe sleeping environments persist. This may be in part due to baby products such as sleep positioners that are not approved by the US Food and Drug Administration or crib bumpers that can be purchased despite clear data about suffocation deaths from the Consumer Product Safety Commission.3 Government and nongovernment agencies must continue and enhance their efforts going forward, along with continuing to educate pediatricians and other primary care providers about safe sleep practices.

References:

  1. Gao Y, Schwebel DC, Hu G. Infant mortality due to unintentional suffocation among infants younger than 1 year in the United States, 1999-2015. JAMA Pediatr. 2018;172(4):388-390. doi:10.1001/jamapediatrics.2017.4887.
  2. Safe sleep for babies: eliminating hazards. Centers for Disease Control and Prevention Web site. https://www.cdc.gov/vitalsigns/safesleep/index.html. Updated January 9, 2018. Accessed April 19, 2018.
  3. Scheers NJ, Woodard DW, Thach BT. Crib bumpers continue to cause infant deaths: a need for a new preventive approach. J Pediatr. 2016;169:93-97.e1. doi:10.1016/j.jpeds.2015.10.050.