The Trend Has Reversed — and the Numbers Are Significant
In 1990, the SUID rate in the United States stood at 158.58 deaths per 100,000 live births. The launch of the “Back to Sleep” campaign in 1994 drove one of the most dramatic reductions in infant mortality in modern public health history. By 2020, that rate had fallen to 92.9 per 100,000. Then it started climbing.
CDC data shows the SUID rate jumped to 100.5 per 100,000 live births by 2022 — a 12% increase in just two years, according to research cited in AAP News. The most recent 2024 figure sits at 93.6 per 100,000, still above the 2020 low point. Roughly 3,500 infants die every year from sleep-related causes, making SUID the leading cause of death for babies between one month and one year of age.
What’s driving the reversal? Pediatric leadership has pointed to pandemic-era disruptions in well-child visits and public health outreach — meaning families simply heard the guidance less often. The guidance itself hasn’t changed. What changed is how consistently families were able to receive it.
Case reviews show the same preventable patterns repeating. A 2025 study published in Worldviews on Evidence-Based Nursing reviewed 154 SUID deaths in Pennsylvania during 2018 and 2019. Among the findings: 46% of infants who died were sharing a sleep surface with another person or an animal. Some 33.1% were found in an adult bed — a surface the AAP identifies as unsafe. Among infants who died in 2018, only 34.5% had been placed on their back — the single most protective sleep position.
These are not rare circumstances. They are common, everyday decisions made by families who may not fully understand the stakes.
The data does not fall equally across communities. CDC surveillance data from 2010–2013 recorded SUID rates of 190.5 per 100,000 for American Indian/Alaska Native infants and 171.8 per 100,000 for non-Hispanic Black infants — more than double the 84.4 per 100,000 rate for non-Hispanic white infants. That gap has not closed.
3 Takeaways for North Atlanta Families
1. Back sleeping is non-negotiable — every single sleep.
In detailed case reviews, nearly two-thirds of infants who died of SUID were not on their back when they were found. Back sleeping on a firm, flat surface — for every nap and every night — is the single most consistently protective sleep practice the evidence supports.
2. Room-sharing is protective. Bed-sharing is not.
The AAP recommends keeping your baby’s sleep surface in your room for at least the first six months — but on a separate surface, not in your bed. Sharing an adult bed, especially with soft bedding or other people present, significantly increases risk. Proximity protects. Surface-sharing does not.
3. A single conversation isn’t enough — repetition is how safe sleep saves lives.
Research and clinical experience consistently show that families are more likely to follow safe sleep guidance when they hear it from multiple sources, repeatedly. A one-time hospital conversation is a starting point, not a finish line. That’s why consistent well-child visits matter — and why One Family Pediatrics reinforces this guidance at every appointment.
“When safe sleep messaging isn’t reinforced from multiple places, families are more likely to conclude it isn’t as important as it actually is.”
— AAP Leadership, cited in AAP News, 2025
That observation carries real weight in the context of the current data. The 12% spike in SUID rates between 2020 and 2022 tracks directly with the period when well-child visits dropped and public health outreach was disrupted. The guidance — back sleeping, firm flat surface, room-sharing without bed-sharing, bare sleep area — didn’t change. Families simply stopped hearing it as often.
The implication is important for how One Family Pediatrics approaches every well-child visit: safe sleep counseling isn’t a box to check. It’s a clinical intervention that works in proportion to how consistently and clearly it’s delivered. The Pennsylvania case review data underscores exactly why. Nearly two-thirds of infants in that study were not in the position most likely to keep them alive. Changing that outcome requires more conversations, not fewer.
About the Study
This report was prepared by One Family Pediatrics, a pediatric practice serving families across Forsyth, Gwinnett, Hall, Dawson, Cherokee, and Fulton Counties in North Atlanta. It draws exclusively on peer-reviewed research, federal surveillance data, and clinical policy statements — including CDC National Vital Statistics System mortality data, a 2025 study in Worldviews on Evidence-Based Nursing, and the American Academy of Pediatrics’ 2022 Safe Sleep Policy Statement. No data was modeled or extrapolated. The goal is straightforward: give families raising infants right now the clearest possible picture of what the evidence shows.
Frequently Asked Questions
Q: What does SUID mean, and is it the same as SIDS? SUID stands for Sudden Unexpected Infant Death — an umbrella term that includes SIDS (Sudden Infant Death Syndrome), accidental suffocation and strangulation in bed, and other sudden infant deaths where the cause is unknown or undetermined. SIDS is the most recognized subset, but all SUID categories are captured in the statistics cited throughout this report.
Q: What is the single most important thing I can do to reduce my baby’s risk? Place your baby on their back — every sleep, every time, from birth. CDC and AAP data consistently show this is the most protective sleep practice. In detailed case reviews, nearly two-thirds of infants who died of SUID were not found in this position.
Q: Is it safe for my baby to sleep in a car seat or swing? No — not unsupervised. Inclined surfaces like car seats, bouncers, swings, and strollers are not safe sleep environments. If your baby falls asleep in one, move them to a firm, flat surface as soon as possible. The AAP’s safe sleep guidelines are specific on this point.
Q: I’ve heard that room-sharing helps — but does it matter how long we do it? Yes. The AAP recommends room-sharing — keeping your baby’s crib or bassinet in your room — for at least the first six months, and ideally through the first year. The key distinction is surface: your baby should be in their own sleep space, not in your bed. Room-sharing without bed-sharing is protective. Bed-sharing, particularly with soft bedding or other people present, increases risk significantly.
Q: My baby seems to sleep better on their stomach. Is it okay just for naps? No. Back sleeping is recommended for every sleep — naps and nighttime alike. Babies often do appear to sleep more deeply on their stomachs, but that deeper sleep can actually reduce their ability to arouse in response to breathing difficulties. The guidance applies consistently, regardless of sleep duration.
Your Baby’s Next Visit Could Be the Conversation That Makes the Difference.
Safe sleep guidance works best when families hear it repeatedly — from their pediatrician, from nurses, from family members, and from public health programs. One Family Pediatrics provides personalized, evidence-based safe sleep counseling at every well-child visit, serving families across Forsyth, Gwinnett, Hall, Dawson, Cherokee, and Fulton Counties.
If you have questions about safe sleep, or if it’s been a while since your last appointment, we’re here.
