Minnesota has the highest rate of crib deaths at day-care businesses when compared with 10 other states, and health experts don’t know why. They suspect, however, that caregivers may be less likely to have heard about the importance of putting babies to sleep on their backs.
“We were doing a pretty good job of reaching parents, but maybe not those who care for their children,” said Cheryl Fogarty, infant mortality consultant to the Minnesota Health Department.
In a study published in Monday’s issue of the journal Pediatrics, a researcher at Children’s National Medical Center in Washington said that 20.4 percent of deaths caused by Sudden Infant Death Syndrome in 11 states occurred in day-care settings.
Surprisingly, Minnesota led the list with a rate of 40 percent, although the percentage has dropped since the 1995-1997 study. Florida was lowest, at 9 percent. The other states in the study were Arizona, California, Colorado, Maryland, Massachusetts, Michigan, Missouri, New Hampshire and New Jersey.
Though its cause is unknown, SIDS resembles suffocation, and parents are advised to have babies sleep on their backs to avoid airway blockage. Soft mattresses, loose bedding, pillows and soft toys also should be kept out of cribs.
The highest-risk period for SIDS is when infants are 2 months to 5 months old, which is often the time working mothers return to their jobs after childbirth, said Dr. John Kattwinkel, chairman of an American Academy of Pediatrics SIDS task force.
Fogarty said two factors may help explain Minnesota’s high rate: It has a high number of women in the work force, which means more children are likely to be in day care, and it has the highest rate of mothers with children under age 6 among the 11 states included in the study.
Minnesota has about 65,000 births annually. In the early 1990s, the state recorded about 100 to 115 SIDS deaths each year. Since the national Back to Sleep campaign began in 1992, the numbers have steadily dropped to between 45 and 56 SIDS deaths annually, Fogarty said.
In addition, since data for the Pediatrics study was gathered from January 1995 to June 1997, the rate of SIDS deaths in Minnesota day-care settings has dropped from 40 percent to 29.9 percent, Fogarty said. “But it’s still quite high, and we are quite concerned,” she added.
In the study, the researchers examined 1,916 SIDS cases and found that 60 percent of the deaths occurred in home day care, which, they added, tend to be unlicensed and run by older women with less access to pediatricians and others who promote SIDS risk reduction efforts.
Dr. Rachel Moon, the study’s lead author, said it was especially disturbing to find that, of children placed on their stomachs by caregivers, more than half were usually put to sleep on their backs by their parents.
Moon said previous research shows that compared to babies who always sleep on their backs, back sleepers switched to their stomachs are 20 times more likely to die of SIDS and habitual stomach sleepers are about five times more likely.
Kattwinkel said Moon’s study is “just one other bit of evidence from a national health standpoint that tells us we ought to be educating day-care centers and grandparents . . . as well as parents” about back-sleeping.