Study: Soft bedding top cause of infant suffocation during sleep

Soft bedding is the top cause of sleep-related suffocation deaths among infants, according to a new study.

Authors said these deaths are preventable if families follow the AAP’s recommendations that infants sleep on their backs in a crib or bassinet with no soft objects or bedding.

More U.S. infants die each year from accidental suffocation than any other type of injury, and most of these cases occur in bed, according to “Sleep-Related Infant Suffocation Deaths Attributable to Soft Bedding, Overlay, and Wedging,” (Erck Lambert, AB, et al. Pediatrics. April 22, 2019, https://doi.org/10.1542/peds.2018-3408).

Because these deaths have been on the rise, authors including several from the Centers for Disease Control and Prevention (CDC), sought to better characterize them to improve prevention strategies.

They analyzed 2011-’14 data from the CDC’s Sudden Unexpected Infant Death (SUID) Case Registry, which includes about one-third of cases, and found 14% of the 1,812 deaths involved suffocation. Infants had a median age of 3 months, and the majority were male.

About 69% of the suffocation cases involved soft bedding like a blanket or pillow, 19% occurred when a person was on top of or against the infant (overlay) and in 12%, the infant was wedged between objects, according to the study.

In the soft bedding cases, the median age was 3 months, and nearly half occurred in an adult bed. Almost all these infants were laying on their stomach or side. Blankets were the most common soft object preventing the child from breathing followed by adult mattresses and pillows.

In overlay cases, the median age was slightly lower at 2 months, and 71% occurred in an adult bed. Nearly a quarter involved an adult impaired by alcohol or drugs, and 14% occurred while breastfeeding. Neck or chest compression was more common than obstruction of the nose and mouth.

Wedging cases typically occurred in older infants with a median age of 6 months, and 73% occurred in an adult bed. Infants often were trapped between a mattress and a wall.

Authors noted that in all three types of suffocation, infants most commonly were sleeping in an adult bed and were not on their backs.

During the study period, about 87 infants per 100,000 died of SUID. That rate would have dropped to 75 per 100,000 if suffocation deaths had been prevented.