Politics & Government

In Kansas, the rate of infant deaths from asphyxia doubled in three years

Kansas State Child Death Review Board.
Kansas State Child Death Review Board.

Kansas infants are dying from asphyxia – a lack of oxygen – at a much higher rate than they did a decade ago, a new report shows. The death rate from asphyxia more than doubled in just three years.

Twenty Kansas children died in 2016 from unintentional asphyxia, such as suffocation, strangulation or choking. While only a small fraction of the 394 child deaths in Kansas that year, the rate of death from asphyxia has grown steadily since 2013.

Sixteen of the 20 children who died from asphyxia last year were less than one year old – and 17 of the deaths were sleep-related.

“I think the increase in sleep-related deaths and the unintentional asphyxia deaths is very concerning,” said Christy Schunn, director of the KIDS Network, which focuses on preventing infant death in Kansas.

The rising number of child asphyxia deaths was revealed in a report published by the Kansas State Child Death Review Board. The board’s report examined deaths that happened in 2016.

The report comes as statistics show the rate of sleep-related infant deaths is on the rise nationally.

In 2005, Kansas had an unintentional asphyxia death rate of 5.2 per 100,000 population for children less than one year old, according to the report. The death rate in 2016 was 41.9 per 100,000. The rate has risen every year since 2013.

One common theme among many of the 2016 deaths: co-bedding.

State figures show that the vast majority of the sleep-related deaths happened when the child was not sleeping in a crib or bassinet, but was instead sharing a sleeping surface with another person.

As a Wichita pediatrician who is an expert on child abuse injuries and child neglect, Katherine Melhorn tries to help families understand what she calls “the danger of sleeping with your babies.”

A baby doesn’t have the strength and agility to get out from under a pillow or an arm that can suffocate them. The child is simply “too young to get themselves out of a bad situation,” Melhorn said.

They can’t move, and they can’t breathe.

“There’s a lot of denial. People think that is not going to happen to them,” she said.

Part of the problem is the human factor: new parents who are exhausted, who will do whatever they can to get sleep — and let their baby sleep with them — even when they know it’s not safe.

The only safe practice is to put the child in a crib without things inside that will cause the baby to get tangled up, she said.

It’s what experts call the ABCs of safe sleep for young children: A. alone; B. on their back; and C. in an uncluttered crib.

“One of the things we ask parents to do is plan for the night, to make a sleeping plan: What am I going to do when the baby wakes up in the middle of the night so that we don’t put them in the bed with them?” Schunn said.

While the number of infant asphyxia deaths in Kansas has ticked up over the past decade, the number of deaths classified as Sudden Infant Death Syndrome has declined. The SIDS rate in Kansas in 2016 was 0.7 per 1,000 live births, down from 1.1 in 2005.

Schunn said some deaths that in the past may have been categorized as SIDS are now classified as an asphyxia death, which may be contributing to the increasing rate of asphyxia deaths. But she also expressed concern that a rise in unsafe sleep practices may be adding to the number of deaths.

“We’re getting much better investigations and with technology we’re able to hone in and make a really solid diagnosis,” Schunn said. But I don’t want to say – it’s not all about reclassification. There’s another very concerning issue in our state and in our nation … what we’re seeing right now is a number of babies that are dying in unsafe sleep environments.”

Research suggests that co-bedding is on the rise nationally, despite years of warnings to avoid the practice.

A study published in JAMA Pediatrics found 13.5 percent of infants shared a sleeping surface with another person in 2010, up from 6.5 percent in 1993.

A report earlier this year from the federal Centers for Disease Control showed that while sleep-related infant deaths fell sharply in the 1990s, the rate of decline has slowed since the early 2000s.

The rate of sleep-related deaths in infants nationally actually rose between 2013 and 2015, the report says. The rate ticked up from 87.3 deaths per 100,000 live births in 2013 to 92.6 deaths per 100,000 in 2015.

“This report shows that we need to do better at promoting and following safe sleep recommendations,” Jennifer Bombard, M.S.P.H., scientist in CDC’s Division of Reproductive Health and lead author of the analysis, said when the report was released in January.

Do you want more information on safe sleep practices?

Visit the KIDS Network resources page at www.kidsks.org/safe-sleep.html