Sleep Position in District of Columbia

District of Columbia

Placing a baby to sleep on their back is the most effective action for reducing a baby’s risk of sudden infant death syndrome (SIDS). SIDS is the third-leading cause of all infant deaths. Stomach sleeping among infants also increases the risk of overheating, carbon dioxide buildup and insufficient oxygen in the blood. Approximately 3,700 infant deaths occurred in the United States in 2022 as a result of sleep-related problems.

Parents and caregivers at a disproportionate risk for not placing an infant to sleep on their backs include:

• Those with a high school education or less compared with those with higher levels of education.
• Those who lack health insurance or have Medicaid compared with those with private insurance.
• Black, Hispanic and multiracial women compared with white women.
• Those who did not participate in WIC during pregnancy compared with those who did.
• Those who were not told by their provider that supine — lying flat on one’s back — is the only safe sleep position for their infant, or who were told something different. Caregivers who received correct advice from their providers were 28% more likely to place their babies to sleep on their backs.

The American Academy of Pediatrics recently updated guidelines for reducing sleep-related infant deaths, including:

• Placing infants on their backs for sleep on a firm, flat surface until 12 months of age unless the infant has a medical reason to sleep in a different position.
• Removing soft objects, loose bedding and crib bumpers from the infant's sleeping area.
• Sleeping in the same room as the infant, but not in the same bed.
• Watching for signs of overheating and avoiding overdressing infants or covering their heads. 

Studies have shown that addressing common caregiver concerns and misconceptions, such as fears about choking or beliefs that their baby is not at risk, can improve adherence to safe sleep recommendations. Additionally, community-based programs that use real stories from affected families and culturally relevant materials have been linked to greater awareness and reductions in sleep-related infant deaths. 

Increasing new and expecting parents’ knowledge of the recommended guidelines is crucial to keeping infants safe during sleep.

Healthy People 2030 has an objective to increase the percentage of infants put to sleep on their backs.

Ely, Danielle M., and Anne K. Driscoll. “Infant Mortality in the United States, 2022: Data from the Period Linked Birth/Infant Death File.” National Vital Statistics Reports 73, no. 5 (July 25, 2024). https://dx.doi.org/10.15620/cdc/157006.

Hirai, Ashley H., Katherine Kortsmit, Lorena Kaplan, Erin Reiney, Lee Warner, Sharyn E. Parks, Maureen Perkins, Marion Koso-Thomas, Denise V. D’Angelo, and Carrie K. Shapiro-Mendoza. “Prevalence and Factors Associated With Safe Infant Sleep Practices.” Pediatrics 144, no. 5 (November 1, 2019): e20191286. https://doi.org/10.1542/peds.2019-1286.

Moon, Rachel Y., Rebecca F. Carlin, and Ivan Hand. “Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment.” Pediatrics 150, no. 1 (July 1, 2022): e2022057990. https://doi.org/10.1542/peds.2022-057990.

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Von Kohorn, Isabelle, Michael J. Corwin, Denis V. Rybin, Timothy C. Heeren, George Lister, and Eve R. Colson. “Influence of Prior Advice and Beliefs of Mothers on Infant Sleep Position.” Archives of Pediatrics & Adolescent Medicine 164, no. 4 (April 1, 2010).https://doi.org/10.1001/archpediatrics.2010.26.