Health advisory: Sudden Unexpected Infant Death (SUID)

| February 28, 2025

Per the CDC, in 2022, about 3,700 babies died suddenly and unexpectedly in the United States.  Kitsap County preliminary death data for 2024 show 14 total infant deaths, of which 5 were SUID.  There is no guaranteed way to prevent SUID. 

However, research tells us that a safe sleep environment can help reduce infant SUID risk.

ACTIONS REQUESTED

BE AWARE that sudden unexpected infant death (SUID) includes sudden infant death syndrome, accidental suffocation and strangulation in bed, and other deaths from unknown causes.

CONSIDER sharing this guidance with parents and caregivers of infants:

It’s extra important to not share a bed with your baby if:

  • You have been drinking alcohol, used marijuana or taken any medicines or illicit drugs. The risk of sleep-related infant death is more than 10 times higher for babies who bed share with someone who is fatigued or has taken medications that make it harder for them to wake up or has used substances such as alcohol or drugs.
  • Your baby is very young, small or was born prematurely. The risk of sleep-related infant death while bed sharing is 5 to 10 times higher when your baby is younger than 4 months olds. And the risk of sleep-related infant death is 2 to 5 times higher when your baby was born preterm or with low birth weight.
  • Your baby is sick with any respiratory illness. Studies show a highly significant correlation between respiratory infections and SUID.

Never share a bed with your baby.

Based on the evidence, the AAP doesn’t recommend bed sharing with your baby under any circumstances. This includes twins and other multiples.

  • If you bring your baby into your bed to feed or comfort them, place them in their own sleep space when you’re ready to go to sleep.
  • If there is any possibility that you might fall asleep while your baby is in your bed, make sure there are no pillows, sheets, blankets or any other items that could cover your baby’s face, head and neck or overheat them. As soon as you wake up, be sure to move your baby to their own bed.
  • Avoid falling asleep with your baby in other spots, too. The risk of sleep-related infant death is up to 67 times higher when infants sleep with someone on a couch, soft armchair or cushion.

Use a firm, flat sleep surface.

A firm surface means that it shouldn’t indent when your baby is lying on it. Any surface that inclines more than 10 degrees isn’t safe for your baby to sleep on.

  • Place your baby in a crib, bassinet, portable crib or play yard that meets the safety standards of the Consumer Product Safety Commission (CPSC).
  • Check the CPSC website to make sure your crib hasn’t been recalled, especially if it’s not new.
  • Make sure your crib mattress is designed for your specific crib and that it fits tightly. Use a fitted sheet only—nothing else should be in the crib with your baby.
  • Don’t use a crib that doesn’t have instructions, is missing hardware or that’s broken.
  • Alternative sleep surfaces are only considered a safe option IF they comply with the June 2021 CPSC rule that all infant sleep products meet existing federal safety standards for cribs, bassinets, portable cribs or play yards. This includes inclined sleep products, hammocks, baby boxes, in-bed sleepers, baby nests and pods, compact bassinets, travel bassinets and baby tents. If a product doesn’t meet federal safety standards, avoid it.
  • If your baby falls asleep in a car seat, stroller, swing, infant carrier or sling, you should move them to a firm sleep surface on their back as soon as possible.
  • Don’t use products for sleep that aren’t specifically marketed for infant sleep. Examples include Boppy pillows and Dock-a-Tots.
  • In an emergency, you can temporarily put your baby to sleep in a box, basket, dresser drawer or something similar. It should have thin, firm padding. As soon as you can get a CPSC-approved sleep surface, move your baby to that instead.

BE AWARE

  • A newborn should be placed skin-to-skin with their parent as soon after birth as possible, for at least an hour. After that, or when the mother needs to sleep or take care of her other needs, the baby should be placed on their back in a bassinet with no incline.
  • Preemies may need to be on their stomachs temporarily while they’re in the NICU, but parents should place them on their backs as soon as they’re medically stable. This helps them adjust to sleeping on their backs before going home.
  • Some babies will roll onto their stomachs. Parents should always place their baby to sleep on their back. But if they’re comfortable rolling both ways (back to tummy, tummy to back), then you don’t need to keep turning your baby to their back again. Parents should make sure that there are no blankets, pillows, stuffed toys or bumper pads in their baby’s bed. The baby could roll into any of these items, which could block their airflow.

BACKGROUND

Child Death Review (CDR) teams in Washington review unexpected deaths of children, including deaths that occur in a sleeping environment.  The Kitsap County CDR team (an interdisciplinary team composed of individuals from healthcare, social services, educational services, law enforcement, EMS rescue teams, and public health) is currently monitoring infant and childhood deaths in Kitsap County residents with the primary goal of developing strategies to improve child safety and to implement preventative measures within the community.

RESOURCES:

CONTACTING THE HEALTH DISTRICT 

  • For more information and resources, call the Health District’s Pregnancy & Parenting Support Line at 360-728-BABY (2229). 
  • For other inquiries, call: 360-728-2235 and leave a message. Includes reporting notifiable conditions 24 hours a day, 7 days a week. Leave the patient’s name, date of birth and disease. 
  • Fax: 360-813-1168. 

This advisory is also sent to our provider email list. You can subscribe here.