Child and Youth Mortality Review Committee

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In Our Hands: Preventing Sudden Unexpected Deaths in Infants

20 November 2006

Up to nine out of every ten cases of sudden unexpected death in infants may be preventable according to the latest report by a specialist health group.

Child and Youth Mortality Review Committee chair Professor Barry Taylor says if we as a community collectively used the knowledge currently available, 45 of our current approximate 50-60 deaths a year in this category, may not happen.

For the period considered in the report the rates of sudden unexplained deaths in infants rose from 48 in 2002 to 60 in 2003 and 69 in 2004. Preliminary data for 2005 suggests a lower number and rate suggesting the long term trend is for little change.

However, Professor Taylor says there is no cause for complacency. He says while rates for non-Māori and non-Pacific are similar to our overseas counterparts, the rates for Māori during this three year period are more than five times that of the general population. Similarly for Pacific infants the rate is three times higher.

The report states that although there have been public information and parental education campaigns about safe sleeping practices, more needs to be done.

The current advice is that parents can reduce the risk of sudden unexplained death in infancy by:

• not smoking before and during pregnancy
• putting babies to sleep on their back (ideally in the same room as parents for the first six months)
• breastfeeding their baby
• not sharing their bed with their baby if they have smoked during pregnancy, are overtired, have been drinking alcohol, taking prescription or other drugs that may slow their reactions.

The report advocates specifically targeted messages for Māori and Pacific communities and broader health promotion approaches considered for these communities.

Smoking rates amongst Māori and Pacific communities, especially amongst mothers is a particular concern.

It also calls for these health messages to be re-evaluated in light of recent research and recommendations by the American Academy of pediatrics - particularly their recommendation to use dummies or pacifiers after one month of age to reduce the risk of sudden unexplained death in infancy.

Professor Taylor says, "The participation of our Local Mortality Review Groups (Waikato, Tairawhiti, Taranaki, Hawke’s Bay, MidCentral, Canterbury and Otago DHBs) has been crucial to our work and we keen to establish groups in the remaining 14 District Health Boards."

Background

The committee is concerned that many infants and children in New Zealand are dying because of poor safety.

Intentional self harm, especially suicide remains a major problem with our youth. It's particularly concerning the rise in the number of deaths from suicide from children aged 10-14 years. These numbers have increased and a high proportion of suicides among those under 15 are Māori.

Death rates for our most vulnerable children (under the age of 1 year of age) shows that the gap between different ethnic groups appears to have widened.

The committee has three key goals:

• to improve the quality of information and improve the process for obtaining that information and analysis
• to aid prevention of death and harm, and to aid research to assist this
• to improve communication and build partnerships to help reduce harm and deaths in young people.

This is the third report from the committee. The committee is dedicated to helping the information collected be used to reduce the number of preventable deaths in New Zealand as well as bring further meaning to those deaths we cannot prevent by learning as much from them as possible.

The committee believes that the information gathered on deaths must in the end change what individuals do. The continued discussion about the deaths, their causes and what can be done to prevent them at many levels of the health and social sectors must continue if we are to identify critical ways to improve local services.