HJAR Jan/Feb 2023

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2023 43 Jennifer Dillaha, MD Director Arkansas Department of Health is hard to pinpoint how many deaths are due to unsafe sleep practices. Medical ex- aminers do not code for unsafe sleep prac- tices in their autopsy reports, although they have made recent changes in how they code autopsies that may eventually help. While some of the reported deaths likely have other factors involved, deaths are happen- ing, including sleep-related ones, that can be prevented. The numbers that are available on sleep- related deaths show there are issues with disparities — the deaths are not equally dis- tributed among all populations and socio- economic classes. Black infants are twice as likely to die from an SUID than white infants. Using 2019-2020 data, the CDC reported a 2.5 infant mortality rate for every 1,000 black infants born, while the mortality rate was 1.3 for every 1,000 white infants born. This might be attributed to cultural, communi- cation, and trust issues. People might listen to their grandparents and family members more than healthcare professionals. Our job as healthcare professionals is to explain that current safe sleep recommendations are dif- ferent from the way past generations put newborns to sleep and why these recom- mendations matter. According to the CDC, more than half of caregivers surveyed in 2017 reported not receiving correct advice on safe sleep practices from healthcare pro- viders. This needs to change. Conversations about safe sleep should happen every time a healthcare provider sees a newborn for a checkup or has any appointment with anyone who has a young child in their first year of life. The visit may not be about the child, but it is an opportu- nity to reinforce safe sleep practices. I encourage healthcare providers to ask parents about how they place their babies to sleep and inquire about any challenges they may have in following the recommenda- tions. Help them find solutions. Many hos- pitals have begun using sleep sacks, which are wearable blankets designed to keep ba- bies warm as well as safe, to keep babies on their backs. In some cases, the babies are even sent home with sleep sacks. Oth- er resources are available to help in these discussions and to provide patients with needed information. The Injury Preven- tion Center partners with local communi- ties to provide Safety Baby Showers for ex- pectant mothers. Mothers who attend the showers receive education on home safety, safe sleep, motor vehicle safety, and pre- vention of shaken baby syndrome. More information on the Injury Prevention Cen- ter at Arkansas Children’s Hospital is avail- able by calling 501-364-3400 or emailing injuryprevention@archildrens.org . n RESOURCES Please visit the following resources for further information: • Arkansas Department of Health — healthy.arkansas.gov • CDC, Vital Signs — www.cdc.gov/vitalsigns/ safesleep/ • CDC, Reproductive Health — www.cdc.gov/ reproductivehealth/features/baby-safe-sleep/ • American Academy of Pediatrics — www.aap. org/en/patient-care/safe-sleep/ in mortality rates. Parents are also encour- aged to follow the ABCs of Safe Sleep: • A is for ALONE. A baby should never sleep with another person or pet. They can share a room, just not a bed. • B is for BACK . Ababy should be placed on their back for every sleep. Once a baby can comfortably roll over both ways (back to tummy, tummy to back), there is no need to move them if they roll over during sleep. • C is for CRIB. A baby should sleep in a safety-approved crib, bassinet or play yard. The crib should be free of any suf- focation hazards like blankets, bumper pads, stuffed animals, or soft toys. The issue with having other items or people sleeping with newborns is that these items can cause accidental suffocation or harm. The greatest risk is in the first six months of life. Babies cannot turn over and rescue themselves frompotentially compro- mising positions that could harm them (es- pecially within their first fewmonths of life). Communication with families is key. The safe sleep practices recommended today are not the same as recommendations prac- ticed in the past. The CDC reports that one in five mothers nationwide has reported not placing their baby on their back to sleep as recommended. Two in five mothers have reported using soft bedding when plac- ing their babies to sleep, which is also not recommended. Since statistics include all deaths reported in children within their first year of life, it “Our job as healthcare professionals is to explain that current safe sleep recommendations are different from the way past generations put newborns to sleep and why these recommendations matter.”