In 2020, the United States achieved a record low infant mortality rate: 541.9 infant deaths per 100,000 live births. At the same time, the sudden infant death syndrome (SIDS) rate increased 15% from 2019 to 2020, moving up to the 3rd leading cause of infant death. The study “Sudden Unexpected Infant Deaths: 2015–2020,” which is published in the April 2023 issue of Pediatrics (published online March 13), acknowledges the uncertainty around the SIDS rate bump. Potential reasons may be related to the COVID-19 pandemic or changing death certification practices. Exploring why SIDS rates increased is important, but due to variability in reporting practices, rates must be explored in conjunction with other sudden unexpected infant deaths (SUID). When researchers examined SUID as a group, the authors concluded that the 2020 increased SIDS rate was likely explained by diagnostic shifting -- the SIDS rate increased, but the overall SUID rate did not. Researchers say increased rates of SUID from 2019 to 2020 among non-Hispanic Black infants, but not for other single race or Hispanic infant groups, was unexpected. The COVID-19 pandemic disproportionately affected communities of color compared to non-Hispanic white families through exacerbation of crowded housing, food insecurity, unemployment, limited healthcare access, altered childcare, and social or emotional health stressors. Factors compounded by the COVID-19 pandemic and related stay-at-home orders (e.g., access to health care, changes to or loss of childcare, parental/caregiver financial and emotional stressors, and increased parental or caregiver substance use) may have also influenced the increased SUID rate among non-Hispanic Black infants in 2020. These factors affect family vulnerability and may have led to more unsafe sleep practices like bedsharing, thereby increasing the occurrence of SIDS and other sudden unexpected infant deaths. The increasing trend in SUID rates among non-Hispanic Black infants has widened the racial-ethnic disparity in rates among non-Hispanic Black infants relative to non-Hispanic white infants.
###
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.