National Center Quick-Look

Sleep-Related Infant Deaths

Collect:  The National Center for Fatality Review and Prevention collects information on sleep-related infant deaths in the National Fatality Review- Case Reporting System (NFR-CRS).

Data: This Quick-Look examines the 26,059 deaths of infants less than 12 months old whose deaths were related to the sleep environment.¹

Learn:  To see other Quick-Looks using NFR-CRS data and learn more, visit the National  Center’s website at ncfrp.org.

National Center’s Structural Inequity Statement

Some families lose infants, children and youth to the types of deaths reviewed by fatality review teams not as a result of the actions or behaviors of those who died, or their parents or caregivers. Social factors such as where they live, how much money or education they have and how they are treated because of their racial or ethnic backgrounds can also contribute to a child’s death. Segregation impacts access to high-quality education, employment opportunities, healthy foods and healthcare. Combined, the economic injustices associated with residential, educational, and occupational segregation have lasting health impacts that include adverse birth outcomes, infant mortality, high rates of homicide and gun violence and increased motor vehicle deaths.

Demographics and Birth History

22% of infants were low birth weight—weighing less than 5lbs. 8oz

25% of infants were preterm—born prior to the 37th week of pregnancy

Median age of the infants at time of death was 87 days

74% of infants were covered by Medicaid

86% of deaths occurred in the first 5 months of life

Race:

White (55%)
Black (33%)
Other (8%)
Missing (4%)

Age:

31% aged 0 – 1 month (10% of these were in the first 27 days)
37% ages 2 or 3 months
18% ages 4 or 5 months
8% ages 6 or 7 months
6% ages 8 through 11 months

Incident Details

51% occurred in an adult bed

56% of sleep environments contained soft objects like pillows, blankets, or bumper pads

21% were found in a new or different sleeping environment

66% were surface-sharing with another person at the time of the incident

24% occurred in a crib or bassinette

37% were found on their back
48% were found on their stomach
16% were found on their side

When their status was known, 79% of supervisors were not impaired at the time of incident*
*Whether a supervisor was impaired was unknown in 14% of these cases

Investigation and Community Response

Death scene investigation was conducted in 97% of deaths

Primary cause of death

36% injury
Of injuries, 87% were determined to be asphyxia

25% medical condition
Of medical causes, 68% were determined to be SIDS

36% undetermined if injury or medical condition
Of undetermined causes, 88% were undetermined manner

Community Response Site-Specific Recommendations

Delaware:

Launched an infant safe sleep media campaign to increase community awareness about unsafe sleep risk factors

Michigan:

Passed the Infant Safe Sleep Awareness and Education Act, requiring hospitals to provide infant safe sleep education and materials before post-birth hospital discharge

Tennessee:

Implemented the Direct On Scene Education (DOSE) program, training first responders to identify unsafe infant sleep conditions and provide a safe sleep kit and education to pregnant women or families when called out to homes

Prevention Resources

Safe Sleep for Babies, Centers for Disease Control and Prevention
https://www.cdc.gov/vitalsigns/safesleep/index.html

Safe to Sleep, National Institute for Child Health and Human Development
https://safetosleep.nichd.nih.gov/

Safe Sleep, American Academy of Pediatrics
https://www.aap.org/en-us/about-the-aap/aap-press-room/campaigns/Safe-Sleep/Pages/default.aspx

This quick look was made possible in part by Cooperative Agreement Numbers UG7MC28482 and UG7MC31831 from the US Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB) as part of an award totaling $1,099,997 annually with 0 percent financed with non-governmental sources. Its contents are solely the responsibility of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

¹These data have been reviewed and recorded into the NFR-CRS by participating fatality review teams.  Some percentages may not add up to 100% due to rounding.

These data represent a smaller percent of the cases entered into the CRS. For more information about the data contained in this Quick-Look, please visit https://ncfrp.org/wp-content/uploads/NCRPCD-Docs/NCFRP_Quick_Looks_Analysis.pdf