Abstract

The “Back to Sleep” campaign has been remarkably effective at decreasing the incidence of SIDS in the United States, similar to educational programs worldwide. Chang et al report a decrease in SIDS from 1.38 for 1989 to 0.31 per 1000 live births in 2004 in California. This striking decrease in SIDS is compared with the more modest decline in overall infant mortality. The main point of the study by Chang et al is that some of the associations with SIDS have changed as the rate of SIDS has decreased. The peak age of death shifted from 2 to 3 months, seasonal variation was less evident, and the occurrence of SIDS over weekends decreased relative to weekdays. Although subtle, these changes in the epidemiology may guide new strategies to further decrease SIDS. The “Back to Sleep” campaign has been remarkably effective at decreasing the incidence of SIDS in the United States, similar to educational programs worldwide. Chang et al report a decrease in SIDS from 1.38 for 1989 to 0.31 per 1000 live births in 2004 in California. This striking decrease in SIDS is compared with the more modest decline in overall infant mortality. The main point of the study by Chang et al is that some of the associations with SIDS have changed as the rate of SIDS has decreased. The peak age of death shifted from 2 to 3 months, seasonal variation was less evident, and the occurrence of SIDS over weekends decreased relative to weekdays. Although subtle, these changes in the epidemiology may guide new strategies to further decrease SIDS.

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