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The Ironies of Infant Sleep Safety

In case you haven’t noticed, the world often makes no logical sense.  Clearly, the first thing that we should take care of is what we value most, but this is sadly not always the case.  The standout example of this irony concerns our babies.  You’d think that important discoveries aimed at keeping our precious ones alive would disseminate through society at great speed, but the exact opposite has historically been true, and I’m not talking about minor delays.

In 2005 an article appeared in an international journal by a group of authors based at the Institute of Child Health in London.  These people looked back to the 1940s in an effort to track how official parenting advice evolved on the one hand, and how scientific knowledge evolved on the other hand.  The specific issue they were interested in was not a highly technical one.  The question was simply whether infants in their first 12 months of life should be positioned face up to sleep, or face down.  In other words, was a tiny tot safer sleeping on their back or on their tummy?

This isn’t a purely academic question, because infants are known to suffocate while sleeping, and such cases form part of the Sudden Infant Death Syndrome.  Admittedly, some infants have died while face up, and other infants have died while face down, but what are the odds, that’s the question.  Which sleep position is statistically riskier, and moreover, had the advice to parents kept pace with advances in our understanding of the relative risks?

Well, the answer is ‘No’ − the advice to parents had not kept pace with the scientific knowledge.  By 1970 there was enough cumulative research to conclude with confidence that infants are at much less risk of suffocation when they are placed face up.  However, these research findings were not reflected in the advice to parents until some 22 years later.  As a direct consequence of the delay, upwards of 60,000 infants died in Europe, the UK, North America and Australia.  That’s 60,000 otherwise healthy infants who died as a result of bad advice.  I hasten to point out that the cost of providing bad advice was no less than the cost of providing good advice.

Who was to blame for this tragedy?   I can’t escape the conclusion that we, adult society in general, are the culprits.  We allowed this to happen, because we did not sufficiently value the translation of science into action.  We did not recognise the role of advocates for change.  The average person could be forgiven for assuming that new knowledge is sufficient on its own to drive change.  Unfortunately it doesn’t work that way.  Even very good, and affordable, ideas require champions to promote them.

I thought that I might be such a champion when, in 2013, Standards Australia and Standards New Zealand jointly published a new voluntary standard specifying the minimum safe firmness for infant mattresses.  This document was based on a test method that I invented, which was quickly awarded a major prize by the US Consumer Product Safety Commission.  But prizes don’t save lives.  I worked like crazy to promote this approach to the relevant standards organisation in the United States, but to no avail.  Then I tried to encourage a mandatory regulation in Australia and in the United States, but again without success.  More than seven years have passed, and finally the US Government is proposing such a regulation.  I continue to marvel at the irony of this delay.  I have no doubt that some babies have died unnecessarily on unsafe sleep platforms while society continued to ignore the latest science.  Once again we have placed in danger the very thing that we value most.

 

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