SIDS and SUID Are on the Rise, With Highest Rates for Black Infants 

“The disparities—infant mortality, maternal mortality—among black women and black infants have been consistent, unfortunately,” Sriraman says. 

Recent statistics confirm that non-Hispanic Black infants in the U.S. continue to experience higher infant mortality and SUID rates than other groups. In 2022, the infant mortality rate for Black non-Hispanic mothers was 10.90 per 1,000 live births, almost double the U.S. average of about 5.61 per 1,000. According to the Office of Minority Health, in 2023, Black infants died approximately 2.5 times more often from disorders related to low birthweight and more than twice as often from SIDS and accidents compared with all infants in the U.S. Data from 2017 to 2022 show that Black infants had among the highest rates of SUID—rising from about 192.4 per 100,000 live births in 2017 to 244.0 per 100,000 in 2022. Despite progress in reducing overall infant mortality, the racial disparity gap remains wide.

Inequities in healthcare access, environmental stressors, economic conditions, and implicit bias in healthcare are a few of the factors behind these health disparities. Black women are more likely to live in neighborhoods with limited access to high-quality healthcare—a fact exacerbated by the pandemic hospital closures, including in Black communities. According to the Center for American Progress, Black women are more likely than any other demographic of women to be the breadwinners in their families. And with no federally mandated paid parental leave and a continued child care crisis, Black families often lack the support to attend postpartum and well-baby visits with their doctors.

Sriraman says postpartum care can make a significant difference in maternal and infant health outcomes, but many women of color don’t follow up. “This is detrimental because there is a lack of follow-up for many things, including mental health, physical health, as well as future family planning,” she says. In her expertise, the issue is also one of trust: “Some Black women feel that they are not heard or that they received poor care and do not feel comfortable going back.”

Sriraman recommends that healthcare providers use a culturally competent approach that considers a family’s housing situation and sleep setup when discussing postpartum guidance, including safe sleep practices. “We want to gain trust,” she says. “For me, it’s coming from a place of curiosity instead of coming from a judgmental point of view.” She also recommends including aunts, grandmothers, and other family members in the conversation whenever possible, as guidance from elders is often held in high regard by Black mothers, even though much of the advice might be outdated.

When healthcare providers are not a family’s primary source of guidance, and federally and state-funded programs are cut or fail to support Black families, community-focused responses to racial disparities in infant and maternal health outcomes can be effective. Doulas, for example, are often members of a woman’s community who also share lived experiences, along with training and expertise. 

Research shows that doulas can help improve maternal health outcomes for women of color. Joy Thomas is a full-spectrum doula, providing birth and postpartum support to her clients.

“My goal is to make sure that mom and family are cared for,” Thomas says. “From the mother on down to the baby, and the baby on up to the mother, so whatever the mom needs.” During the postpartum period, she says her role as a doula includes ensuring her clients feel seen and heard, monitoring for any postpartum complications, and ensuring the newborn is cared for—from diapering to feeding and safe sleeping. She says that as a doula, she provides evidence-based, individualized care as opposed to generalized guidance. 

“Some cultures do different things. Some families want to do safe sleeping, but they’re more fond of or open to co-sleeping,” Thomas says. “So, always asking them or understanding what their family dynamics are. Some families that I work with don’t have the luxury of a nursery or a crib, so they may be using a pack-and-play or bedside bassinet.” It’s her role, she says, to make sure families know where and how to put their baby to sleep safely, no matter their situation.

In her experience working with her childbirth clients in hospitals, it’s common for healthcare providers to tell parents to put their baby on their backs to sleep before sending them home. 

“That’s pretty much the standard, and families are just expected to know that that’s the only thing that can prevent SIDS,” Thomas says. “Not considering if there are smokers in the house or other kids in the house. They don’t consider all of the factors. Sometimes that is probably missed in a lot of the childbirth education in hospitals.” 

Sriraman recognizes that providers often lack the time to dedicate to safe sleep discussions and delving deeper into a family’s particular circumstances.

“It’s not that we don’t care,” she says. “If a baby is premature or if a baby is jaundiced, I’m going to focus on the immediate problem. We may not go into a full discussion because there’s something more important that we need to deal with for the baby’s safety or health, or mom’s maternal health.”

Because maternal health and infant health are intrinsically linked, the loss of the Safe to Sleep campaign represents a disinvestment in infant health education that signals a potential backslide in national progress to reduce preventable infant and maternal deaths—especially among Black families who already face disproportionate risks and barriers to care.

Sriraman says that at a time when families are getting their information from social media and alternative sources, the loss of funding to the Safe to Sleep campaign will affect groups who need it the most. “I think it impacts the community groups that are doing education—whether that’s in the WIC offices or through other community outreach,” she says.