Module 1: A New Approach
Conversations Approach

1.3 Going Deeper

Going DeeperDefinitions of Key Terms

  1. SUID, SIDS and sleep-related deaths. You may have heard a number of different terms used to talk about babies who die when sleeping. These all relate to deaths that are unexpected—the infant is not seriously ill and does not have a serious disability or birth anomaly that would be expected to have a fatal outcome. These deaths occur in infants who appear to be healthy and then die unexpectedly when sleeping.

    Sudden Unexpected Infant Death (SUID) is a term used by the Centers for Disease Control and Prevention (CDC) that refers to the sudden and unexpected death of an infant (less than one year of age) and the cause and manner of death are not immediately obvious prior to an investigation. This is an overall term for one of three types of infant deaths: Sudden Infant Death Syndrome (SIDS), unknown cause, and accidental suffocation and strangulation in bed (ASSB).

    Sudden Infant Death Syndrome (SIDS) is one type of SUID and this term is one that is familiar to many people. SIDS is the sudden death of an infant less than 1 year of age that cannot be explained after a thorough investigation is conducted, including a complete autopsy, examination of the death scene, and a review of the medical history.

    Accidental Suffocation and Strangulation in Bed (ASSB) is the leading cause of infant injury death. Mechanisms that lead to accidental suffocation or strangulation include

    • Suffocation by soft bedding, such as when a pillow or waterbed mattress covers an infant’s nose and mouth
    • Overlay—when another person rolls on top of or against the infant while sleeping
    • Wedging or entrapment—when an infant is wedged between two objects, such as a mattress and wall, bed frame, or furniture.
    • Strangulation—when an infant’s head and neck become caught between crib railings

    Unknown cause is the sudden death of an infant less than 1 year of age that cannot be explained. Often a thorough investigation was not conducted and cause of death could not be determined.

    We will use the term sleep-related deaths In these modules. This takes into account the range of possible causes of death in the SUID category and focusses on the needed interventions—implementing safe sleep practices. SIDS is a term that many families and others recognize and you may want to use it as part of your conversations with them. On the other hand, some families have said that since no one knows what causes SIDS, there is nothing that can be done to prevent it. So moving the focus to the term sleep-related deaths broadens the conversation.

  2. Caregivers are individuals who put babies to sleep: Mothers, fathers, grandparents, siblings, other relatives, legal guardians, foster parents, babysitters, and child care and early education providers
  3. Optimal breastfeeding will be used to describe practices that reflect the American Academy of Pediatrics (AAP) recommendations set forth in its policy statement, Breastfeeding and the Use of Human Milk (2012). The AAP recommends exclusive breastfeeding for 6 months (no formula, other nutritional liquids, or solid foods) and breastfeeding for one year or more based on the preferences of the mother and baby.
  4. Safe Sleep practices refers to the most current recommendations of the AAP set forth in its policy statement, SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment (2016), and promoted by the Safe to Sleep® campaign’s educational materials and community outreach efforts.

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Ajzen’s Theory of Planned Behavior

American Academy of Pediatrics Recommendations


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Bartick, M., & Reinhold, A. (2010). The burden of suboptimal breastfeeding in the United States: A pediatric cost analysis. Pediatrics, 125(5), e1048-e1056.

Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. (2015, July 31). Breastfeeding among U.S. children born 2002–2012, CDC National Immunization Survey.

Centers for Disease Control and Prevention, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. (2016, February 08). Data and statistics.

Centers for Disease Control and Prevention, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. (2017, February 1). About SUID and SIDS.

Colson, E. R., Willinger, M., Rybin, D., Heeren, T., Smith, L. A., Lister, G., & Corwin, M. J. (2013). Trends and factors associated with infant bed sharing, 1993-2010: The National Infant Sleep Position Study. JAMA Pediatrics, 167(11), 1032-7. doi: 10.1001/jamapediatrics.2013.2560.

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Koloroutis, M. (2004). Relationship-based care: A model for transforming practice. Minneapolis, MN: Creative Health Care Management.

Mathews, T. J., & MacDorman, M. F. (2013). Infant mortality statistics from the 2009 period linked birth/infant death data set. National Vital Statistics Reports, 61(8), 1-28.

Moon, R. Y. & Task Force on Sudden Infant Death Syndrome. (2016). SIDS and other sleep-related infant deaths: Evidence base for 2016 updated recommendations for a safe infant sleeping environmentPediatrics, 138(5) e20162940.

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U.S. Department of Health and Human Services. (2011). The Surgeon General's call to action to support breastfeeding. Washington, D.C.: U.S. Department of Health and Human Services, Office of the Surgeon General.

U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. (2014). Child health USA 2014. Rockville, MD: U.S. Department of Health and Human Services.