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March 17, 1999

Putting Babies "Back to Sleep"—Reply

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(11):983-984. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-11-jbk0317

In Reply: Since the introduction of public health campaigns to encourage back sleeping in a number of countries, the SIDS rates in those countries have declined substantially. Although these programs have often included messages regarding a number of other infant care practices, only modest changes have occurred in practices other than sleep position, which are unlikely to account for the decline in SIDS rates. Therefore, we disagree with Dr Moy's assertion that elements other than sleep position should be given equal emphasis at this time. In our study, we sought to identify risk factors associated with continued use of prone sleeping. We believe that an understanding of these factors may be useful in developing future public health efforts directed at reducing the prevalence of this behavior. We do not wish to chastise parents for continuing to use prone sleeping; rather, we should chastise ourselves for not delivering the Back-to-Sleep message more effectively.