Four infants have died in Baltimore County in the past two months due to unsafe sleeping conditions, according to the county health officer, who called on health care providers to step up safe-sleep education efforts for new parents and other caregivers.

“Over the last two months, we have seen four preliminary findings of sleep-related deaths in infants. While one such death is cause for sounding an alarm, four is what we normally see over the course of an entire year,” said Dr. Gregory Wm. Branch, the health officer, in a statement.

“It is critically important that all potential caregivers understand the importance of practicing these precautions, including fathers, grandparents, and ... mothers,” added Branch.

Officials noted the deaths were still preliminary but attributed them to unsafe sleep practices coupled with the increase in respiratory infections such as RSV, which leads to potentially dangerous congestion, breathing troubles and frequent waking in young children.

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Branch alerted pediatricians, hospitals and other community groups of the deaths in a letter Feb. 7. He asked them to advise parents and other caregivers about proper sleeping positioning.

The accepted standard advice goes by the acronym ABCDE: Babies should be alone, on their backs, and in a crib with no blankets or toys. Also, don’t smoke. No exceptions.

Dr. Scott Krugman, chair of the Baltimore County Child Fatality Review Team, said almost every infant death occurs in an unsafe sleeping location, like an adult’s bed or sofa.

“It is imperative that the ABCDEs of safe sleep are a part of every child’s environment,” Krugman said in a statement.

The officials said they were relying heavily on providers to help get the word out, but the county health department also has a child and maternal health program to educate parents and caregivers.

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The deaths come on the heels of a report from the Abell Foundation, a nonprofit focused on health, education and economic issues, that found a Baltimore City program aimed at educating parents and caregivers was effective in reducing infant deaths.

From the program’s inception in 2009 through 2019, the report found, the third main cause of infant deaths in the city were sleep related. The top cause was prematurity, or babies born before 27 weeks, followed by low birth weight, or babies born weighing less than 5.5 pounds.

The city program called B’more for Healthy Babies had reduced deaths by more than a third by educating parents, often through home visits, about safe sleep practices. Parents also got access to prenatal medical care, support groups and counseling.

The report noted there had been “some setbacks, but given the disruptions to [B’more for Healthy Babies] programming stemming from the COVID pandemic, officials are hopeful that will prove an anomaly.”

City health officials were not immediately available to comment on the recent uptick in infant deaths.

Meredith Cohn is a health and medicine reporter for The Baltimore Banner, covering the latest research, public health developments and other news. She has been covering the beat in Baltimore for more than two decades.

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