Racial disparities in infant sleep position in Rhode Island.

Positioning an infant to sleep on the back (supine positioning) has been recommended by the American Academy of Pediatrics (AAP) since 1992 to reduce the risk of Sudden Infant Death Syndrome (SIDS).1 SIDS is defined as a sudden death before 1 year of age that cannot be explained despite a thorough case investigation, including a complete autopsy, death scene examination, and review of the clinical history.2,3 SIDS is the leading cause of post-neonatal (1-12 months of age) mortality, and the third leading cause of infant (under 1 year old) mortality in the United States.3,4 In 2010, 2,063 deaths were reported as SIDS.3 The rates of SIDS are disproportionately higher for non-Hispanic black and American Indian/ Alaska Native infants than the rest of the population.3,4 Infants who are placed to sleep on their stomachs or sides (non-supine positioning) are at higher risk for SIDS than infants who are placed on their backs to sleep (supine positioning).4 Therefore, to reduce the risk of SIDS, infants should be placed to sleep in a supine position for every sleep by every caregiver until 1 year of life.5 The Healthy People 2020 target is to increase the proportion of infants who are put to sleep on their backs to 75.9%. This report describes 1) the trends in the prevalence of supine sleeping among black and white infants in Rhode Island, and 2) the disparities in spine sleeping position among subgroups. This report also provides the most recent AAP recommendations on a safe infant sleep environment.