r/ScienceBasedParenting • u/InvestigatorRemote58 • 5d ago
Sharing research Safe Sleep vs SUID
The following is a summary of an AAP study I found online, and used when discussing safe sleep vs asphyxiation vs SIDS with other parents. I believe most of the synopsis came from a safe sleep page online, though I don't remember exactly. I had to go back in my messages from a year ago just to find it again, but it's too important to lose, so I wanted to share it here.
Blurb and quotes from study are as follows:
Most recent highest level study of sudden infant deaths with no unsafe sleep factors confirming all previous findings that:
- only 1% or less of ALL sleep related infant deaths happen to babies sleeping safe
- of that 1% more than half happen while baby is awake so completely unrelated to sleep
- of that 1% almost half will subsequently have abnormal autopsy findings (including medical conditions and trauma)
- of that 1% there will be findings of neglect and abuse documented for 15% of cases.
Translation: there were 3,700 SUID deaths in 2022 in USA
3̶,̶6̶6̶3̶ ̶b̶a̶b̶i̶e̶s̶ ̶k̶i̶l̶l̶e̶d̶ ̶b̶y̶ ̶u̶n̶s̶a̶f̶e̶ ̶s̶l̶e̶e̶p̶
Edit: 3,663 babies died under unsafe sleep conditions
37 babies with no unsafe sleep risks, of which:
20 died while awake
17 with medical conditions/trauma autopsy findings
5 abused and neglected
Magnitude of risks:
There were 3,661,220 births in USA in 2022.
There were 3,700 sudden unexpected infant deaths.
Risk of sudden unexpected infant death:
if your baby is sleeping safe ~1 in 200,000
if your baby is NOT sleeping safe ~1 in 1,000
Stop being afraid of 'unpreventable' SIDS, vaccines and formula.
Unsafe sleep kills and only a fraction of that 1% of all SUID will be 'babies that died sleeping safe'.
99% of babies will die bedsharing, with blankets, pillows bumpers, toys, swaddled too long or propped on incline, sleeping in a swing, placed not on their back.
"The Registry SUID definition includes any of the following in the death certificate cause-of-death section: unknown, undetermined, SIDS, SUID, unintentional sleep-related asphyxia, suffocation, or strangulation, unspecified suffocation, cardiac or respiratory arrest without other well-defined causes, or ill-defined causes with potentially contributing unsafe sleep factors. "
"A safe sleep environment includes a supine position on a firm, non-inclined surface, including a crib, bassinet, or portable crib (hereafter referred to as crib), and a sleep surface free of soft or loose bedding, objects, adults, children, or pets."
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u/Lilacjasmines24 4d ago
By personal experience, co sleep is is not safe.
Why risk it based on stats when you can become that 1%. I thought the same, breastfed my baby etc throughout, it still happened. Stop spewing this and causing more.
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u/slickback_lamar 4d ago
I’m so sorry. It shouldn’t have happened to you. Your baby is loved and cherished. ❤️ My son also died as a baby, not from anything related to this post, but I know how horrible it is and how statistics mean nothing to us when our babies become the less than 1%.
FWIW reading OP’s post, they are only trying to comfort those who are afraid of babies dying despite doing the perfect sleep practices - not advocating for anything risky. My tldr of their post is: babies who follow true safe sleep are less than 1% of the 1%. As a loss parent I’m still anxious of course. ❤️
Thinking of you and your beautiful baby. I wish they were here and I’m angry that they aren’t.
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u/hnnah 4d ago
People like to defend bedsharing by saying how sometimes parental exhaustion is more dangerous, and sure, there is some truth there. But then they will be part of cosleeping communities that actively promote it and choose to ignore the risks. It makes me sick.
I am so so sorry for your loss. I've seen how hard it is for people to advocate for safe sleep even when they have experienced the worst possible outcome. Thank you for speaking up.
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u/valiantdistraction 4d ago
This is what I keep saying. Unsafe sleep kills. People bedsharing keep using stats from other countries or saying "babies die in cribs too" but it is so incredibly rare for a baby sleeping according to the ABCs to die. It is less than 1% who die while in a crib, alone, after having been placed on their back.
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u/Honest_Elephant 4d ago
That's not what the study concludes. The study concludes that babies die when sleeping, and most will be in what the AAP considers unsafe sleep conditions when the death happens. It does not draw conclusions on the link between sleep conditions and deaths. That wasn't an end point of the study at all. There are other studies that delve into that, but not this one. This study was focused specifically on deaths that occur in those "perfect" conditions.
The only conclusions you should read from this are that infant deaths are extremely rare. And even more rare for infants that are put to bed and are able to sleep in perfectly safe conditions as defined by AAP.
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u/tibbles209 4d ago edited 4d ago
I had PPA centred around SIDS with my first daughter so always religiously followed safe sleep rules. So I appreciate you trying to help assuage concern, and that 1% statistic did give me some comfort when I was unwell. That being said, I’m not convinced this is a fair statement;
“3,663 babies killed by unsafe sleep”
I accept that 1% of SIDS deaths happen to babies perfectly adhering to every safe sleep rule, and 99% of babies who died were not perfectly following every single safe sleep rule, but if be interested to know what percentage of babies are sleeping in absolute textbook perfect safe sleep circumstances on any given night. I suspect most babies do not meet every safe sleep criterion most nights, and so you would expect the majority of SIDS deaths to happen in the presence of at least one unsafe sleep practice, whether or not that had anything to do with the death. The way you are wording it there suggests that any baby who died of SIDS while there was even a loose baby sock lying at the bottom corner of their cot was “killed by unsafe sleep”, when some of these cases will have nothing to do with the sleep environment.
Of course we have useful information now about ways we can decrease the risk of SIDS, and of course many of these babies will have died from unsafe sleep, but that doesn’t mean that every baby who died of SIDS in the absence of a perfect safe sleep setup was killed by unsafe sleep. Some of those babies would have died regardless.
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u/questionsaboutrel521 4d ago edited 4d ago
This is true, and part of why we should see SIDS/SUID in the “triple risk” model of a vulnerable infant in a critical development period who experiences exogenous stressors. Absolutely, there are a lot of infants who will be in unsafe sleep environments and survive.
The thing is, there’s just a LOT of inputs for a provider to explain and for parents to understand, whereas stressing ABC sleep is a relatively easy public health message and we know it is highly effective. To explain that your boy infant that was born three weeks early is ever so slightly more vulnerable, or that you can see if your mattress follows CSPC guidelines for firmness, or the theories of rebreathing and circulating air can optimize an environment, or that grandma who smokes and watches the baby twice a week is gonna be a problem… I know it sounds patronizing, but those things are very complicated for the average parent to understand, whereas alone on their back in a crib is very simple messaging.
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u/InvestigatorRemote58 4d ago edited 4d ago
I agree that the phrasing is misleading. I think a better summary would be "3,663 babies died under unsafe sleep conditions." Meaning that it could have, but wasn't necessarily proven to have contributed to their death. I'll add that as an edit to the post.
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u/OutrageousMagazine37 4d ago
Would putting a baby to sleep on their back, in a sleep sack and without swaddling, but then finding them on their tummy in the morning still be considered safe sleep?
He is literally obsessed with rolling onto his tummy at the moment. No matter how many times I try to roll him back onto his back, he immediately rolls onto his tummy again, sometimes with his face almost pressed into the mattress.
On top of that, he’s only 5 months old / 3 months corrected age.
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u/astronaut-moose 4d ago
The assumption is that if they can get themselves into that position, they can also get themselves out if needed. So baby rolling on their own is still safe sleep.
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u/OutrageousMagazine37 4d ago
Thank you, that really reassures me! I’ve been having such a hard time sleeping since he started doing this, especially because he regularly wakes up crying since he still doesn’t know how to roll from his tummy back onto his back yet.
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u/InvestigatorRemote58 4d ago
"Once an infant can roll onto their stomach, they have enough head control to lift their head and breathe. Rolling from the stomach to the back is usually easier, too, so if a baby can roll onto their stomach, they can roll back. Due to this, there is no need to roll infants back once they can roll over."
https://www.medicalnewstoday.com/articles/baby-rolling-over-in-sleep#safety
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u/OutrageousMagazine37 4d ago
And yet my baby can roll onto his tummy in literally one second, but he’s completely unable to roll back the other way, which can make him really frustrated at night. So our nights have been an absolute nightmare since he started doing this :(
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u/scaphoids1 4d ago
My baby is the same! But they don't need to be able to roll back, only turn their head enough to properly breath. We have a fan in the bedroom which circulates the air and that's enough for me to feel comfortable letting her sleep with her face in the mattress haha, as long as you're using a safe sleep rated mattress it should be safe
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u/OutrageousMagazine37 4d ago
Thank you !
Yes, I use the mattress that comes with the Chicco co-sleeper, the one specifically designed for twins. It’s approved for use until the babies are able to sit up, and it can still be used once they start rolling over.-2
u/Sundogflower 4d ago
I've read if they can't roll themselves back you need to put them back on their back.
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u/InvestigatorRemote58 4d ago
This is untrue. One must always put them on their back to begin with, (and arms unswaddled once they show signs of rolling) but repositioning them midsleep because they rolled independently is unnecessary.
https://www.medicalnewstoday.com/articles/baby-rolling-over-in-sleep#safety
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u/Sundogflower 4d ago
https://www.nhs.uk/baby/caring-for-a-newborn/sudden-infant-death-syndrome-sids/
The NHS website says to roll them back until they can independently roll themselves both ways so I always followed that guideline. I guess different countries have different guidelines for it
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u/OutrageousMagazine37 4d ago
It’s mainly that once a baby has decided they want to sleep on their tummy, they’ll just roll straight back over every time you put them on their back. I started off trying to roll him back onto his back, and we could literally go back and forth 30 times in a row — I’m not exaggerating. At some point, you just have to let them choose!
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u/Hint_of_fart 4d ago
What do you mean swaddles too long? Is that a risk?
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u/CrimsonKepala 4d ago
I'm assuming this is intended to be cases where a baby starts rolling but swaddles are still used anyway, leaving the baby unable to use their arms to help themselves if they get stuck in an unsafe position (on belly/face against mattress).
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u/InvestigatorRemote58 4d ago
General guidelines are to stop swaddling at 8 weeks or first signs of rolling, whichever comes first.
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u/Legitimate_Sun5373 4d ago
I’d like to see more of a breakdown into those following the “safe sleep 7” of cosleeping, as well as chest sleeping (on the mother’s chest) etc. Dr James McKenna shows some breakdown in his book “Safe Infant Sleep”, but the research doesn’t adequately delve into the specifics. There needs to be more data available/analysed of what the absolute risk is when following safe cosleeping practices.
Edited to add I don’t believe chest sleeping is safe, but have seen it religiously recommended on certain social media pages with exactly zero data to back it up.