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The Bulletin
safe sleeping, cont.
SIDS and SUID deaths in King County
All sudden and unexpected infant deaths in King County are reviewed
by King County’s Child Death Review Committee, made of up
partners throughout King County from a variety of disciplines
that systematically review the preventable deaths of children. The
committee reviews the circumstances of each death and discusses
recommendations to implement in programs, systems, and/or poli-
cies to strengthen the safety of children in
King County.
Between July 2013 and January 2016,
38 infant SIDS or SUID deaths were
reviewed by King County’s Child Death
Review Committee. Through KCMEO
and
responding law enforcement agency inves-
tigations, an unsafe sleep environment was
found to be a risk factor in 37 of the 38
deaths. The 38th case was certified as SIDS
with no known cause of death. Unsafe sleep
environment is defined as bed sharing in an
adult bed, poor sleep position, soft sleep
surface and loose bedding, toys or other objects in the bed, or
a too-warm sleep environment. Additionally, 17 confirmed and
two probable cases identified either substance abuse during preg-
nancy or substance use by the caregiver at the time of the death
as a risk factor.
The table below shows risk factors identified for all of the 38 infant
deaths reviewed by the Child Death Review Committee between
July 2013 and January 2016.
Call to action
This table underscores CDC findings that sleep environment is
the major modifiable risk factor in prevention of SIDS and SUID
deaths. It is imperative for perinatal health
care providers to understand the importance
of a safe sleep environment for infants and
to educate and support families to provide
the safest sleep environments possible. This
becomes even more critical for infants who
have additional risks including prematurity,
LBW or maternal smoking or substance use.
Discussion and recommendations from the
King County Child Death Review Committee
include the need to review safe sleep envi-
ronments prenatally and post-natally with all
parents or caregivers of newborn infants. In
addition, it is important to discuss the family’s ability, willingness,
and/or barriers to providing a safe sleep environment. This allows
an opportunity to assist the family to decrease barriers and improve
ability to provide the safest sleep environment for their infant given
their unique circumstances and resources.
King County Child Death Review: Cases Reviewed June 2013–May 2016: SUID and SIDS
CDR SUID/SIDS Cases Reviewed: Identified Risk Factors
Identified Risk Factor
# of Cases
% Occurrence
Bed sharing or co-sleeping
22
57.9%
Soft sleep surface and/or loose bedding
21
55.3%
Parent/caregiver substance use involved
17
44.7%
Too-warm sleep environment
11
28.9%
Toys or other objects in sleep environment
9
23.7%
Sleep position on side
9
23.7%
Born premature
9
23.7%
Maternal smoking or drug use during pregnancy
7
18.4%
Secondhand smoke exposure
6
15.8%
Sleep position on stomach
4
10.5%
Total cases reviewed
38
It is imperative for perinatal
health care providers to
understand the importance
of a safe sleep environment
for infants and to educate
and support families to
provide the safest sleep
environments possible.
