Background on the Safe Sleep Issue
Georgia has one of the highest infant mortality rates in the country, averaging three infant deaths per week due to sleep-related causes. SIDS (Sudden Infant Death Syndrome) was the third leading cause of fatality to children under age one in Cobb County between 2011 and 2015, and suffocation was the fourth leading cause for this category of children in the same time period (Georgia Department of Public Health Online Analytical Statistical Information System [OASIS] database). During 2015, Cobb County suffered nine sleep-related infant deaths (Georgia Vital Records; Death Certificate File). In October 2016, the American Academy of Pediatrics expanded its safe infant sleep recommendations to reinforce sleep position (back versus stomach) and proper sleep environment. As the illustration below shows, infants placed on their back will have a lowered risk of choking due to the position of the airway/trachea and gravity (i.e., when placed on their back, an infant’s stomach contents that may come up into the throat/esophagus during sleep will more likely go back to the stomach instead of into the lungs).
In addition to sleep position, it is critical that we educate parents about the baby’s sleep environment. We are cautioning against co-sleeping arrangements with parents or other siblings in the same bed as the infant. There are also significant concerns with putting infants in beds with lots of loose bedding, stuffed animals or excess clothing. All of the above can potentially result in severe injury or death.
- In 2014, 81% of Georgia’s sleep-related deaths occurred prior to 5 months of age and 89% occurred during the first 6 months.
- CDC data show sleep-related infant deaths occur among all races and ethnicities, but African American and Native American babies have a rate that is two times greater than that of White, non-Hispanic babies.
- The Georgia Child Fatality Review from 2009-2013 indicates that out of 785 infant sleep-related deaths, 405 (52%) occurred in the adult bed. More often than not, these parents had the best intentions in keeping their child safe.
The Georgia Department of Public Health (GA DPH) launched a limited Safe Sleep initiative in 2016 to help prevent sleep-related deaths and to educate parents about creating a safe sleep environment for their children. GA DPH is providing the design of various public health messages, newborn travel bassinets for bedside sleeping near parent in the first few weeks of life and educational board books to reinforce the messaging while also encouraging reading to the infants ($75,000). The Cobb County Safe Sleep initiative will expand on this statewide campaign to reach ALL new parents and caregivers in Cobb County with additional accurate, consistent, and tailored messages.
Goals, Objectives, and Evaluation of the Cobb County Safe Sleep Initiative
The Cobb County Safe Sleep initiative’s goal is to saturate the county’s population of 717,190 people with educational Safe Sleep messaging and to provide safety equipment to families in need during 2017.
- To implement public health interventions that empower parents, caregivers and healthcare providers to make informed decisions to prevent additional injury and death due to controllable environmental factors.
- To support Georgia’s Safe Sleep initiative locally with direct education and equipment distribution (e.g., sleep sacks with back placement reminders, Pack ‘n Plays for a safe sleep surface for infants, and informational literature).
- To raise awareness through media advertising, one-on-one education, and distribution of educational materials on the ABCs (Alone, on Back, in Crib) of safe sleep environments.
During this Safe Sleep initiative in Cobb County, we will track the number of advertisements, educational materials, and safety supplies distributed and the number of education sessions provided. We will also measure effectiveness of education and supply distribution efforts through pre- and post-intervention surveys (please see Attachment 3). The outcome sought is a reduction in sleep-related infant deaths in Cobb County post interventions as monitored and investigated by the local Child Fatality Review Committee.