Safe Sleeping of Infants

The South Australian Safe Infant Sleeping Standards are a comprehensive set of standards for placing infants less than 12 months old to sleep. These standards were developed to help reduce the occurrence of sudden unexpected deaths of infants during sleep. Several factors occur frequently in the circumstances of these deaths. These factors are not causes of death in their own right.  Rather, they increase the risk of infants dying after being placed to sleep. The Standards provide a consistent suite of messages that health professionals can use to guide the decisions families make about safe infant sleeping.

 

Through the careful work of South Australia police, a great deal of information about the circumstances of sudden unexpected infant deaths is recorded that can help prevent these deaths from happening. Between 2005 and 2016 in South Australia, there were 128 cases where an infant died after being placed to sleep, where no apparent cause could be found for the death. The Child Death and Serious Injury Review Committee has analysed data about the factors that occurred in the circumstances of these deaths. The interactive visualisation allows you to investigate these factors and see how they co-occur. Some important intersections include:

  1. The infant not being placed to sleep in an approved bed is the factor that most frequently occurs together with a number of other factors.
  2. In more than half the cases in which the factor was breast-feeding, a parent also smoked.

These data have driven the recommendations by the Child Death and Serious Injury Review Committee in 2006 and 2016 that all families be provided with an approved bed for their infant to sleep in, along with information about safe infant sleeping. This is particularly true for families living in the most disadvantaged areas of South Australia. As shown in the Committee’s last quarterly blog post, sudden unexpected infant deaths occur more frequently in the State’s most disadvantaged areas.

Death and Disadvantage

More children die in areas of South Australia where there are greater levels of social disadvantage. The Committee has documented this association over the past 12 years and published data showing this relationship in its 2016-17 Annual Report.

In countries like Australia, this relationship between child death and social disadvantage is well known:

‘Relative poverty is highlighted as the most important social determinant for child deaths in high-income countries. The authors identify a persistent – across all causes and in time – inverse association between socioeconomic status and child mortality in high-income countries.’ The Lancet V p830. Child deaths: inequity and inequality in high-income countries.

The relationship between South Australian child deaths and disadvantage, across different categories of death, can be explored in more detail in this interactive visualisation. This includes all deaths of children in the listed categories that occurred in South Australia between 2005 and 2016 inclusive.


The Committee’s analysis shows that, between 2005 and 2016 and across all categories of death:

  • There is a broad pattern of increasing deaths with increasing levels of disadvantage across all age groups.
  • A consistent pattern of low numbers of deaths in the age range 5 to 14 years, and two peaks, one in the youngest age group and one in the oldest.
  • An increase in the number of deaths at younger and older ages is greater at higher levels of socioeconomic disadvantage. The impact of this disadvantage is demonstrated by the particularly high number of deaths in children under one year of age at higher levels of SEIFA.

Some key points to notice about disadvantage and different categories of death:

  • There is a strong association between social disadvantage and children dying from natural causes and in transport crashes. But these two categories are mirror opposites with respect to age, with natural causes involving greater numbers of younger children and transport related deaths involving greater numbers of older children.
  • Fire-related deaths, drowning and deaths resulting from the deliberate act of another person all involved greater numbers of children from areas of greater social disadvantage.
  • The distribution of deaths in these three categories also highlights the vulnerability of toddler and pre-school aged children since they had more deaths in the 1 to 4 age range than any other age.
  • Suicide deaths stand out because there is the least evident effect of social disadvantage.

Go to the Committee’s latest Annual Report to learn more about how the Committee defines ‘disadvantage’ and ‘categories of death’ and what the Committee is doing to address issues arising from the deaths of children in South Australia.