Healthy Start of Hillsborough strives to reduce infant deaths from unsafe sleep

Each year in the United States, 3,400 babies die suddenly while sleeping, according to Centers for Disease Control and Prevention statistics. The cause can be suffocation from a pillow or blankets, co-sleeping with a parent or another adult caregiver or getting wedged between a mattress and the side of a crib.

Medical experts have a specific term to describe these deaths: sudden unexpected infant death. In Hillsborough County, it is a heartbreaking and significant community issue that a coalition of local government agencies, hospitals and nonprofits have launched programs and campaigns to address. In 2022, there were 11 sleep-related infant deaths in Hillsborough. That number jumped to 21 in 2023, according to provisional numbers. Already in 2024, there have been five.

Safe Baby, a Healthy Start Coalition of Hillsborough County program funded by the Children’s Board of Hillsborough County, is taking the lead to work on solutions to reduce the county's infant mortality rate and improve the health of pregnant women in a county with 17,000 births annually.

Safe Baby program serves approximately 3,200 participants annually from 55 different zip codes across the county, says Jessica Reynolds, community outreach manager for the Safe Baby program. The program's goal is simple but serious- to give parents the training and guidance to keep their babies safe. 

One way to do that is to keep the crib or sleeping area safe. Even the most useful baby products, if left in the wrong place, are a danger to a baby, Reynolds says.

Jessica Reynolds, community outreach manager for Healthy Start Hillsborough's Safe Baby program.“Babies don't need all those squishy comforters, blankets, pillows, things like that, inside their crib,” she says. “These items must be removed from the newborn's sleeping environment.” 

If these extra items make the crib look beautiful, they also create unsafe conditions for the newborn, says Reynolds.

“Suffocation and strangulation in bed is preventable,” she says.

For Reynolds, Safe Baby helps new parents identify unsafe items and behavior. 

“The leading preventable cause of death is primarily due to unsafe sleep, shaking baby syndrome,” she says.

Suffocation and strangulation in bed was the number one cause of infant death in Hillsborough County for 2022, according to a Florida Department of Health report. Experts categorize this cause of death as unintentional injury. Consequently, nonprofit organizations and county officials have set their sights on improving the safety of a baby’s environment by providing appropriate training for new parents through programs like Safe Baby, which also provides training for hospital employees. A related Safe Baby Plus program provides developmental screening of babies for parents and caregivers of children under age one.

A mother's point of view

Before attending the training session, many parents think co-sleeping or bed-sharing is normal. That’s the case for Nadine Pierre, who went through the training in 2016.

“Sleeping next to a newborn is more than normal in some customs,” Pierre says. “But when you get the training, the trainers tell you the baby must sleep alone in his or her crib.”

Whether some parents deliberately sleep next to their newborn, others “unintentionally fall asleep while feeding their babies,” according to the American Academy of Pediatrics. 

That national organization of pediatricians offers guidance for parents about the risk of sleep-related infant death, which is 67 times higher when infants sleep next to someone on a couch, soft armchair or cushion.

When Pierre gave birth to her first child at St. Joseph's Hospital, a nurse provided some necessary tips on how to care for her firstborn.

A few days later, at her first doctor’s visit with the baby, Pierre says her primary care physician guided her to the WIC program.Nadine Pierre

“I went to the new class and learned the baby must sleep alone, and shaking the baby can be deadly,” she says.

Today, Pierre has two children, a seven-year-old child, and a preschooler.

“I wish that program could reach my community with assistance for Creole or French speakers.”

Some new parents are from different cultures with different practices regarding newborn care, explains Pierre, who immigrated to Florida in 2014.

“However, Safe Baby Plus allows us to follow a standard for the well-being of our babies,” she says. “That’s great.”

Safe Baby’s countywide impact 

“Our program operates in many different areas to reach families everywhere,” Reynolds says. “We were able to meet and educate families through our major birthing hospitals in Hillsborough County.”

In 2022, around 4,000 parents went through WIC and online programs. Five hundred fifty-four babies received developmental screening, activities, Safe Baby education for parents and follow-up for up to 12 months. Hospital-based staff provides 148 park n' plays to new moms and their babies. Also, an additional group of 605 medical and social services professionals received Safe Baby training, according to the Healthy Start Coalition of Hillsborough County.

Top five tips for new parents 

“We would love for new parents to understand that SIDS, which means sudden infant death syndrome, is not the primary cause of unexpected death during sleep. But it's suffocation and strangulation in bed," says Reynolds, who also outlines five essential tips for new parents.

• “Any item that could block the newborn's airway must be kept away from the baby's sleeping environment. The three safest locations for baby to sleep are crib, park and play and the bassinet,” Reynolds says.
• The safest sleep position for babies is on their backs, according to the American Academy of Pediatrics. Reynolds says when after that guidance was first released in the '90s, the sleep-related death rate dropped to 50% lower. 
•  Select a safe caregiver. The Safe Baby Plus provides significant tips and assistance for new parents on how to find a safe nanny. 
• Distracted parents “is a newer component of our education program,” Reynolds says. Increasingly, cell phones hav emerged as a source of distraction. “The baby is in one hand, the phone in the other,” Reynolds says. “This behavior could, unfortunately, have a deadly impact.”
• The “PURPLE period” of crying, when babies can cry inconsolably for hours, happens around two to three months of age. This period is very challenging, exhausting and tiring for parents. Sometimes, the babies are going to start crying more than usual. Reynolds urges parents to calm down first and address the baby's needs in such a situation.