RECOMMENDATIONS TO AVOID THE PRONE SLEEPING POSITION AND RECENT STATISTICS FOR SUDDEN-INFANT-DEATH-SYNDROME IN THE UNITED-STATES

Objective: To determine whether two recent, nonsynchronized recommenda tions to avoid the prone position for sleeping infants were each follo wed by a decline in the incidence or expected number of cases of sudde n infant death syndrome (SIDS). Data Sources: Data were collected from SIDS counseling programs, state vital statistics, and medical examine r records of 44 states and the city of Los Angeles, Calif. Data for a state were excluded because of either incompleteness or nonresponsiven ess to request. Data Synthesis: In the 8 months following an article i n the Seattle Times advising against the use of the prone position for sleeping infants, the incidence of SIDS fell by 52.0% in King County (where 32 households in every 100 receive the Seattle Times) and by 19 .9% in Snohomish County (16 in 100 households). in the remaining 37 co unties of Washington State (on average, <1 in 100 households are subsc ribers), the incidence rose 3.4%. Examination of medical examiner reco rds for King County and Snohomish County revealed no compensatory incr ease in other causes of death and no cases attributed to aspiration. I n the 12 months following the initial 8 months, the number of SIDS cas es in King County remained at approximately half the previous annual a verage (25 vs 49 cases). At the national level, the American Academy o f Pediatrics' recommendation on April 15, 1992, was followed in the ne xt 6 months by a decrease of 12.0% in the number of SIDS cases compare d with the previous year. Conclusions: The results are consistent with those of intervention programs in other countries. A national campaig n to inform parents of the risk of the prone position in early infancy should be given serious consideration.