- The Washington Times - Sunday, June 11, 2000

Many babies are still being placed on their stomachs to sleep, despite a campaign by pediatricians to encourage placing babies in a position to reduce the risk of sudden infant death syndrome (SIDS).

SIDS is the sudden, unexplained death of an infant younger than 1 while sleeping. It is the leading cause of death in babies between 1 and 12 months of age.

The American Academy of Pediatrics (AAP) reports the rate of SIDS has decreased by 40 percent since 1992, when pediatricians began recommending that babies be placed on their side or back to sleep. Another contributor to the decline was the start of the AAP's "Back to Sleep" publicity campaign in 1994.

The rate of decline has leveled off in the past year, however, and nearly 3,000 babies are still succumbing to SIDS annually, according to National Institutes of Health (NIH) data.

"Back placement is increasing but has not reached desired levels," says SIDS specialist Marian Willinger of the National Institute of Child Health and Human Development.

Dr. John Kattwinkel, chairman of the AAP's task force on infant sleep position and SIDS, says there is concern that the message is not getting through to large segments of the population.

"SIDS has been cut in half among the general population," Dr. Kattwinkel says. "However, blacks still have a SIDS rate of over two times the national average and are more than twice as likely to be placed on their stomachs to sleep. We need to study why this is happening. It might just be a matter of the message not getting out or people listening to grandmother's advice."

Most SIDS cases occur between 1 and 4 months of age.

Dr. Kattwinkel says it is important for new parents to remember that the peak risk for SIDS occurs between 2 and 4 months. More than 20 percent of parents and caregivers switch the baby from his back to a stomach-sleeping position between 1 and 3 months, he says.

Many parents change the baby's sleeping position against doctor's advice because they feel the baby will sleep better or not choke if the child spits up.

"The doctors are doing a pretty good job of getting the message out," Dr. Kattwinkel says. "There is just a segment of the population that is not hearing it."

Other things parents and caregivers can do to reduce the risk of SIDS include:

• Avoid placing an infant on soft surfaces such as a waterbed, sofa, soft mattress, quilt or comforter.

• Keep pillows and stuffed toys out of the baby's crib. They can obstruct a baby's airway if the child is lying his or her back.

• Don't smoke during or after pregnancy. Mothers who smoke during pregnancy are three times more likely to lose a baby to SIDS, according to NIH data. Exposing an infant to secondhand smoke also doubles the baby's risk of SIDS.

The AAP also recommends a certain amount of "tummy time" when the baby is awake for developmental reasons and to avoid a flat spot on the baby's head. The group does not recommend devices designed to maintain sleep position or to reduce the risk of re-breathing (breathing in the carbon dioxide the baby has just exhaled). None has been proved to reduce the risk of SIDS.

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