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CDC: Too many parents continue to put infants to sleep unsafely

Eunice Shriver Foundation

Far fewer infants in the United States are dying as a result of unsafe sleep practices than 25 years ago, thanks to a major national public health campaign that got under way in the early 1990s.

To reduce the risk of sudden infant death syndrome (SIDS) as well as accidental suffocation and strangulation, parents are now told to avoid putting their babies to sleep on their stomach or side and to make sure the child’s sleep surface is hard and free of loose bedding. They are also advised not to share a bed with their infant. 

Yet many parents still fail to follow those recommendations, according to a study released this week by the Centers for Disease Control and Prevention (CDC). One in five mothers puts her baby to sleep on the child’s stomach, for example, and about three in five have shared a bed with their baby. 

As a result, the risk to infants persists. Each year about 3,500 babies die from sleep-related causes in the United States, the CDC study reports.

Major findings

For their study, CDC researchers used 2009-2015 data from the Pregnancy Risk Assessment Monitoring System (PRAMS) for 32 states and New York City. PRAMS collects self-reported behavioral information from women before, during and shortly after pregnancy. That information includes the ways in which the women put their children to sleep.

Here are the key findings from the study:

  • 21.6 percent of the mothers in the study said they had placed their infant to sleep on the child’s stomach or side.
  • 61.4 percent of the mothers said they had allowed their infant to sleep in the same bed with them; 37 percent said they did it “rarely or sometimes,” while 24.4 percent said they did it “often or always.”
  • 38.45 percent of the mothers said they put loose or soft materials in their infants’ cribs; the most frequently reported materials were bumper pads (19.1 percent), followed by plush or thick blankets (17.5 percent) and pillows (7.1 percent)

The study also found that the prevalence of unsafe infant sleep practices varied by state. The proportion of the mothers who said they put their baby to sleep on the child’s stomach or side ranged from 12.2 percent in Wisconsin to 33.8 percent in Louisiana, for example. (Minnesota was not among the states whose data was used for the study.)

Unsafe infant sleep practices also tended to be more common among mothers who were younger than 25 and poorly educated. There were also racial/ethnic differences. Bed sharing, for example, was higher among mothers who were American Indian, black or Asian than among those who were Hispanic or white.

‘We need to do better’

"This report shows that we need to do better at promoting and following safe sleep recommendations," said Jennifer Bombard, the report’s lead author and a scientist in the CDC's Division of Reproductive Health, in a released statement.

"This is particularly important for populations where data show infants may be at a higher risk of sleep-related deaths," she added.

The CDC report notes that parents are not always receiving good advice from their doctors and other health care providers about how to make sure their babies sleep in a safe environment.


In another study published last fall in the journal Pediatrics, researchers surveyed a nationally representative sample of more than 3,200 mothers of infants under the age of 6 months. The survey found that 55 percent of the mothers had received incorrect advice about safe-sleep practices from a health care provider, while 25 percent had received incorrect advice. The remaining 20 percent had received no advice at all.

Safe-sleep practices

Here are the safe-sleep practices recommended by the American Academy of Pediatrics (AAP). Parents should make sure that other people who care for their children — including baby sitters and grandparents — are aware of these practices, too.

  • Place the baby on his or her back at all sleep times — including naps and at night.
  • Use a firm sleep surface, such as a safety-approved mattress and crib.
  • Keep soft objects and loose bedding out of the baby’s sleep area.
  • Share a room with the baby, but not the same bed.

FMI: The CDC study was published as a Vital Signs report in the Jan. 9 issue of the agency's Morbidity and Mortality Weekly Report (MMWR), where it can be read in full. For more information about “How to Keep Your Sleeping Baby Safe,” go to the AAP’s website.

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