Since 1992, the government’s Back-to-Sleep Campaign has encouraged parents to place infants on their backs to sleep. Still, more than 4,500 infants die unexpectedly during sleep each year in the United States. Now, a University of Missouri injury prevention researcher says that safe, separate sleep environments for infants are critical to preventing sudden unexpected infant deaths (SUIDs).

"Many of these SUIDs are due to unsafe sleep environments, and these deaths are totally preventable," said Patricia Schnitzer, an associate professor in the MU Sinclair School of Nursing. "The safest place for infants to sleep is on their backs in their own cribs without soft bedding."

Schnitzer and her colleagues reviewed infant death case reports listing the families’ information and causes of death from the National Child Death Review Case Reporting System. The researchers identified risk factors for sleep-related SUIDs based on data from nine states, including California, Delaware, Hawaii, Michigan, Nevada, Ohio, Pennsylvania, Tennessee, and Texas. Their study of more than 3,000 infant deaths found that 70% of SUID victims were on surfaces not suitable for infants, such as adult beds or couches, and 64% of the babies were sharing sleeping surfaces, often with adults.

Although many parents now recognize that infants should sleep on their backs, Schnitzer says the Back-to-Sleep message doesn’t explain all of the possible dangers in sleep environments, such as sharing beds, sleeping on soft bedding or furniture, or sleeping near objects that could suffocate infants, including blankets, stuffed animals, and crib bumpers.

"Many public health organizations and researchers have focused on safe sleep environments; now we need to understand if people aren’t getting that message or if they’re disregarding it," Schnitzer said.

The study, "Sudden Unexpected Infant Deaths: Sleep Environment and Circumstances," was published in the American Journal of Public Health and was funded by the Health Resources and Services Administration’s Maternal and Child Health Bureau.