October is Safe Sleep Month. While Hamilton County has seen improvement in the overall infant mortality rate, sleep-related deaths aren't decreasing at a similar rate — and Black babies are at the highest risk. Local health agencies want to understand why the needle isn't moving and how they can help families.
"We have identified those at greatest risk. We must put culturally appropriate and nonjudgmental communication between doctors, clinicians and parents into play so that young mothers are aware of the dangers to their infants," says Dr. Grant Mussman, interim health commissioner for the Cincinnati Health Department.
Cradle Cincinnati compared data from 2017 to 2021, finding nearly 7 in 10 sleep-related infant deaths were Black babies. The agency plans to spend Safe Sleep Month promoting safe sleep messaging and working directly with parents and communities on best practices.
Hamilton County's infant mortality rate — the rate at which babies die before their first birthday — was 6.4 deaths per 1,000 live births (66/10,266) in 2021. That set a record low for the second year in a row. In 2017, the county recorded 9 deaths per 1,000 live births.
The work is ongoing
Improvements have been made in several areas, but sleep-related deaths caused by things like co-sleeping, unsafe sleep positioning, and use of soft bedding items like pillows, blankets, and stuffed toys, account for 67% of infant deaths in Hamilton County from 2017 to 2021.
The data review found:
- Almost 6 in 10 deaths involved co-bedding (58%).
- Some 20% of infant deaths involved a mother smoking anytime during pregnancy.
- Mothers in 42% of infant deaths received less than adequate prenatal care.
- More than 60% of sleep-related infant deaths had mothers under 30.
Cradle Cincinnati Senior Epidemiologist Anthony Nixon Jr says messaging is important, but so is "starting a dialogue and engaging the community around safe sleep."
The group has already begun hosting community listening sessions "diving deeper into this narrative and allowing the community to tell their stories, specifically, about sleeping habits, sleeping environment, some of the stressors or some of the lived experiences."
He says it's important to get a better understanding of why people are making certain choices about sleep so they can target education or otherwise tailor their efforts.
Some of the work is a continuation of ongoing efforts, including Queens Village — which creates a community of support for expectant parents — and Mama Certified, a program that aims to help parents assess birthing centers and ensure babies of color receive equitable care.
Cradle Cincinnati also put a direct focus on supporting Black families in 2019. The agency implemented a four-pronged approach for addressing racism and racial disparities in health care.
Nixon points out the pandemic and the added stressors it has placed on people and families have made things harder and that is certainly playing a role in the decisions people make.
"The pandemic is really taking a toll on the community in a lot of different ways, and understanding what that looks like when it comes to the family handling certain aspects at home — I think that that's going to show up in data; that's going to show up in narratives when we're talking and engaging," he says.
"One of the misconceptions is, (people who say) 'Why doesn't someone just put their baby in a crib?' I think it's a little bit more complex than that."
