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Between 2013 and 2017, more than 70% of infant deaths that occurred after discharge from hospital in South Dakota were due to sleep-related causes, according to the state's Department of Health.
The infant mortality rate in South Dakota between 2013 and 2015, due to a variety of sleep-related causes, was 157.3 deaths per 100,000 live births, ranking 46th in the country. Under a new, broader cause of death known as Sudden and Unplanned Infant Death, the death rate in South Dakota is 43% higher than the national average of 89.2 and is the highest of the seven Great Plains states. . SUID deaths all occur during sleep and include sudden infant death syndrome, accidental asphyxiation and strangulation, as well as causes that can not be determined.
Child mortality due to sleep-related causes remains problematic despite the many media awareness and information campaigns to prevent it. The number of American infants who died during sleep dropped significantly in the 1990s, when parents were sensitized to the "Back to Sleep" health campaign to put babies on their backs at bedtime, open airway, reduce the risk of choking or choking and allow a baby to cry and wake up a caregiver if he is in danger.
However, since 1999, the SUID mortality rate has stabilized, according to the Centers for Disease Control and Prevention.
This graph shows the rate of infant deaths per 100,000 live births at 3-year intervals over the last 25 years for reasons related to sleep, including Sudden Infant Death Syndrome and Choking and Lung Disease. Accidental strangulation. Rates across the country have dropped dramatically from the early 1990s to the early 2000s due to an extensive public awareness campaign on people who sleep safely, but they do not. Have not declined so rapidly since then and have increased slightly in some states. The last category shows the evolution of the rate from 2002 to 2015, a period during which public health campaigns have gradually decreased. The highest death rate in South Dakota (157.3) is 43% higher than the national average (89.2) and remains the highest in the Great Plains region. Source: American Academy of Pediatrics
| Location | 1990-1992 | 2000-02 | 2013-15 | % chg 2002-15 |
|---|---|---|---|---|
| WE. | 150.3 | 94.5 | 89.2 | -5.70% |
| Iowa | 168.6 | 97.8 | 81.2 | -17% |
| Minnesota | 151 | 72.3 | 63.7 | -12% |
| Mountain. | 243.3 | 151.6 | 136.4 | -ten% |
| Nebraska | 178.3 | 102.9 | 86.7 | -15.70% |
| NORTH DAKOTA. | 152.1 | 130.1 | 114.2 | -12.20% |
| SOUTH DAKOTA. | 248.8 | 164.9 | 157.3 | -4.60% |
| Wyo. | 303.8 | 100.4 | 86.6 | -13.80% |
In response, national and national health authorities – including in South Dakota – have recently redoubled efforts to reduce the number of sleep-related child deaths. Data collection and badysis has increased; educational programs are developing for parents; and programs provide government-funded child beds that are safer for infants. The updated health recommendations include the ban on allowing babies to sleep with their parents, place them on a firm sleeping surface and remove loose clothing, blankets and toys blocking the airways. A new method called co-sleep, in which a baby sleeps separately from his parent but within earshot, is encouraged.
At the same time, a tribal health agency in South Dakota recently received a five-year, $ 5 million grant aimed at reducing the high rate of infant mortality among Native Americans, including the promotion of good sleep habits.
"People need to be aware that the problem has not gone away," said Bonny Specker, professor of epidemiology and director of the E.A. Martin Nutrition Program Association at South Dakota State University.
"For a while, these deaths really went down significantly, and then I think everyone said," OK, put them to sleep on their backs and the problem is solved. "But this is obviously not solved because there are still infants dying."
The American Academy of Pediatrics recommends safe measures, including the removal of soft objects and loose bedding from the bed, to protect babies while they sleep.
Sleep-related deaths are a persistent concern
Between 2013 and 2017, in South Dakota, 396 babies died in the year following their birth, of whom 95 died of sleep-related causes after leaving the hospital.
State registers show that overall infant mortality rates in South Dakota have been relatively stable or have declined slightly in recent years and remained close to the national average. Despite the slow decline, the 2017 rate jumped to 7.75 deaths per 1,000 live births, its highest level in six years and the third highest since 2004, placing South Dakota in 41st of the worst cities from the country.
However, mortality data also show that sleep-related accidents remain a major cause of infant death in South Dakota.
Conbad anomalies and premature birth have long been the leading causes of infant death in South Dakota and throughout the country, followed by sleep-related accidents and Sudden Infant Death Syndrome. The new clbadification of sleep-related deaths, SUID, includes SIDS and accidental deaths.
State data show that over the 5-year period from 2013 to 2017, conbad anomalies caused 24.2% of infant deaths in South Dakota, followed by premature births (15.9%), accidents (11.1%) and SIDS (8.6%). the category is dominated by suffocation or respiratory restriction during sleep.
In terms of specific numbers, the South Dakota Child Death Review 2013-2017 indicates that 61,245 babies were born in South Dakota, 396 of whom died. Of these, 151 died after leaving the hospital, a so-called post-neonatal period that usually excludes conbad anomalies or premature birth weight.
More than 70% of the 151 deaths after discharge from the hospital, a total of 95, were clbadified as sleep-related, with bed sharing being the most common cause. The records show that 44 sleep-related deaths occurred in an adult bed, 19 in a crib and 12 on a couch in 20 indeterminate locations.
State data also highlighted other trends in infant mortality.
The infant mortality rate among children of tobacco-consuming mothers is 11.35 per 1,000 births, more than double the rate for non-users. The disparity is even greater with respect to post-neonatal deaths that occur after the baby has left the hospital.
Some data also suggest that income level plays a role in infant mortality rates in South Dakota. The death rate of infants born to mothers receiving federal nutritional supplement programs for women, infants and children is 30% higher than that of mothers born in the program. The greatest disparity occurs after the release of babies from the hospital.
State and national data also show that infant mortality rates are higher among non-whites. According to the CDC, the highest national child mortality rate in 2016 was for non-Hispanic blacks, at 11.4 deaths per 1,000 live births. Native Americans / Alaska were next at 9.4, followed by Hawaiian / Pacific Islanders at 7.4, Hispanics at 5.0, non-Hispanic whites at 4.9, and Asians at 3.6.
South Dakota data generally follow this trend line. The infant mortality rate among American Indians between 2013 and 17 (12.2) was about twice that of white infants during this period (5.6).
Expanding public health efforts
The focus on improving infant health in South Dakota increased in 2011 following the publication by a working group of former First Lady Linda Daugaard of three major issues: tobacco by parents, especially mothers; a lack of antenatal care during the first trimester of pregnancy and unsafe sleep practices.
One of the immediate answers was the creation of South Dakota's Cribs for Kids program within the Department of Health, which provides a safe portable crib, nightwear and educational materials for low-income parents.
According to the program, Katelyn Strbader, an epidemiologist for maternal and child health in the state health department, has distributed approximately 1,400 safe beds and sleep kits.
Strbader said other state efforts were aimed at both education and improving pre- and post-natal behaviors, providing education and support to new parents at home. times by home visits and in health service offices across the state. Health workers advocate for healthy lifestyles, including avoiding smoking and using alcohol and drugs before and after pregnancy.
She said that the understanding of the causes of death related to sleep steadily improved and led to new initiatives and recommendations in the area of education.
"What we really see in our data is that there are other safety factors besides just putting kids on the back," she said.
Tips for improving the sleep safety of infants
These are Level 1 or most important recommendations from the American Academy of Pediatrics recommending that parents create a safe sleeping environment for infants under one year of age. The full list can be found online.
■ Place the baby on his back for each sleep.
■ Use a firm sleeping surface.
■ Breastfeeding is recommended.
■ It is recommended to share the room with the child on a separate sleeping area.
■ Keep soft objects and bedding away from the baby's sleeping area.
■ Consider proposing a pacifier at nap and bedtime.
■ Avoid exposure to smoke during pregnancy and after birth.
■ Avoid the use of alcohol and illicit drugs during pregnancy and after birth.
■ Avoid overheating.
■ Pregnant women should seek and obtain regular prenatal care.
■ Infants should be immunized according to the recommendations of the PAA and CDC.
■ Do not use home-based cardio-respiratory monitors as a strategy to reduce the risk of SIDS.
■ Healthcare providers, nursery staff, NICUs, and child care providers should approve and model recommendations for reducing the risk of SIDS from birth.
■ Media and manufacturers should follow the safety guidelines in their messages and advertisements.
■ Continue the "Safe to Sleep" campaign with a focus on ways to reduce the risk of sleep-related mortality in all infants, including SIDS, choking and other unintended deaths.
■ Paediatricians and other primary care providers should actively participate in this campaign.
Source: American Academy of Pediatrics
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