States now focus on saving babies from unsafe-sleep deaths

Faced with mounting evidence that a majority of sudden unexpected infant deaths are related to unsafe sleep conditions, several states are intensifying efforts to keep babies out of adult beds and sleeping alone.Officials in Georgia, West Virginia and New York are among jurisdictions with recent campaigns to educate social workers, public health nurses and parents of the threats posed to babies laid down anywhere but a properly made crib.Some experts estimate that as many as 3,600 of the more than 4,500 sudden unexpected infant deaths each year could be prevented if babies were placed in a safe spot and position every time they're laid down to sleep.A national campaign for a safer infant sleep environment was started in the mid-1990s and continues today. But that program, called "Back to Sleep," emphasized placing babies on their backs to sleep over other aspects of baby sleep surroundings in a bid to reduce the risk of Sudden Infant Death Syndrome.The new state initiatives underscore a trend reported by Scripps Howard News Service last fall: While only one in six sudden infant deaths are attributed to accidental suffocation in national statistics, incomplete probes and biased diagnoses may mask the true causes of many other infant fatalities labeled SIDS deaths.Scripps established that babies are about twice as likely to be found to have died from accidental suffocation in places that carry out independent examinations of child deaths compared to locations where there is little or no review.It is those kinds of reviews that are driving the new safe sleep efforts.West Virginia's Child Fatality Review Team, for instance, now uses a sudden unexplained infant death classification for deaths that in the past were considered SIDS -- a category that's supposed to mean no other cause of death could be determined through an autopsy and medical history.According to the review team's latest report for 2004-05, issued in May, 45 of the 64 infants who died unexpectedly were sleeping with at least one other person, and the same proportion were surrounded by unsafe bedding -- pillows, heavy blankets, quilts or comforters."We've been working hard for several years now to get the word out about these dangers. A lot of our initial focus has been making sure everyone who talks to new moms is aware of safe sleep practices and that they're giving the same message,'' said Maureen Runyon, coordinator for the West Virginia fatality review team."Once people see the data on the risks of bed sharing, it usually changes their opinion. Parents need to know that if you do these things, you greatly increase the risk that your child is going to die,'' Runyon said.Medical investigators around New York are also re-examining their records and discovering most of the unexpected infant deaths in their areas are neither SIDS nor of unknowable causes. Instead, most of these babies suffocated."That's what's happened in my area. We had 21 infant deaths recently, but 15 of them had something very wrong with their sleeping arrangements," said James Terzian, a forensic pathologist based in Binghamton, N.Y. "Nine of them were co-sleeping with adults."Similarly, in Georgia -- where more than half of the 144 sudden infant deaths investigated by the state's Child Fatality Review Panel in 2005 were sleeping in an adult bed -- officials at the Division of Family and Children Services are making sure its workers are aware of the threat and communicating the danger to new parents."These are preventable deaths, '' said Mary Dean Harvey, director of the division, which started its campaign last winter. "What we're seeing in the child fatality reports is that where the child sleeps is critical to infant safety. One co-sleeping infant death is one too many."In New York state, medical and health officials have begun a "Babies Sleep Safest Alone" campaign warning parents not to sleep in the same bed with their infants."Just over a dozen small children died so far this year in beds they were sharing with their caregivers," Commissioner Gladys Carrion of the New York State Office of Children and Family Services said of the $500,000 effort. "These may have been preventable deaths."It was the first admission in several years by New York health officials that unexpected infant death is still a major problem.State health officials were embarrassed last year when critics decried their official report that only 23 infants died of Sudden Infant Death Syndrome in 2004, giving New York the nation's lowest reported rate of SIDS. Four years earlier, the state reported 115 such deaths.What drove the declining SIDS rate, Terzian said, was actually a dramatic rise in the number of infants who were reported to have died of "unknown" or "undetermined" causes, a scientifically useless diagnosis.New York leads the nation in reporting infant deaths of undetermined cause, according to Scripps' study of 20,000 infant deaths. Only 5 percent of infant deaths in the state were reported to be accidental asphyxiation caused by sharing a bed with adults or other unsafe sleeping practices, the kind of accidents the state's new campaign seeks to prevent.Authorities with the New York State Department of Health declined to be interviewed for this story. But they apparently are making changes. The state recently reported there were 49 SIDS cases in 2005, more than doubling the number from 2004.(Distributed by Scripps Howard News Service, http://www.scrippsnews.net)