An eight-week-old baby boy slips out of his sleeping grandmother’s arms and suffocates in the folds of a couch. A seven-week-old girl is found dead lying on her stomach in her mother’s bed, where she had been placed to sleep, as a nearby crib sat unused. These are two of 23 infants who died in Connecticut last year of “sudden infant death syndrome,” or undetermined causes.
Of those cases, 18 were found to have risk factors associated with the sleep environment, including co-sleeping in an adult bed with parents, sleeping with a heavy blanket or pillows, or being placed on their stomachs.
In a public health alert issued Monday, the Office of the Child Advocate and the Connecticut Child Fatality Review Panel warned that the number of Connecticut infants who died between 2001 and 2013 in cases involving unsafe sleep conditions was almost three times higher than the number of infants who died from child abuse. Related risk factors include parental mental health challenges, such as depression, substance use and parental isolation.
State officials urged a number of prevention strategies, including better education about sleep-related dangers, screening for maternal depression by health care providers, expansion of home visiting programs for parents and infants, and uniform protocols for first responders in sudden infant death investigations.
“While many of us have heard messages regarding safe sleep and ‘back to sleep,’ very few are aware how often infants in Connecticut die from unsafe sleep conditions,” said state Child Advocate Sarah Eagan, co-chair of the Child Fatality Review Panel. “Barely a month goes by where our panel doesn’t review a tragic case of preventable infant death. We must shout this message from the rooftops.”
Dr. Kirsten Bechtel, the other co-chair, said “the multidisciplinary collaboration” among professionals on the panel had been critical to understanding factors resulting in infant deaths during sleep. More work is now needed to reduce the number of infants in unsafe sleep conditions, she said.
The report on sleep-related deaths in 2013 showed the average age of infants was three months. In at least seven of the 23 cases, parents had documented histories of substance use.
The child advocate’s office and fatality review panel said many of the families who suffered a sudden infant death had been involved with the Department of Children and Families (DCF). They noted that the agency recently had issued a new policy emphasizing the role that case workers will play in educating families about “safe sleep” and ensuring that such expectations are part of families’ case plans.
“Given the importance of this new policy in reducing child deaths, DCF should incorporate this policy into training, and rigorously enforce compliance through spot checks of the records of all children under 1 year of age,” the report recommends.
It also calls on pediatricians, ob-gyns and other providers to discuss safe sleep practices with new mothers – particularly those who fall into high-risk categories.
In 2011 and 2012, Connecticut had 43 unexpected or unexplained infant deaths, 31 of which had risk factors associated with the sleep environment. Of 211 infant fatalities between 2002 and 2010 that were classified as sudden, undetermined or accidental asphyxia, the Office of the Child Advocate identified at least 140 that had findings associated with unsafe sleep environments, including infants sleeping in beds with adults or older children, or with adult pillows, toys, comforters, stuffed animals and other items.
This story was reported under a partnership with the Connecticut Health I-Team (c-hit.org).