This Resource Center publication addresses
the following:
Sudden Infant Death Syndrome (SIDS) is the
sudden death of an infant under 1 year of age which remains
unexplained after a thorough case investigation, including
performance of a complete autopsy, examination of the death
scene, and review of the clinical history (Willinger et al.,
1991).
What SIDS is
- the major cause of death in infants
from 1 month to 1 year of age, with most deaths occurring
between 2 and 4 months
- sudden and silent--”the
infant was seemingly healthy
- a death often associated with sleep
and with no signs of suffering
- a recognized medical disorder
- determined only after an autopsy, an
examination of the death scene, and a review of the infant's
and family's clinical histories
- a diagnosis of exclusion
- an infant death that leaves unanswered
questions, causing intense grief for parents and families
(Back to the Top)
What SIDS is not
- preventable, but the risk can be reduced
by placing the baby on his or her back to sleep on a firm
surface, by making sure the baby has a smoke-free environment,
and by keeping the baby from being overheated
- suffocation
- caused by vomiting and choking or by
minor illnesses such as colds or infection
- caused by the diphtheria, pertussis,
tetanus (DPT) vaccines or other immunizations
- contagious
- child abuse or neglect
- the cause of every unexpected infant
death
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What Are the Most Common Characteristics of SIDS?
SIDS is unexpected, usually occurring in
healthy-appearing infants under 1 year of age. A SIDS death
occurs quickly and usually during sleep. SIDS is rare during
the first month of life. Although SIDS can occur in older infants,
most SIDS deaths occur by the end of the sixth month, with
the greatest number occurring in infants between 2 and 4 months
of age (AAP, 2000).
In the United States, more SIDS cases are
reported in the fall and winter than in spring or summer. SIDS
occurs more often in boys than in girls (approximately a 60-
to 40-percent male-to-female ratio). African-American and American-Indian
infants are two to three times more likely to die from SIDS
as other infants (AAP, 2000; NICHD, 2001). Several Government
agencies are intensifying efforts to reach these populations
with the latest information about SIDS.
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How Many Babies Die from SIDS?
Each year between 1983 and 1992, the average
number of reported SIDS deaths ranged from 5,000 to 6,000.
Over the past few years, especially since the mid 1990s, the
number of SIDS deaths has declined significantly. The National
Center for Health Statistics (NCHS) reported that in 2002 in
the United States, 2,295 infants under 1 year of age died from
SIDS (NCHS, 2004). Still, when considering the number of live
births each year, SIDS remains the leading cause of death in
the United States among infants between 1 month and 1 year
of age and the third leading cause of death overall among infants
less than 1 year of age (NCHS, 2004).
Although the overall SIDS rates have declined
in all populations throughout the United States, disparities
in SIDS rates and prevalence of risk factors remain in certain
groups. SIDS rates are highest among African Americans and
American Indians and are lowest among Asians and Hispanics
(NICHD, 2001).
2,295 |
57.1 |
1,269 |
55.2 |
642 |
110.9 |
52 |
123.3 |
51 |
24.3 |
260 |
29.7 |
*Per
100,000 live births by group.
Source: NCHS, 2004.
Mathews, T.J., Menacker, F., MacDorman, M.F.,. Infant Mortality
Statistics from the 2002 Period Linked Birth/Infant Death Data
Set. National Vital Statistics Reports; Vol. 53, No. 10. Hyattsville,
Maryland: National Center for Health Statistics. November 24,
2004.
(Back to the Top)
How Do Professionals Diagnose a SIDS Death?
By definition, a SIDS diagnosis requires
a complete autopsy, a thorough death scene investigation, and
a clinical history. A death is diagnosed as SIDS only after
all probable alternatives have been eliminated-in other words,
SIDS is a diagnosis of "exclusion."
Often, the cause of an infant death can be determined only
through a process of collecting information; conducting sometimes
complex forensic tests; and by talking with parents, other
caregivers, and physicians.
Medical and legal experts rely on three methods
to determine a SIDS death:
- a thorough death scene investigation
- autopsy
- review of infant's and family's medical
records and histories.
When a death is sudden and unexplained, investigators,
including medical examiners and coroners, call on forensic
experts, who apply their expertise in medicine and the law
to help determine a cause of death. SIDS is no exception.
In most cases, the death investigation is
led by the medical examiner or coroner for the county, district,
or State in which the death occurred. Deaths suspected to be
SIDS usually require law enforcement officers to conduct a
thorough death scene investigation. The medical examiner/coroner
gathers information from the death scene and case histories
and presents this information to the pathologist (usually board
certified or with credentials in forensic pathology). The pathologist
conducts or supervises the autopsy and assesses results of
the autopsy, death scene investigation, and case histories
to determine whether a SIDS death has occurred. The pathologist
issues a SIDS diagnosis when there is no other apparent cause
for the infant's death (Valdes-Dapena, 1995).
1. A Thorough Death Scene Investigation
Although it may be emotionally painful for the family, a death
scene investigation will help shed light on the cause of
death by providing a detailed record of the location and
circumstances of the death. Therefore, the investigator will
attempt to learn as much as possible about the events leading
up to the death, even the very moment that the death occurred.
The Centers for Disease Control and Prevention
(CDC) have developed guidelines for death scene investigation
of a sudden, unexplained infant death (CDC, 1996). Local jurisdictions
may use these guidelines or develop their own protocols for
investigating sudden unexpected infant death.
Investigators will interview the parent or
other individual who was caring for the child at the time of
the death, as well as any other family members or adults who
were present at the time of the death or before the death occurred.
The investigator will ask open-ended, neutral questions such
as, "Can you tell me what happened?"
"How old was the baby?" "What did the baby weigh?" "What time was the baby
put to bed?" "When did the baby fall asleep?" "Who last saw the baby alive?" "Who
discovered the baby, and what did that person do?"
"What position was the baby in when he/she was found?" "Were there covers over
the baby's head?" "Was CPR attempted?" "Did the baby share a bed with anyone
else?" "What was the general health of the baby?"
"Had the baby been ill recently?"
The individual investigating the death will
take notes about the appearance of the room where the death
occurred; condition and characteristics of the crib or sleeping
environment; objects, if any, in the crib; medications at the
death scene; and any unusual or dangerous items in the room,
such as sharp objects or plastic bags. The investigator may
make notes about the behavior of those present at the death
scene. The investigator will also photograph the death scene
and record the temperature of the room. It is likely that investigators
will collect the infant's bedding (e.g., sheets, blankets,
etc.), any objects in the crib (e.g., toys or bottles), or
any unusual or dangerous items found near the death scene.
2. Autopsy
An autopsy provides evidence of the cause of death through
microscopic examination of tissue samples and examination
of the body and vital organs. An autopsy is particularly
important when a SIDS death is suspected because a definitive
diagnosis cannot be made without a thorough postmortem examination.
It is estimated that in 15 percent of cases suspected to
be SIDS, the autopsy identifies another cause of death, such
as a disease or genetic disorder, as well as unintentional
injury or unnatural death (Valdes-Dapena, 1995). Also, if
a cause (or causes) of SIDS is ever to be uncovered, it is
likely that the cause will be detected from evidence gathered
from a thorough pathological examination.
An autopsy may help parents and other caregivers
deal with the death. According to noted authority Marie Valdes-Dapena,
M.D., parents whose child has died need to know why the death
occurred; they need to be reassured that their baby's death
could neither have been predicted nor prevented (Valdes-Dapena,
1995). Moreover, an autopsy leading to a diagnosis of SIDS
will help remove the parents (or caregiver) from potential
suspicion of wrongdoing by the legal system and by society
in general.
Parents are usually anxious to consult with
the pathologist after the autopsy. Discussing the autopsy results
often helps most parents accept the reality of their infant's
death. The pathologist reviews the autopsy results, explaining
in terms the parents can understand how these findings point
to a determination of cause of death. The pathologist should
also take the time to answer parents' questions, responding
with "compassion, understanding, and respect for the parents'
dignity and grief" (Valdes-Dapena, 1995).
3. Review of the Infant's and Family's
Medical Histories
A comprehensive medical history is essential for a SIDS diagnosis.
Along with a death scene investigation and an autopsy, a careful
review of the infant's and family's history of disease, previous
illnesses, accidents, and behaviors often helps to corroborate
what is detected from the death scene investigation and the
autopsy.
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SIDS Deaths Require Special Understanding
Any sudden, unexpected death disturbs the
sense of normalcy and security for the victim's family. These
deaths force family members and those around them to confront
their own mortality (Corr et al., 1991). This is particularly
true in the case of a sudden infant death. Simply put, babies
are not supposed to die. Because the death of an infant is
a disruption of the natural order, it is especially traumatic
for parents, other family members, and friends (Arnold et al.,
1997).
Like any sudden death, a SIDS death leaves
a family with a sense of shock and loss and an urgent need
to understand what happened. Lack of a discernible cause, the
suddenness of the death, and possible involvement of law enforcement
authorities make a SIDS death even more difficult. A SIDS death
also leaves the family with a need for understanding from those
close to the family--”even the surrounding
community.
A SIDS death is as tragic as a death from
any readily definable disease or cause. Thus, investigators
compiling or reviewing the case histories should be especially
sensitive and recognize that the family may view this process
as an intrusion, even a violation, of their grief. The interviewer
should also be sensitive to the family's cultural practices
and traditions. The interviewer should point out to the family
that although obtaining the case histories may be stressful,
this information may reveal that the death could not have been
prevented, which may provide some solace to a grieving family.
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Are There Ways to Reduce the Risk of SIDS?
Currently there is no known way to prevent
SIDS, but there are things that parents and caregivers can
do to reduce the risk of a SIDS death. For example, researchers
now know that the mother's health and behavior during her pregnancy
and the baby's health before birth seem to influence the occurrence
of SIDS.
Scientists also know that certain environmental
and behavioral influences (called risk factors) can make an
individual more susceptible to disease or ill health. Although
risk factors are not necessarily the cause of a condition,
by studying risk factors, scientists are able to better understand
a disease or condition, which often leads to detecting a cause.
SIDS researchers and clinicians continue
to try to identify risk factors that can be modified or controlled
to reduce an infant's risk for SIDS. For example, SIDS experts
now know that the baby's sleep position, exposure to smoke,
and becoming overheated while asleep can increase the infant's
risk for SIDS.
Infant Sleep Position
In April 1992, the American Academy of Pediatrics (AAP) Task
Force on Infant Sleep Position issued a statement recommending
that infants be placed on their backs to sleep to reduce
the risk of SIDS. Then, in 1994, the U.S. Public Health Service,
AAP, the SIDS Alliance, and the Association of SIDS and Infant
Mortality Programs cosponsored the Back to Sleep campaign,
a national public service initiative to disseminate AAP's
recommendation that infants be placed on their back to sleep.
Between 1992 and 1998, among U.S. infants,
stomach (prone) sleeping decreased from more than 70 percent
to approximately 20 percent. During that same time frame, the
number of SIDS deaths declined by more than 40 percent (Willinger
et al., 1998; AAP, 2000; NICHD, 2001). Not surprisingly, most
researchers, policymakers, and SIDS professionals agree that
this significant decline occurred largely as a result of changing
sleep position (AAP, 2000).
Rates of SIDS are over twice as high among
American Indians and African Americans compared with Whites.
Prone sleeping was found to be a significant risk factor for
SIDS in an African- American urban sample (Hauck et al., 2002).
These authors recommend educational outreach to the African-American
community.
Another recent study of the relationship
between infant sleep position and SIDS concluded that infants
placed in an unaccustomed prone or side sleeping position are
at a higher risk of SIDS (Li et al., 2003). This ethnically
diverse, population-based, case-controlled study was conducted
in 11 counties in California. The health message from this
research is that babies should be on their backs for all sleep,
including naps.
Exposure to Smoke
Researchers have concluded that if a mother smokes during or
after pregnancy, she is placing her infant at a greater risk
for SIDS (AAP, 2000). Some studies suggest that exposure
of the newborn to tobacco smoke (whether or not the mother
smokes) may be associated with increased risk for SIDS. In
a 1997 policy statement, AAP cautioned,
"Exposure of children to environmental tobacco smoke is associated with increased
rates of lower respiratory illness and increased rates of middle ear effusion,
asthma, and SIDS" (AAP 1997).
Overheating
According to AAP (2000), some evidence points to an association
of the amount of clothing or blankets on an infant, room
temperature, and the time of the year with an increased risk
for SIDS. The increased risk associated with overheating
is particularly clear when infants are placed on their stomachs
(prone).
AAP cautions that the possible relationship
between clothing and climate as stand-alone factors (or as
a cluster of environmental risk factors) is less clear. Moreover,
although the number of recorded SIDS deaths has been higher
in the winter months, that increase may be due to the greater
frequency of colds, flu, and other infections during the winter.
Infant Bedding
Researchers and consumer safety advocates continue to look
for a possible link between SIDS and soft bedding (Scheers,
Dayton, and Kemp, 1998). During 2000, seven major retailers
joined with the U.S. Consumer Product Safety Commission (CPSC)
to kick off a nationwide campaign promoting safe bedding
practices for infants. Many retailers are developing public
service campaigns to spread this message to parents and other
infant caregivers. The hope is that by circulating this information,
infant deaths will be reduced and that those responsible
for infant care will receive one consistent message about
ensuring a safe sleeping environment for babies.
In recent safety alerts, CPSC has warned
parents to guard against unfounded claims from manufacturers
of some infant bedding materials that the use of certain products
can reduce SIDS. Parents and other caregivers need to be aware
that there is no product currently available that can guarantee
prevention of a SIDS death.
(Back to the Top)
Other Risk Factors
Although sleep position, smoke exposure,
overheating, and infant bedding have been identified as risk
factors for SIDS, researchers have identified a number of other
factors that may put an infant at increased risk for SIDS.
Infant Care Practices and SIDS Risk
Reduction
Several studies have examined various environmental influences
or child-rearing practices that may help protect an infant
from SIDS (Valdes-Dapena, 1995; Hoffman et al., 1996; NICHD,
2000). It is important to point out, however, that these factors,
in and of themselves, are not reliable in predicting how, when,
why, or if SIDS will occur.
For example, although researchers conclude
that breastfeeding is beneficial, there is no clear-cut link
between breastfeeding and reduced risk of SIDS. Other studies
have found a lower rate of SIDS among infants who used pacifiers
compared with infants who did not use pacifiers. Although results
of these studies tend to be consistent, there is still no evidence
that pacifier use prevents SIDS (AAP, 2000).
Maternal Risk Factors
Still other risk factors, called maternal risk factors, are
associated with how the mother's behavior and health affect
the infant before and after birth.
Maternal risk factors include:
- age less than 20 at first pregnancy
- a short interval between pregnancies
- late or no prenatal care
- smoking during and/or after pregnancy
- placental abnormalities
- low weight gain during pregnancy
- anemia
- alcohol and substance abuse
- history of sexually transmitted disease
or urinary tract infection (NICHD, 2001).
How to Lower Your Baby's Risk of
SIDS: Back Sleeping and Safe Bedding*
- make sure that everyone who cares for
your baby puts the baby on his or her back to sleep
- use a firm, tight-fitting mattress in
a crib that meets current safety standards
- remove pillows, quilts, comforters,
sheepskins, stuffed toys, and other soft products from the
crib
- dress your baby in sleep clothing so
that you will not have to use any other covering over the
baby
- place your baby so that his or her feet
are at the bottom of the crib
- tuck a thin blanket around the bottom
of the crib mattress, reaching only as far as the baby's
chest
- make sure the baby's head remains uncovered
during sleep
- keep your baby warm, but not too warm
- make sure that everyone who cares for
your baby understands the dangers of soft bedding
- avoid adult beds, waterbeds, sofas,
or other soft surfaces for sleep
*from
AAP, CPSC, and NICHD
AAP: http://www.aap.org
CPSC: http://www.cpsc.gov
NICHD: http://www.nichd.nih.gov
(Back to the Top)
Current Research Findings and Theories
Most scientists now believe that babies who
die of SIDS are born with one or more conditions that make
them especially vulnerable to the internal and external stresses
that occur in the life of any infant. Currently, many researchers
argue that the clue to finding the cause(s) of SIDS lies in
a further understanding of the development and functions of
the brain and nervous system of SIDS infants.
These scientists theorize that some babies
at risk for SIDS have defects in those parts of the nervous
system that control breathing and heart rate. Maturation of
the brainstem may be delayed in SIDS infants. Myelin, a fatty
substance that facilitates nerve signal transmission, appears
to develop more slowly in SIDS infants than in other babies.
"The detection of subtle abnormalities in SIDS
brains indicates that not all SIDS infants are 'normal' despite
their lack of clinical abnormalities. The occurrence of brain
abnormalities supports the concept that a vulnerable, and not
a normal, infant is at risk for SIDS. The idea of a vulnerable
infant forms a key part of a triple-risk model for the pathogenesis
of SIDS" (Filiano and Kinney, 1994).
The Triple-Risk Model
Pathology studies of SIDS infants support
the view that these infants possess underlying vulnerabilities
that put them at risk for sudden death, a concept advanced
by the triple-risk model in describing the sequence of events
leading to the death of an infant. A number of scientists are
currently applying this model in their search for a cause(s)
of SIDS.
Vulnerable Infant.
The first
key element of the triple-risk model depicts an infant with
an underlying defect or abnormality, which makes the baby vulnerable.
In this model, certain athophysiological factors (e.g., defects
in the parts of the brain that control respiration or heart
rate, and that occur during early life) explain vulnerability
to sudden infant death.
Critical Developmental Period.
The
second element in the triple-risk model refers to the infant's
first 6 months of life. During this critical developmental
period, rapid growth phases occur and changes in homeostatic
controls take place. These changes may be evident (e.g., sleeping
and waking patterns), or they may be more subtle (e.g., variations
in breathing, heart rate, blood pressure, and body temperature).
It may be that some of these changes may temporarily or periodically
destabilize the infant's internal systems.
Outside Stressor(s).
The
third element of this model involves outside stressors. These
may include environmental factors (e.g., exposure to tobacco
smoke, overheating, or prone sleep position) or an upper respiratory
infection that most babies can experience and survive, but
that an already-vulnerable infant may not be able to overcome.
In and of themselves, these stressors do not cause infant deaths,
but in a vulnerable infant, "may tip the balance against an
infant's chances of survival" (Filiano and Kinney, 1994).
According to this model, all three elements
must interact for a sudden infant death to occur--”the
baby's vulnerability is undetected until the infant enters
the critical developmental period and is exposed to an outside
stressor or stressors.
Brain Abnormalities in SIDS Infants
A team of researchers funded by the National Institute of Child
Health and Human Development (NICHD) has discovered that
infants who die of SIDS may have abnormalities in several
parts of the brainstem. This finding builds on the results
of an earlier study that identified abnormalities in the
region of the brain known as the arcuate nucleus in babies
who died of SIDS.
In the NICHD study, SIDS infants were found
to have decreased binding of serotonin in the nucleus raphe
obscurus, a brain structure linked to the arcuate nucleus,
as well as four other brain regions. These areas of the brain
are thought to play a crucial role in regulating breathing,
heart beat, body temperature, and arousal (Panigrahy et al.,
2000).
(Back to the Top)
Back to Sleep Campaign
Since its inception in 1994, the Back to
Sleep campaign has focused on heightening awareness among parents,
health care providers, and other caregivers about the benefits
of putting a baby to sleep on his or her back. Over the course
of the campaign, almost 80 million brochures, posters, public
service announcements, and informational videos have been distributed.
The Back to Sleep campaign continues as a nationwide public
health effort, with NICHD having major responsibility for disseminating
information and educational materials on this crucial health
topic.
Back in 1994 when the Back to Sleep campaign
was first initiated, there were almost twice as many SIDS deaths
among African-American infants than among White infants. Despite
the almost 50 percent drop in the number of SIDS deaths in
both groups, a significant disparity still exists (NICHD, 2002).
To continue efforts to reach minority and hard-to-reach populations
about the importance of placing an infant on its back to sleep,
NICHD has partnered with community groups to provide outreach
to minority and underserved communities.
Partners in the Back to Sleep Campaign
Outreach to Underserved Populations
- Alpha Kappa Alpha Sorority
- Chi Eta Phi Sorority
- Chicago Department of Public Health
- Congress of National Black Churches
- District of Columbia Department of Public
Health
- National Association for the Advancement
of Colored People
- National Black Child Health Development
Institute
- National Coalition of 100 Black Women
- National Medical Association
- National Association of Black Owned
Broadcasters
- Pampers Parenting Institute
- Zeta Phi Beta Sorority
(Back to the Top)
SIDS Deaths in Child Care Settings
Twenty percent of SIDS deaths occur in a
day care setting (Moon, Patel, and Shaefer, 2000). Although
media and mailings have been largely effective in communicating
BTS information to many child care centers, nonprone positioning
and other risk reduction measures are not universally practiced
among child care providers (Moon and Biliter, 2000). To promote
these messages in child care settings, the Health Resources
and Services Administration's Maternal and Child Health Bureau
is sponsoring the Healthy Child Care America Back to Sleep
campaign. The campaign, which was officially launched in January
2003, is a nationwide effort to unite child care, health, and
SIDS prevention partners to reduce the risk of deaths in child
care settings (AAP, 2003).
Over the past 9 years, the Back to Sleep
campaign has been extremely effective in helping reduce the
number of SIDS deaths. AAP cautions, however, that while continuing
to emphasize the
"importance of infant positioning for sleep as an effective modifiable risk
factor for SIDS," it is also important to "focus increased attention on other
modifiable environmental factors, to describe complications that may have arisen
from modifying risk factors, and to make recommendations about other strategies
that may be effective for further reducing the risk of SIDS" (AAP, 2000).
Acknowledgments
Review panel members
Michael Corwin, M.D.
Co-Director
Massachusetts Center for Sudden Infant Death Syndrome
Anne Harvieux, C.I.C.S.W.
Program Administrator
Infant Death Center of Wisconsin
Jeffrey Jentzen, M.D.
Medical Examiner, Milwaukee County, Milwaukee, WI
John Teggatz, M.D.
Deputy Chief Medical Examiner, Milwaukee County, Milwaukee,
WI
Mary McClain, R.N., M.S.
Massachusetts Center for Sudden Infant
Death Syndrome
Marian Willinger, Ph.D.
Special Assistant for SIDS
National Institute of Child Health and
Human Development
For Additional Information on SIDS
and Infant Death, and for a List of State SIDS Coordinators,
Please Contact:
National Sudden and Unexpected Infant/Child
Death and Pregnancy Loss Resource Center
http://www.sidscenter.org
(Back to the Top)
Other SIDS Resources
American Academy of Pediatrics (AAP)
The best way to contact AAP is to access their Web site: www.aap.org
. To locate news releases
and policy statements, search the site using "SIDS" as keyword.
Association of SIDS and Infant Mortality
Programs (ASIP)
8280 Greensboro Drive
Suite 300
McLean, VA 22102
Phone: (800) 930-7437
Fax: (703) 902-1320
E-mail: info@sidsprojectimpact.com
http://www.asip1.org
C.J. Foundation for SIDS
Barry Bornstein, Executive Director
The Don Imus-WFAN Pediatric Center
Hackensack University Medical Center
30 Prospect Avenue
Hackensack, NJ 07601
Phone: (201) 996-5111, 1-888-8CJ-SIDS
Fax: (201) 996-5326
E-mail: barrycjf@aol.com
http://www.cjsids.com
First Candle/SIDS Alliance
1314 Bedford Avenue
Suite 210
Baltimore, MD 21208
Phone: (800) 221-7437, (410) 653-8226
Fax: (410) 653-8709
E-mail: info@firstcandle.org
http://www.firstcandle.org
National Center for Cultural Competence (NCCC)
SIDS/ID Component
Georgetown University Center for Child and Human Development
University Box 571485
Washington, DC 20007-3935
Phone: (800) 788-2066, (202) 687-5387
Fax: (202) 687-8899
E-mail: cultural@georgetown.edu
http://www11.georgetown.edu/research/gucchd/nccc
National SIDS and Infant Death Program Support
Center
Kathleen Graham, Director
1314 Bedford Avenue
Suite 210
Baltimore, MD 21208
Phone: (410) 415-6628, (800) 638-7437
Fax: (410) 415-5093
E-mail: kathleen.graham@firstcandle.org
http://www.firstcandle.org/health/health_human.html
National SIDS and Infant Death Project IMPACT
8280 Greensboro Drive
Suite 300
McLean, VA 22102
Phone: (703) 902-1260, (800) 930-7437
Fax: (703) 902-1320
E-mail: lcooper@sidsprojectimpact.com
http://www.sidsprojectimpact.com
U.S. Consumer Product Safety Commission
4330 East-West Highway
Bethesda, MD 20814-4408
Phone: (800) 638-2772
(Consumer Hotline: Call toll-free to obtain product safety
information and to report unsafe products.)
Fax: (301) 504-0124
E-mail: info@cpsc.gov
http://www.cpsc.gov
Contact Information for the Back
to Sleep Campaign
The National Institute of Child Health and Human Development
Back to Sleep Campaign
31 Center Drive, Room 2A32
Bethesda, MD 20892-2425
Public Information: (301) 496-5133
Fax: (301) 496-7101
http://www.nichd.nih.gov
To order campaign materials, call toll-free: 1-800-505-CRIB
References
American Academy of Pediatrics, Task Force on Infant Sleep
Position and Sudden Infant Death Syndrome. "Changing Concepts
of Sudden Infant Death Syndrome: Implications for Infant
Sleeping Environment and Sleep Position." Pediatrics 2000
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American Academy of Pediatrics, Healthy Child
Care Back to Sleep Campaign, 2003. http://www.healthychildcare.org .
Arnold, J., McClain, M.E., and Shaefer, S.J.M.
"Reaching Out to the Family of a SIDS Baby." In: Woods, J.R., and Woods, J.L.E.
(Eds.).
Loss During Pregnancy or in the Newborn Period: Principles
of Care with Clinical Cases and Analysis. Pitman (NJ): Jannetti
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Centers for Disease Control and Prevention.
"Guidelines for Death Scene Investigation of Sudden, Unexplained Infant Deaths:
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and Mortality Weekly Report 1996;
45 (No. RR-10).
Corr, C.A., Fuller, H., Barnickol, C.A.,
and Corr, D.M. (Eds.).
Sudden Infant Death Syndrome: Who Can Help and How. New York:
Springer Publishing Co., 1991.
Filiano, J.J., and Kinney, H.C. "A Perspective
on Neuropathologic Findings in Infants of the Sudden Infant
Death Syndrome: The Triple Risk Model." Biology of the Neonate
1994; 65(3-4):194-7.
Hauck, F.R., Moore, C.M., Herman, S.M., Donovan,
M., Kalelkar, M., Christoffel, K.K., Hoffman, H.J., and Rowley,
D. "The Contribution of Prone Sleeping Position to the Racial
Disparity in Sudden Infant Death Syndrome: The Chicago Infant
Mortality Study."
Pediatrics 2002 Oct; 110(4):772-80.
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This publication was produced by the
National SIDS/Infant Death
Resource Center (NSIDRC)
8280 Greensboro Drive
Suite 300
McLean, VA 22102
Phone: (866) 866-7437, (703) 821-8955
E-mail: sids@circlesolutions.com
http://www.sidscenter.org
The NSIDRC is funded under contract to Circle
Solutions, Inc., with the Maternal and Child Health Bureau
(MCHB), Health Resources and Services Administration, U.S.
Department of Health and Human Services. This publication is
not copyrighted; it may be reproduced in whole or in part without
permission. However, in accordance with accepted publishing
standards, it is requested that proper credit be given to the
source(s). The views in this publication do not necessarily
reflect the views of the sponsoring agency.
Health Resources and Services Administration
Maternal and Child Health Bureau
SIDS/Infant Death Program
(301) 443-2115
http://www.hrsa.gov
Last Updated On May 26, 2005.
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