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Dr. Michael Goodstein is on a mission to end infant sleeping deaths.

You could say the WellSpan physician is more than passionate when it comes to preventing sudden unexpected infant deaths, specifically sudden infant death syndrome, or SIDS. The Centers for Disease Control and Prevention estimates sleep-related infant deaths kill thousands each year despite recommendations that could save lives.

The neonatologist wouldn’t disagree with you.

Sudden unexpected infant death includes all sleep-related infant deaths, including accidental suffocation, unknown deaths and SIDS, which is the sudden and unexplained death of a baby under the age of one year that remains unexplained after an autopsy, an examination of the scene of death and a review of the baby’s medical history.

A change in numbers: Sleep-related infant deaths decreased drastically in the early '90s after the American Academy of Pediatrics and other partners launched the Safe to Sleep education campaign, recommending babies sleep on their backs instead of their stomachs. However, after a 50 percent initial decrease, the number of babies dying from sleep-related deaths in the last decade has remained steady — about 3,500 a year — and the rates of accidental suffocation and strangulation in bed have increased 30 percent from 2000 to 2010.

“It’s a national tragedy, and we don’t talk about it,” Goodstein said. “That’s a really bad thing, because with education we could fix this.”

Recently, the WellSpan York Hospital doctor helped author new AAP recommendations. Babies must still be on their backs, but to decrease the risk of SIDS, it also recommends breastfeeding, routine immunizations, using a pacifier and avoiding exposure to smoke, alcohol and illicit drugs.

“If mothers didn’t smoke when they were pregnant, a third of SIDS cases would disappear,” Goodstein said.

Recommendations for a safe sleep environment include positioning babies on their backs, using a firm sleep surface, room-sharing without bed-sharing and avoiding soft bedding and overheating.

Despite the recommendations, AAP researchers earlier this year found that 10 percent to 21 percent of babies examined were placed on a nonrecommended sleep surface, 14 percent to 33 percent were placed in nonrecommended positions, and 87 percent to 93 percent had potentially hazardous items, such as loose blankets or crib bumpers, on their sleep surfaces.

“People say ‘well that looks so sad,’ but all these cute things that make cribs look beautiful are a hazard to a baby’s environment,” Goodstein said.

Guidelines updated: He said the guidelines have to be updated every few years, whether significantly changed or not. The last update was done in 2011, but new research since then includes the positive effects of skin-to-skin care for newborn infants and the effects of using bedside and in-bed sleepers, sleeping on couches or armchairs and in sitting devices.

Though the sample size is too small to compare York County deaths year to year, Goodstein said 2015 was the worst year in recent memory for SIDS deaths in York with nine deaths recorded, up from a handful in 2014.

York Hospital, he said, is working hard to decrease sleep-related deaths with a hospitalwide campaign focusing on policy, training staff and education for every family that leaves delivery.

The hospital-based safe sleep education program includes viewing the "B’more for Healthy Babies" video, reinforcement of safe sleep information from nurses and a voluntary consent form signed by parents confirming they understand the importance and the receipt of safe-sleep information. Signs and photographs throughout the hospital show babies sleeping safely, alone in their cribs without extraneous blankets, just as the guidelines recommend.

Despite increased education efforts, the guidelines will still come too late for some.

Cribs for Kids: Carol Shapiro, of Spring Garden Township, lost her 2-month-old son, Stephen, to SIDS in 1979. Since then she’s become an advocate for safe sleep methods and volunteers for Cribs for Kids, which assists families in York who cannot afford a safe place for their baby to sleep by providing them with a Pack N Play Crib with documentation from the family along with other safe sleep tips.

The national voluntary health organization started in 1998 to provide support to those affected by sleep-related deaths. The model has spread to 50 counties in Pennsylvania.

“I didn’t think it would happen to me, but it can happen to you, and even though some of these guidelines might be difficult to follow, it’s definitely worth it to get through the period where you can lose a baby,” she said. “We all love our babies, and we all want them to be around longer than less than a year. Go by the guidelines.”

In York, Cribs for Kids started a hospital certification program that focuses on decreasing sleep-related infant deaths. WellSpan York Hospital is the first participant to reach the highest level of certification and the only certified hospital in central Pennsylvania.

“Even though it’s many years ago, that child is always a part of your life,” Goodstein said. “Every one of those deaths is a tragedy, and our job is to make it so nobody ever has to suffer again.”

The new American Academy of Pediatrics guidelines can be found at pediatrics.aappublications.org.

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