Joint Statement on Safe Sleep: Reducing Sudden Infant Deaths in Canada

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Sudden infant deaths that occur during sleep continue to be a significant public health concern in Canada. This joint statement provides health practitioners with current evidence-based information so they may offer guidance to parents and caregivers to help reduce the risks.

Background

Sudden infant deaths in Canada:

Sleep-related sudden infant deaths occur unexpectedly in otherwise healthy infants. They include deaths due to Sudden Infant Death Syndrome (SIDS) as well as accidental deaths caused by suffocation or strangulation in bed.

SIDS

SIDS is defined as the sudden death, during sleep, of an infant less than one year of age, which remains unexplained after a thorough case investigation, including the performance of a complete autopsy, an examination of the death scene and a review of the clinical history.^{Footnote 1} Current medical and scientific evidence explains SIDS as a multifactorial disorder arising from a complex interaction of underlying vulnerabilities of the infant and the environment.^{Footnote 2},^{Footnote 3},^{Footnote 4} However, the exact cause or causes of SIDS remains unknown.

SIDS can occur at any time during the first year of life but peaks between 2 and 4 months, with fewer SIDS deaths occurring after 6 months.^{Footnote 5},^{Footnote 6},^{Footnote 7} There is a higher incidence of SIDS in infants who are male, premature or of low birth weight.^{Footnote 5},^{Footnote 6},^{Footnote 8} Further research is necessary to increase our understanding of the biological causes and mechanisms that predispose some infants to sudden infant deaths relative to non-affected infants in seemingly comparable circumstances.

Large-scale epidemiological studies over the last two decades have increased our understanding of SIDS and identified certain modifiable risk factors. The most important modifiable risk factors for SIDS are infants sleeping in the prone position, and exposure to tobacco smoke prenatally and after birth.^{Footnote 9},^{Footnote 10},^{Footnote 11},^{Footnote 12},^{Footnote 13},^{Footnote 14},^{Footnote 15},^{Footnote 16},^{Footnote 17}

Common terms:

SUID (sudden unexpected infant death) - also referred to as SUDI (sudden unexpected death in infancy) is a broad term used to describe all sudden, unexpected infant deaths for which a cause is not immediately clear.

Once investigated, some SUIDs can be explained by a specific cause (for example, an underlying infection or disease, accidental suffocation or strangulation in bed (ASSB), etc.). When a death cannot be explained, it is called SIDS.

While the terms SUID/SUDI have sometimes been used by death certifiers as an alternative to a final SIDS diagnosis, the practice is not recommended given the imprecision of these umbrella terms.^{Footnote 25},^{Footnote 27},^{Footnote 28} It has been noted that there can be inconsistency in the meaning of the "U" - which may represent unexpected, undetermined, unknown, unexplained, or unascertained in actual usage.^{Footnote 28}

The rate of SIDS has declined significantly since the late 1980's. Between 1999 and 2004, Canada observed a 50% decrease in the rate of SIDS, which coincided with the launch of recommendations to place infants on their back to sleep, a message reinforced by the Back to Sleep campaign in 1999.^{Footnote 18},^{Footnote 19} The decline may also be attributable, in part, to a decrease in maternal smoking during pregnancy and an increase in breastfeeding.^{Footnote 19},^{Footnote 20}

A similar decline in the SIDS rate in the United States in the 1990s was found to be partially attributed to a shift in diagnosis away from SIDS towards deaths from accidental suffocation and strangulation, as well as other/unspecified causes.^{Footnote 21},^{Footnote 22} An analysis of Canadian data did not support a change in reporting practices as the explanation for the SIDS decline during that time period.^{Footnote 23}

In the years that followed, there was little change in the SIDS rate in Canada. Between 2007 and 2011, 5.8% of all infant deaths (0 to 1 year of age) and 19.6% of postneonatal deaths (28 days to 1 year of age) were attributed to SIDS.^{Footnote 24}

Over the last decade, there has been a notable shift in reporting practice for infant deaths, in Canada as well as globally, making it challenging to assess the prevalence of SIDS. Since 2012, SIDS is no longer being used for the classification of infant deaths in most provinces/territories in Canada. These deaths are instead classified as "undetermined" cause. The practice raises serious concern about implications for SIDS surveillance and research, as well as worries about the unsettling impact for bereaved families left without a diagnosis.^{Footnote 25},^{Footnote 26},^{Footnote 27},^{Footnote 28} This has prompted calls for the establishment of consistent classification categories for SIDS and other unexplained sudden deaths in infants, including clear definitions and guidance for death certifiers.^{Footnote 28}

Based on the last available data (pre 2012), the highest rate of SIDS in Canada is in Nunavut, where the SIDS mortality has been found to be over 3 times the Canadian rate.^{Footnote 20} Alarming disparities persist among Canada's Indigenous population, with a SIDS rate more than seven times higher than the non-Indigenous population.^{Footnote 29} Canadian research has also identified differences in SIDS rates based on neighbourhood income, with the ratio of SIDS being about two times greater in the lowest income quintile compared to the highest.^{Footnote 30}

Other causes

Other causes of death that occur while an infant is sleeping include unintentional suffocation or asphyxiation due to overlay or entrapment. These deaths can be difficult to distinguish from SIDS and many of the risk factors are similar.^{Footnote 31},^{Footnote 32} These risk factors include the presence of soft or loose bedding, using a sleeping surface that is not designed for infant sleep, and infants sharing a sleeping surface with an adult or another child – particularly when combined with the presence of at least one other risk factor.^{Footnote 9},^{Footnote 16},^{Footnote 32},^{Footnote 33},^{Footnote 34},^{Footnote 35},^{Footnote 36},^{Footnote 37},^{Footnote 38},^{Footnote 39},^{Footnote 40},^{Footnote 41}

In Canada, threats to breathing (suffocation, choking, strangulation) were the most common underlying cause of unintentional death for infants under the age of one, representing 69% of accidental deaths.^{Footnote 42} Infants under 4 months accounted for the vast majority (70%) of these deaths.^{Footnote 42}

BRUE vs SIDS:

There is no evidence connecting BRUE as a risk factor for SIDS.
A brief resolved unexplained event (BRUE) is when an infant younger than one year stops breathing, has a change in muscle tone, turns pale or blue in color, or is unresponsive. The event occurs suddenly, lasts less than a minute, is completely resolved, and there is no explanation for the event after a thorough history and exam.^{Footnote 43},^{Footnote 44} In the past, these events were mistakenly thought to be precursors to SIDS, and were referred to as near-miss SIDS or aborted SIDS. These terms were abandoned in the 1980s when the evidence confirmed no correlation between these events and SIDS.^{Footnote 43} The evidence continues to confirm that there are, in fact, more differences than similarities between BRUE and SIDS. The only risk factor that has been shown to influence both is maternal smoking.^{Footnote 44}

Principles of safe sleep

Key modifiable factors that reduce the risk of SIDS and other sleep-related infant deaths:

Infants placed on their backs to sleep, for every sleep, have a reduced risk of SIDS.

Infant sleep position is one of the most significant modifiable factors to reduce the risk of infant sleep-related deaths. Prone and lateral sleeping positions are linked to increased rates of SIDS. Even infants who regurgitate should be placed to sleep on their backs.^{Footnote 9},^{Footnote 11},^{Footnote 16},^{Footnote 39},^{Footnote 45},^{Footnote 46},^{Footnote 47},^{Footnote 48},^{Footnote 49},^{Footnote 50} Infants who normally sleep on their backs and are then placed to sleep in the prone position are at a particularly high risk.^{Footnote 11},^{Footnote 45},^{Footnote 46} This reinforces the importance of consistently placing infants on their backs to sleep at home, in childcare settings and when travelling. Sleep positioners or any other infant sleep positioning devices should not be used as they pose a risk of suffocation.^{Footnote 51},^{Footnote 52}

Once infants are able to roll from their backs to their stomachs or sides, it is not necessary to reposition them onto their backs. However, soft or loose bedding and other objects can pose a suffocation hazard if the infant rolls onto them, so parents/caregivers should continue to keep the infant's sleep area clear.^{Footnote 41}

Although positional plagiocephaly, commonly referred to as flat head, is most commonly caused by supine sleep position, the condition can largely be prevented. Placing the infant's head towards alternating ends of the crib will help to encourage the infant to lie equally on both sides of the head. When awake, infants will benefit from supervised tummy time, several times every day, to prevent plagiocephaly and counteract any effects of regular back sleeping on muscle development.^{Footnote 53},^{Footnote 54},^{Footnote 55}

Despite the intention to follow safe sleep recommendations, not all parents/caregivers put their babies in the supine position for every sleep.^{Footnote 56} Canadian research has found that mothers with lower levels of formal education were more likely to place their infants in a non-supine sleep position.^{Footnote 57} Another study found particularly high rates of non-supine infant sleep position among the Inuit population.^{Footnote 58} These findings suggest the need for tailored health promotion strategies for specific populations.

Preventing exposure to tobacco smoke, before and after birth, reduces the risk of SIDS.

Maternal smoking during pregnancy is an important risk factor for SIDS.^{Footnote 6},^{Footnote 9},^{Footnote 14},^{Footnote 39},^{Footnote 59},^{Footnote 60},^{Footnote 61},^{Footnote 62} The risk of SIDS associated with maternal smoking is dose-dependant.^{Footnote 9},^{Footnote 63},^{Footnote 12},^{Footnote 64} Women who reduce the amount of cigarettes smoked during pregnancy can reduce the risk of SIDS for their infant, and those who stop smoking can further reduce the risk.^{Footnote 9},^{Footnote 10},^{Footnote 15}It is estimated that one third of all SIDS deaths could be prevented if maternal smoking was eliminated.^{Footnote 65},^{Footnote 66},^{Footnote 67}

Infants who are exposed to second-hand smoke after birth are also at a greater risk of SIDS, and this risk increases with the level of exposure.^{Footnote 68},^{Footnote 10},^{Footnote 14}

Smoking and bed sharing appear to have a synergistic effect. The risk of SIDS is significantly higher for infants that bed-share with an adult who is a smoker or if their mother smoked during pregnancy.^{Footnote 64},^{Footnote 69},^{Footnote 70},^{Footnote 71},^{Footnote 72}

There is little published research on cannabis exposure and SIDS. As cannabis smoke contains many of the same harmful chemicals as tobacco smoke, avoiding infant exposure before and after birth is strongly advised. Vaping cannabis does not eliminate the potential risk.^{Footnote 120},^{Footnote 121}

The use of vaping products has increased dramatically in recent years. While often marketed as a means to reduce smoking, vaping products are a less harmful option only for existing smokers who quit smoking completely and switch to vaping. Vaping while pregnant exposes infants to nicotine as well as a host of other potentially harmful substances.^{Footnote 73},^{Footnote 74},^{Footnote 75} Until there is further evidence on the long term health effects, it is safest to avoid vaping during pregnancy and to protect infants from exposure to second-hand vapour from vaping products.^{Footnote 76},^{Footnote 77},^{Footnote 78}

The safest place for an infant to sleep is in a crib, cradle or bassinet that meets current Canadian regulations.

Cribs, cradles, bassinets (including bassinet attachments for playpens) are regulated in Canada and are the safest places for an infant to sleep.

When infants sleep on surfaces that are not designed for them, such as sofas, armchairs and adult beds, they are more likely to become trapped and suffocate, in particular when the surface is shared with an adult or another child.^{Footnote 71},^{Footnote 32},^{Footnote 16},^{Footnote 39},^{Footnote 38},^{Footnote 79},^{Footnote 80}

A safe infant sleep surface:

Has a firm, flat mattress with a tightly fitted sheet;
Has no gaps between the mattress and sides, where the infant could become trapped;
Is free of soft bedding, bumper pads, toys and sleep/head positioners.

Infant sleep products that attach to the adult bed are not recommended. These products present a risk of suffocation and entrapment.^{Footnote 51}

A crib, cradle or bassinet should never be modified and should always be used according to the manufacturer's instructions.

Toys and soft bedding such as pillows, duvets, quilts, comforters and bumper pads increase the risk of suffocation and should not be placed in an infant's crib, cradle or bassinet.^{Footnote 16},^{Footnote 33},^{Footnote 34},^{Footnote 35},^{Footnote 36},^{Footnote 37},^{Footnote 38},^{Footnote 41},^{Footnote 40},^{Footnote 81}

Overheating is a risk factor for SIDS.^{Footnote 82} Infants are safest when placed to sleep in simple, fitted sleepwear that is comfortable at room temperature and does not cause them to overheat. Infants do not require additional blankets as infants' movements may cause their heads to become completely covered and cause them to overheat.^{Footnote 83},^{Footnote 84} If a blanket is used, infants are safest with a thin, lightweight blanket.^{Footnote 51} If a sleep sack is used, it should be sized properly to protect the infant from slipping down inside the sleep sack.^{Footnote 85}

Swaddling is often used to calm infants and promote sleep. Swaddled infants have an increased risk of death when they roll or are placed prone.^{Footnote 86},^{Footnote 87},^{Footnote 88} If swaddling is used, the infant should always be placed on their back and swaddling discontinued as soon as the infant shows signs of trying to roll. Care should be taken to ensure that a swaddled infant's mouth and nose remain well clear of the blanket, and that the infant is wrapped in a way to allow free movement of the hips and legs.^{Footnote 89}

Products that maintain an infant in a seated position, such as car seats, strollers, swings and bouncers, are not intended for infant sleep. When sleeping in a seated position, an infant's head can fall forward and their airway can become blocked.^{Footnote 90},^{Footnote 91} For that reason, if an infant falls asleep while travelling in a car seat or stroller, they should be moved to a crib, cradle or bassinet once the destination is reached. Similarly, when using inclined products such as bouncers or swings, which are often used to lull infants to sleep, the infant should be moved to a crib, cradle or bassinet once asleep.

Babies may also fall asleep in baby slings or carriers. It is important that the baby always be in an upright position, with their face in full view, and without any obstruction to their airway when in a baby sling or carrier. If the baby is positioned incorrectly, their chin may fall forward and they can suffocate against the product's fabric, the wearer's body, or their own chest.^{Footnote 92},^{Footnote 93},^{Footnote 94},^{Footnote 90}

Safe sleep away from home

It is important that infants have a safe sleep space when sleeping away from home, including in child care settings, when visiting or travelling. Bassinet attachments for playpens provide a safe option until the infant starts rolling over or exceeds the weight limit for the attachment. Playpens themselves are not regulated for infant sleep in Canada and do not meet the same safety requirements as cribs, cradles or bassinets (including bassinet attachments for playpens). If used as a temporary sleep space while travelling, it is important to ensure the playpen is securely set up following the manufacturer's instructions and that precautions are taken to create a safe infant sleep surface. An extra mattress or padding should never be added to a playpen, and it should be clear of soft items, bedding and toys. Particular attention should be given to the location of the playpen within the room to make sure no additional risks, such as strangulation hazards posed by corded window coverings or electrical cords, are introduced into the sleep environment.

Infants who share a room with a parent or caregiver have a lower risk of SIDS.

Room sharing refers to a sleeping arrangement where an infant's crib, cradle or bassinet is placed in the same room and near the parent or caregiver's bed. Infants who share a room have a lower risk of SIDS and will benefit from room sharing for the first 6 months, the period of time when the risk of SIDS is highest.^{Footnote 14},^{Footnote 79},^{Footnote 95},^{Footnote 96} Room sharing facilitates breastfeeding and frequent contact with infants at night.

Bed sharing describes a sleeping arrangement where an infant shares a sleeping surface, such as an adult bed, sofa, or armchair, with an adult or another child. Sharing a sleeping surface increases the risk of SIDS, suffocation from overlay or entrapment, and overheating.^{Footnote 39},^{Footnote 71},^{Footnote 79},^{Footnote 97},^{Footnote 98} The risk is particularly high for infants less than 4 months of age, or if the infant was born preterm or with low birthweight.^{Footnote 98},^{Footnote 71},^{Footnote 99} Other factors that put infants at greater risk when bed sharing include:

When an infant shares a sleeping surface with a parent or caregiver who smokes, has consumed alcohol, is under the influence of illicit drugs or medications that may cause drowsiness, or is overly tired.^{Footnote 14},^{Footnote 39},^{Footnote 42},^{Footnote 69},^{Footnote 70},^{Footnote 71},^{Footnote 95},^{Footnote 96}
If the infant's mother smoked during the pregnancy.^{Footnote 64},^{Footnote 69}
Sleeping with an infant on a soft surface, such as a sofa, armchair, waterbed or air mattress.^{Footnote 32},^{Footnote 42},^{Footnote 69},^{Footnote 71},^{Footnote 100}
Not placing the infant on their back.^{Footnote 16},^{Footnote 42},^{Footnote 69}
The presence of loose bedding, pillows, blankets and other objects in the bed.^{Footnote 69}
When an infant shares the bed with more than one person or animal.^{Footnote 16},^{Footnote 42}

Recent Canadian data indicates that bed sharing is a common practice that parents employ for practical reasons.^{Footnote 101} A third of mothers reported sharing a bed with their infant everyday or almost everyday and an additional 27% reported doing so occasionally. Breastfeeding was the most commonly cited reason for infant bed sharing, followed by facilitating sleep for the infant or mother. Given the prevalence, parents should be aware of the factors that put infants at greatest risk when bed sharing, so they can knowingly avoid them.

The term co-sleeping can refer to a range of sleeping practices that include both bed sharing and room sharing. Definitions of this term are not consistent enough to make it universally acceptable.

Breastfeeding provides a protective effect for SIDS.

Breastfeeding is associated with a decreased risk of SIDS.^{Footnote 102},^{Footnote 103},^{Footnote 104},^{Footnote 105} The evidence indicates that breastfeeding for at least 2 months is necessary to provide a protective effect, and is associated with half the risk of SIDS, with greater protection provided with increased duration.^{Footnote 102} Although exclusive breastfeeding is preferred given the many associated health benefits, exclusive breastfeeding does not appear to provide added protection from SIDS over any breastfeeding.^{Footnote 102}

Canadian research has estimated that increasing efforts to promote, protect and support breastfeeding could help prevent a substantial proportion of SIDS mortality, particularly among Indigenous infants in Canada.^{Footnote 106}

Successful breastfeeding is not dependent on sharing a sleeping surface.^{Footnote 14},^{Footnote 39} However, parents who may bring their infant into bed to breastfeed should be aware of the factors that increase the risks associated with bed sharing. Moving the infant back to sleep in a crib, cradle or bassinet following the feeding will minimize any potential risk.^{Footnote 39},^{Footnote 96},^{Footnote 70}

In Canada, as well as globally, exclusive breastfeeding is recommended for the first six months, and continued for up to 2 years or longer along with age-appropriate complementary feeding.^{Footnote 107}

Other modifiable factors:

In addition to these key principles, other factors that can affect the risk of SIDS and other sleep related infant deaths include:

Pacifiers

Some evidence suggests that pacifiers may provide a protective effect for SIDS.^{Footnote 36},^{Footnote 108},^{Footnote 109},^{Footnote 110},^{Footnote 111},^{Footnote 112} Infants who accept a pacifier should have one consistently, for every sleep.^{Footnote 109},^{Footnote 113} A pacifier is not required to be reinserted if it is expelled during sleep.

While there is no solid evidence to demonstrate that pacifier use impairs breastfeeding, it is recommended to delay the introduction of a pacifier until breastfeeding is well established.^{Footnote 114}

Alcohol and substance use

Alcohol and opiate use during pregnancy are associated with an increased risk of SIDS.^{Footnote 115},^{Footnote 116},^{Footnote 117} Parental alcohol and substance use are also associated with a significantly higher risk of infant death when combined with bed sharing.^{Footnote 118},^{Footnote 119},^{Footnote 42},^{Footnote 70}

Immunizations

Immunization does not increase the risk of SIDS and may even lower the risk.^{Footnote 122},^{Footnote 123},^{Footnote 4} Infants should receive their vaccinations according to the schedule established in their province/territory.

Home monitors: Despite marketing claims, there is no evidence that home sleep monitors - used to detect infant breathing, heart rate or movement - reduce the incidence of SIDS.^{Footnote 44},^{Footnote 124} These products can provide a sense of false reassurance. Priority should be placed on the principles of safe sleep as the most effective way to decrease the risk of SIDS.

Summary

Sudden infant deaths that occur during sleep continue to be a significant public health concern in Canada. The most important modifiable factors that can lower the risk are:

Placing infants on their backs to sleep for every sleep.
Protecting infants from exposure to tobacco smoke, before and after birth.
Providing a safe sleep environment for infants. The safest place for an infant to sleep is in a crib, cradle or bassinet, free of soft loose bedding, placed in the parent's room for the first 6 months.
Breastfeeding - for at least 2 months, with greater protection provided with longer duration.
Practicing the principles of safe sleep FOR EVERY SLEEP - at home, in childcare settings and when travelling.

Although bed sharing is not advised, parents/caregivers should be aware of the factors that put infants at greatest risk when bed sharing so they can take steps to avoid them.

Health care providers are encouraged to share and discuss guidance on safe sleep practices with parents/caregivers of infants, beginning in pregnancy.

This Joint Statement is an update to the 2011 version. The Public Health Agency of Canada, the Canadian Paediatric Society, Health Canada and Baby’s Breath Canada acknowledge with gratitude the contributions of those involved in this and past versions of this document.

References

Footnote 1

Willinger M, James IS, Catz C. Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol. 11, 1991, (5):677–84.

Return to footnote 1 referrer

Footnote 2

Kinney HC, Thach BT. The sudden infant death syndrome. N Engl J Med. 361, 2009, (8)795–805.

Return to footnote 2 referrer

Footnote 3

Goldstein RD, Trachtenberg FL, Sens MA, Harty BJ, Kinney HC. Overall postneonatal mortality and rates of SIDS. Pediatrics. 137, 2016, (1):1–10.

Return to footnote 3 referrer

Footnote 4

Carlin RF, Moon RY. Risk Factors, Protective Factors, and Current Recommendations to Reduce Sudden Infant Death Syndrome: A Review. JAMA Pediatr. 171, 2017, (2):175–80.

Return to footnote 4 referrer

Footnote 5

Blair P, Sidebotham P, Berry P, Evans M, Fleming P. Major epidemiological changes in sudden infant death syndrome: A 20 year population-based study in the UK. Lancet. 367, 2006, (9507):314–9.

Return to footnote 5 referrer

Footnote 6

Leach CE, Blair PS, Fleming PJ, Smith IJ, Platt MW, Berry PJ, Golding J, et al. Epidemiology of SIDS and explained sudden infant deaths. Pediatrics. 104, 1999, (4) e43.

Return to footnote 6 referrer

Footnote 7

Shapiro-Mendoza CK, Tomashek KM, Anderson RN, Wingo J. Recent national trends in sudden, unexpected infant deaths: more evidence supporting a change in classification or reporting. Am J Epidemiol. 163, 2006, (8):762–9.

Return to footnote 7 referrer

Footnote 8

Blair PS, Fleming PJ. Epidemiological investigation of sudden infant death syndrome in infants: Recommendations for future studies. Child Care Health Dev. 28, 2002, Suppl 1:49–54.

Return to footnote 8 referrer

Footnote 9

Mitchell EA, Taylor BJ, Ford RP, Stewart AW, Becroft DM, Thompson JM et al. Four modifiable and other major risk factors for cot death: The New Zealand Study. J Paediatr Child Health. 28, 1992, Suppl 1:S3–8.

Return to footnote 9 referrer

Footnote 10

Blair PS, Fleming PJ, Bensley D, Smith I, Bacon C, Taylor E et al. Smoking and the sudden infant death syndrome: Results from 1993–1995 case-control study for confidential inquiry into stillbirths and deaths in infancy. BMJ. 313, 1996, (7051):195–8.

Return to footnote 10 referrer

Footnote 11

Oyen N, Markestad T, Skjaerven R, Irgens L, Helweg-Larsen K., Alm B, Norvenius G, Wennergren G. Combined effects of sleeping position and prenatal risk factors in sudden infant death syndrome: The Nordic Epidemiological SIDS study. Pediatrics. 100, 1997, (4):613–21.

Return to footnote 11 referrer

Footnote 12

Brooke H, Gibson A, Tappin D, Brown H. Case-control study of sudden infant death syndrome in Scotland, 1992–5. BMJ. 314, 1997, (7093):1516–20.

Return to footnote 12 referrer

Footnote 13

Alm B, Milerad J, Wennergren G, Skjaerven R, Oyen N, Norvenius G, et al. A case-control study of smoking and sudden infant death syndrome in the Scandinavian countries, 1992–1995. Arch Dis Child. 78, 1998, (4):329–34.

Return to footnote 13 referrer

Footnote 14

Carpenter RG, Irgens LM, Blair PS, England PD, Fleming P, Huber J et al. Sudden unexplained infant death in 20 regions in Europe: Case–control study. Lancet. 363, 2004, (9404):185–91.

Return to footnote 14 referrer

Footnote 15

Vennemann M, Findeisen M, Butterfab-Bahloul T, Jorch G, Brinkman B, Kopcke W et al. Modifiable risk factors for SIDS in Germany: Results of GeSID. Acta Paediatrica. 94, 2005, (6):655–60.

Return to footnote 15 referrer

Footnote 16

Hauck FR, Herman SM, Donovan M, Iyasu S, Moore CM, Donoghue E, et al. Sleep environment and the risk of sudden infant death syndrome in an urban population: The Chicago infant mortality study. Pediatrics. 111, 2003, (5 Pt 2):1207–14.

Return to footnote 16 referrer

Footnote 17

Fleming P, Blair P. Sudden infant death syndrome and parental smoking. Early Hum Dev. 83, 2007, (11):721–5.

Return to footnote 17 referrer

Footnote 18

Public Health Agency of Canada. Canadian Perinatal Health Report: 2008 Edition. Ottawa, 2008.

Return to footnote 18 referrer

Footnote 19

Rusen ID, Sauve R, Joseph KS, Kramer MS. Sudden infant death syndrome in Canada: Trends in rates and risk factors, 1985–1998. Chronic Dis Can. 25, 2004, (1):1–6.

Return to footnote 19 referrer

Footnote 20

Public Health Agency of Canada. Sudden Infant Death Syndrome (SIDS) in Canada. [Online] 2014. http://publications.gc.ca/collections/collection_2015/aspc-phac/HP35-51-2014-eng.pdf.

Return to footnote 20 referrer

Footnote 21

Malloy MH, MacDorman M. Changes in the classification of sudden unexpected infant deaths: United States, 1992–2001. Pediatrics. 115, 2005, (5):1247–53.

Return to footnote 21 referrer

Footnote 22

Shapiro-Mendoza CK, Kimball M, Tomashek KM, Anderson RN, Blanding S. US infant mortality trends attributable to accidental suffocation and strangulation in bed from 1984 through 2004: are rates increasing? Pediatrics. 123, 2009, (2):533–9.

Return to footnote 22 referrer

Footnote 23

Gilbert NL, Fell DB, Joseph KS, Liu S, León JA, Sauve R. Temporal trends in sudden infant death syndrome in Canada from 1991 to 2005: contribution of changes in cause of death assignment practices and in maternal and infant characteristics. Paediatr Perinat Epidemiol. 26, 2012, (2):124–30.

Return to footnote 23 referrer

Footnote 24

Public Health Agency of Canada. Perinatal health indicators for Canada 2017. [Online] 2017. http://publications.gc.ca/collections/collection_2018/aspc-phac/HP7-1-2017-eng.pdf.

Return to footnote 24 referrer

Footnote 25

Shapiro-Mendoza CK, Parks SE, Brustrom J, Andrew T, Camperlengo L, Fudenberg J, et al. Variations in cause-of-death determination for sudden unexpected infant deaths. Pediatrics. 140, 2017, (1) e20170087.

Return to footnote 25 referrer

Footnote 26

Gould SJ, Weber MA, Sebire NJ. Variation and uncertainties in the classification of sudden unexpected infant deaths among paediatric pathologists in the UK: findings of a National Delphi Study. J Clin Pathol. 63, 2010, (9):796–9.

Return to footnote 26 referrer

Footnote 27

Crandall LG, Reno L, Himes B, Robinson D. The Diagnostic Shift of SIDS to Undetermined: Are There Unintended Consequences? Acad Forensic Pathol. 7, 2017, (2):212–20.

Return to footnote 27 referrer

Footnote 28

Goldstein RD, Blair PS, Sens MA, Shapiro-Mendoza CK, Krous HF, Rognum TO, Moon RY. Inconsistent classification of unexplained sudden deaths in infants and children hinders surveillance, prevention and research: recommendations from The 3rd International Congress on Sudden Infant and Child Death. Forensic Sci Med Pathol. 15, 2019, (4):622–8.

Return to footnote 28 referrer

Footnote 29

Sheppard AJ, Shapiro GD, Bushnik T, Wilkins R, Perry S, Kaufman JS, Kramer MS, Yang S. Birth outcomes among First Nations, Inuit and Métis populations. Health Reports. 28, 2017, (11):11–16.

Return to footnote 29 referrer

Footnote 30

Gilbert NL, Auger N, Wilkins R, Kramer MS. Neighbourhood income and neonatal, postneonatal and sudden infant death syndrome (SIDS) mortality in Canada, 1991–2005. Can J Public Health. 104, 2013, (3): e187–e192.

Return to footnote 30 referrer

Footnote 31

Syndrome, Task Force On Sudden Infant Death. SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment. Pediatrics. 138, 2016, (5):e20162940.

Return to footnote 31 referrer

Footnote 32

Rechtman LR, Colvin JD, Blair PS, Moon RY. Sofas and infant mortality. Pediatrics. 134, 2014, (5):e1293–300.

Return to footnote 32 referrer

Footnote 33

Mitchell EA, Scragg L, Clements M. Soft cot mattresses and the sudden infant death syndrome. N Z Med J. 109, 1996, (1023):206–7.

Return to footnote 33 referrer

Footnote 34

Thach BT, Rutherford GW, Harris K. Deaths and injuries attributed to infant crib bumper pads. J Pediatr. 151, 2007, (3):271–4.

Return to footnote 34 referrer

Footnote 35

L'Hoir MP, Engelberts AC, van Well GTJ, et al. Risk and preventive factors for cot death in The Netherlands, a low-incidence country. Eur J Pediatr. 157, 1998, (8):681–8.

Return to footnote 35 referrer

Footnote 36

Fleming PJ, Blair PS, Bacon C, et al. Confidential Enquiry into Stillbirths and Deaths Regional Coordinators and Researchers. Environment of infants during sleep and risk of the sudden infant death syndrome: results of 1993–5 case-control study. BMJ. 313, 1996, (7051):191–5.

Return to footnote 36 referrer

Footnote 37

Ponsonby AL. Dwyer T, Couper D, Cochrane J. Association between use of a quilt and sudden infant death syndrome: Case-control study. BMJ. 316, 1998, (7126):195–6.

Return to footnote 37 referrer

Footnote 38

Ostfeld BM, Perl H, Esposito L, Hempstead K, Hinnen R, Sandler A, Goldblatt Pearson P, Hegyi T. Sleep environment, positional, lifestyles, demographic characteristics associated with bed sharing in Sudden Infant Death Syndrome Cases: A population-based study. Pediatrics. 118, 2006, (5):2051–9.

Return to footnote 38 referrer

Footnote 39

McGarvey C, McDonnell M, Chong A, O'Regan M, Matthews T. Factors relating to the infant's last sleep environment in sudden infant death syndrome in the Republic of Ireland. Arch Dis Child. 88, 2003, (12):1058–64.

Return to footnote 39 referrer

Footnote 40

Moon RY, Hauck FR. Hazardous bedding in infants' sleep environment is still common and a cause for concern. Pediatrics. 135, 2015, (1):178–9.

Return to footnote 40 referrer

Footnote 41

Colvin JD, Collie-Akers V, Schunn C, Moon RY. Sleep environment risks for younger and older infants. Pediatrics. 134, 2014, (2):e406–12.

Return to footnote 41 referrer

Footnote 42

Statistics Canada. Circumstances surrounding deaths from unintended threats to breathing in children under the age of one, 2006 to 2017. [DRAFT Reviewed 2020– Date of Publication TBC].

Return to footnote 42 referrer

Footnote 43

Arane K, Claudius, I, Goldman RD. Brief resolved unexplained event: New diagnosis in infants. Can Fam Physician. 2017, (63) 39–41.

Return to footnote 43 referrer

Footnote 44

Behnam-Terneus M, Clemente M. SIDS, BRUE, and Safe Sleep Guidelines. Pediatr Rev. 2019, 40, (9) 443–55.

Return to footnote 44 referrer

Footnote 45

Mitchell E, Thach B, Thompson J, Williams S. Changing infants' sleep position increases risk of sudden infant death syndrome. Arch Pediatr Adolesc Med. 153, 1999, (11):1136–41.

Return to footnote 45 referrer

Footnote 46

Li DK, Petitti DB, Willinger M, McMahon R, Odouli R, Vu H, Hoffman HJ. Infant sleep position and the risk of sudden infant death syndrome in California, 1997–2000. Am J Epidemiol. 157, 2003, (5): 446–55.

Return to footnote 46 referrer

Footnote 47

Vandenplas Y, Rudolph CD, Lorenzo C, Hassall E, Liptak G, Mazur L, et al. Pediatric gastroesophageal reflux clinical practice guidelines: Joint recommendations of the North American and European Society of Pediatric Gastroenterology, Hepatology and Nutrition (HASPGHAN and ESPGHAN). J Pediatr Gastroenterol Nutr. 49, 2009, (4):498–547.

Return to footnote 47 referrer

Footnote 48

Wong FY, Witcombe NB, Yiallourou SR, Yorkston S, Dymowski AR, Krishnan L, et al. Cerebral oxygenation is depressed during sleep in healthy term infants when they sleep prone. Pediatrics. 127, 2011, (3):e558–65.

Return to footnote 48 referrer

Footnote 49

Byard RW, Beal SM. Gastric aspiration and sleeping position in infancy and early childhood. J Paediatr Child Health. 2000. 36, 2000, (4):403–5.

Return to footnote 49 referrer

Footnote 50

Tablizo MA, Jacinto P, Parsley D, Chen ML, Ramanathan R, Keens TG. Supine sleeping position does not cause clinical aspiration in neonates in hospital newborn nurseries. Arch Pediatr Adolesc Med. 161, 2007, (5):507–10.

Return to footnote 50 referrer

Footnote 51

Health Canada. Is Your Child Safe? Sleep Time. [Online] 2012. [Cited: 02 24, 2020.] https://www.canada.ca/en/health-canada/services/consumer-product-safety/reports-publications/consumer-education/your-child-safe/sleep-time.html#a52.

Return to footnote 51 referrer

Footnote 52

Centers for Disease Control and Prevention. Suffocation deaths associated with use of infant sleep positioners-United States, 1997–2011. MMWR Morb Mortal Wkly Rep. 61, 2012, (46):933–7.

Return to footnote 52 referrer

Footnote 53

Hutchison BL, Thompson JM, Mitchell EA. Determinants of nonsynostotic plagiocephaly: a case-control study. Pediatrics. 112, 2003, (4):e316.

Return to footnote 53 referrer

Footnote 54

van Vlimmeren LA, van der Graaf Y, Boere-Boonekamp MM, L'Hoir MP, Helders PJ, Engelbert RH. Risk factors for deformational plagiocephaly at birth and at 7 weeks of age: A prospective cohort study. Pediatrics. 119, 2007, (2):e408–18.

Return to footnote 54 referrer

Footnote 55

Canadian Paediatric Society. Positional Plagiocephaly, Practice Point. [Online] 2011 (Reaffirmed 2018). [Cited: 02 25, 2020.] https://www.cps.ca/en/documents/position/positional-plagiocephaly.

Return to footnote 55 referrer

Footnote 56

Colson ER, Geller NL, Heeren T, Corwin MJ. Factors Associated With Choice of Infant Sleep Position. Pediatrics. 140, 2017, (3):e20170596.

Return to footnote 56 referrer

Footnote 57

Smylie J, Fell DB, Chalmers B, Sauve R, Royle C, Allan B, O'Campo P. Socioeconomic Position and Factors Associated With Use of a Nonsupine Infant Sleep Position: Findings From the Canadian Maternity Experiences Survey. Am J Public Health. 104, 2014, (3): 539–47.

Return to footnote 57 referrer

Footnote 58

Asuri S, Ryna AC, Arbour L. Early Inuit Child Health in Canada Report. Early Inuit child health in Canada: Report 1 – Sleep practices among Inuit infants and the prevention of SIDS. [Online] University of British Columbia and Inuit Tapiriit Kanatami, 2011. [Cited: February 24, 2021.] https://www.itk.ca/wp-content/uploads/2016/07/2011-Report-Sleep-Practices-among-Inuit-Infants-and-the-Prevention-of-SIDS.pdf.

Return to footnote 58 referrer

Footnote 59

Schoendorf KC, Kiely JL. Relationship of sudden infant death syndrome to maternal smoking during and after pregnancy. Pediatrics. 90, 1992, (6):905–8.

Return to footnote 59 referrer

Footnote 60

Sawnani H, Jackson T, Murphy T, Beckerman R, Simakajornboon N. The effect of maternal smoking on respiratory and arousal patterns in preterm infants during sleep. Am J Respir Crit Care Med. 169, 2004, (6):733–8.

Return to footnote 60 referrer

Footnote 61

Sawnani H, Olsen E, Simakajornboon N. The effect of in utero cigarette smoke exposure on development of respiratory control: a review. Pediatr Allergy Immunol Pulmonol. 23, 2010, (3):161–7.

Return to footnote 61 referrer

Footnote 62

Tirosh E, Libon D, Bader D. The effect of maternal smoking during pregnancy on sleep respiratory and arousal patterns in neonates. J Perinatol. 16, 1996, (6):435–8.

Return to footnote 62 referrer

Footnote 63

Mitchell EA, Ford RP, Stewart AW, Taylor BJ, Becroft DM, Thompson JM, et al. Smoking and the sudden infant death syndrome. Pediatrics. 91, 1993, (5):893–6.

Return to footnote 63 referrer

Footnote 64

Zhang K, Wang X. Maternal smoking and increased risk of sudden infant death syndrome: a meta-analysis. Legal medicine (Tokyo, Japan). 15, 2013, (3):115–21.

Return to footnote 64 referrer

Footnote 65

Mitchell EA, Milerad J. Smoking and the sudden infant death syndrome. Rev Environ Health. 21, 2006, (2):81–103.

Return to footnote 65 referrer

Footnote 66

Dietz PM, England LJ, Shapiro-Mendoza CK, Tong VT, Farr SL, Callaghan WM. Infant morbidity and mortality attributable to prenatal smoking in the U.S. Am J Prev Med. 39, 2010, (1):45–52.

Return to footnote 66 referrer

Footnote 67

Rehm J, Gnam W, Popova S, Baliunas D, Brochu S. The Costs of Alcohol, Illegal Drugs, and Tobacco in Canada, 2002. J Stud Alcohol Drugs. 68, 2007, (6):886–95.

Return to footnote 67 referrer

Footnote 68

Liebrechts-Akkerman G, Lao O, Liu F, et al. Postnatal parental smoking: an important risk factor for SIDS. Eur J Pediatr. 170, 2011, (10):1281–91.

Return to footnote 68 referrer

Footnote 69

Blair PS, Sidebotham P, Pease A, Fleming PJ. Bed-sharing in the absence of hazardous circumstances: is there a risk of sudden infant death syndrome? An analysis from two case-control studies conducted in the UK. PLoS One. 9, 2014, (9):e107799.

Return to footnote 69 referrer

Footnote 70

Carpenter R, McGarvey C, Mitchell EA, Tappin DM, Vennemann MM, Smuk M, et al. Bed sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case-control studies. BMJ Open. 3, 2013, (5):e002299.

Return to footnote 70 referrer

Footnote 71

Vennemann MM, Hense H-W, Bajanowski T, Blair PS, Complojer C, Moon RY, et al. Bed sharing and the risk of sudden infant death syndrome: can we resolve the debate? J Pediatr. 160, 2012, (1):44–8.e2.

Return to footnote 71 referrer

Footnote 72

Task Force on Infant Sleep Position and Sudden Infant Death Syndrome, AAP. Changing Concepts of Sudden Infant Death Syndrome: Implications for Infant Sleeping Environment and Sleep Position. Pediatrics. 105, 2000, (3)650–6.

Return to footnote 72 referrer

Footnote 73

Spindel E, McEvoy C. The Role of Nicotine in the Effects of Maternal Smoking during Pregnancy on Lung Development and Childhood Respiratory Disease: Implications for Dangers of E-Cigarettes. Am J Respir Crit Care Med. 193, 2016, (5);486–94.

Return to footnote 73 referrer

Footnote 74

Whittington JR, Simmons PM, Phillips AM, Gammill SK, Cen R, Magann EF, et al. The Use of Electronic Cigarettes in Pregnancy: A Review of the Literature. Obstet Gynecol Surv. 73, 2018, (9):544–9.

Return to footnote 74 referrer

Footnote 75

Eugenín J, Otárola M, Bravo E, Coddou C, Cerpa V, Reyes-Parada M, Llona I, von Bernhardi R. Prenatal to early postnatal nicotine exposure impairs central chemoreception and modifies breathing pattern in mouse neonates: a probable link to sudden infant death syndrome. J Neurosci. 28, 2008, (51):13907–17.

Return to footnote 75 referrer

Footnote 76

Public Health Agency of Canada. Chapter 3: Care During Pregnancy (3–25). Family Centered Maternity and Newborn Care National Guidelines. [Online] 2019. [Cited: February 24, 2021.] https://www.canada.ca/en/public-health/services/publications/healthy-living/maternity-newborn-care-guidelines-chapter-3.html.

Return to footnote 76 referrer

Footnote 77

Health Canada. Risks of Vaping. [Online] 2020. [Cited: February 24, 2021.] https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping/risks.html.

Return to footnote 77 referrer

Footnote 78

National Academies of Sciences, Engineering, and Medicine and Systems, Committee on the Review of the Health Effects of Electronic Nicotine Delivery. Public Health Consequences of E-cigarettes. A Consensus Study Report of the National Academies of Sciences, Engineering and Medicine. Washington (DC) : National Academies Press (US), 2018.

Return to footnote 78 referrer

Footnote 79

Tappin D, Ecob R, Brooke H. Bedsharing, roomsharing, and sudden infant death syndrome in Scotland: A case-control study. J Pediatr. 147, 2005, (1): 32–7.

Return to footnote 79 referrer

Footnote 80

Scheers N, Rutherford W, Kemp J. Where should infants sleep? A comparison of risk for suffocation of infants sleeping in cribs, adult beds, and other sleeping locations. Pediatrics. 112, 2003, (4):883–9.

Return to footnote 80 referrer

Footnote 81

Parks SE, Erck Lambert AB, Hauck FR, Cottengim CR, Faulkner M, Shapiro-Mendoza CK. Explaining Sudden Unexpected Infant Deaths, 2011–2017. Pediatrics. 2021, Vol. 147, 5:e2020035873.

Return to footnote 81 referrer

Footnote 82

Ponsonby AL, Dwyer T, Gibbons IE, Cochrane JA, Jones ME, McCall MJ. Thermal environment and sudden infant death syndrome: Case-control study. BMJ. 304, 1992, (6822): 277–82.

Return to footnote 82 referrer

Footnote 83

Mitchell EA, Thompson JM, Becroft DM, Bajanowski T, Brinkmann B, Happe A, et al. Head covering and the risk of SIDS: Findings from the New Zealand and German SIDS case-control studies. Pediatrics. 121, 2008, (6):e1478–e1483.

Return to footnote 83 referrer

Footnote 84

Blair PS, Mitchell EA, Heckstall-Smith EM, Fleming PJ. Head covering – a major modifiable risk factor for sudden infant death syndrome: a systematic review. Arch Dis Child. 93, 2008, (9)778–83.

Return to footnote 84 referrer

Footnote 85

Glover Williams A, Finlay F. Can infant sleeping bags be recommended by medical professionals as protection against sudden infant death syndrome? Arch Dis Child. 104, 2019, (3):305–7.

Return to footnote 85 referrer

Footnote 86

McDonnell E, Moon RY. Infant deaths and injuries associated with wearable blankets, swaddle wraps, and swaddling. J Pediatr. 164, 2014, (5):1152–6.

Return to footnote 86 referrer

Footnote 87

Pease AS, Fleming PJ, Hauck FR, Moon RY, Horne RSC, L'Hoir MP, et al. Swaddling and the Risk of Sudden Infant Death Syndrome: A Meta-analysis. Pediatrics. 137, 2016, (6)e20153275.

Return to footnote 87 referrer

Footnote 88

Nelson AM,. Risks and Benefits of Swaddling Healthy Infants: An Integrative Review. MCN Am J Matern Child Nurs. 42, 2017, (4):216–25.

Return to footnote 88 referrer

Footnote 89

Canadian Paediatric Society. Swaddling. Caring for Kids. [Online] CPS, May 2018. [Cited: 02 27, 2020.] https://www.caringforkids.cps.ca/handouts/swaddling.

Return to footnote 89 referrer

Footnote 90

Rholdon R,. Understanding the Risks Sitting and Carrying Devices Pose to Safe Infant Sleep. Nurs Womens Health. 21, 2017, (3):225–30.

Return to footnote 90 referrer

Footnote 91

Côté A, Bairam A, Deschesne M, Hatzakis G. Sudden infant deaths in sitting devices. Arch Dis Child. 93, 2008, (5):384–9.

Return to footnote 91 referrer

Footnote 92

Batra EK, Midgett JD, Moon RY. Hazards associated with sitting and carrying devices for children two years and younger. J Pediatr. 167, 2015, (1):183–7.

Return to footnote 92 referrer

Footnote 93

Bergounioux J, Madre C, Crucis-Armengaud A, et al. Sudden deaths in adult-worn baby carriers: 19 cases. Eur J Pediatr. 174, 2015, (12):1665–70.

Return to footnote 93 referrer

Footnote 94

Madre C, Rambaud C, Avran D, Michot C, Sachs P, Dauger S. Infant deaths in slings. Eur J Pediatr. 173, 2014, (12):1659–61.

Return to footnote 94 referrer

Footnote 95

Scragg R, Mitchell EA, Stewart AW, et al. Infant room-sharing and prone sleep position in sudden infant death syndrome. Lancet. 347, 1996, (8993):7–12.

Return to footnote 95 referrer

Footnote 96

Blair PS, Fleming PJ, Smith IJ, et al and Group., CESDI SUDI Research. Babies sleeping with parents: case-control study of factors influencing the risk of the sudden infant death syndrome. BMJ. 319, 1999, (7223):1457–61.

Return to footnote 96 referrer

Footnote 97

Carroll-Pankhurst C, Mortimer EA. Sudden infant death syndrome, bedsharing, parental weight, and age of death. Pediatrics. 107, 2001, (3):530–6.

Return to footnote 97 referrer

Footnote 98

Ruys JH, Jonge GA, Brand R, Engelberts A, Semmekrot BA. Bed-sharing in the first four months of life: A risk factor for sudden infant death. Acta Paediatr. 96, 2007, (10):1399–403.

Return to footnote 98 referrer

Footnote 99

Blair PS, Platt MW, Smith IJ, Fleming PJ. Sudden infant death syndrome and sleeping position in pre-term and low birth weight infants: an opportunity for targeted intervention. Arch Dis Child. 91, 2006, (2):101–6.

Return to footnote 99 referrer

Footnote 100

Doering JJ., Salm Ward TC. The Interface Among Poverty, Air Mattress Industry Trends, Policy, and Infant Safety. Am J Public Health. 107, 2017, (6):945–9.

Return to footnote 100 referrer

Footnote 101

Gilmour H, Ramage-Morin PL, Wong SL. Infant bed sharing in Canada. s.l. : Statistics Canada, Health Reports, July 17, 2019. www.doi.org/10.25318/82-003-x201900700002-eng.

Return to footnote 101 referrer

Footnote 102

Thompson JMD, Tanabe K, Moon RY, Mitchell EA, McGarvey C, Tappin D, et al. Duration of Breastfeeding and Risk of SIDS: An Individual Participant Data Meta-;analysis. Pediatrics. 140, 2017, (5):e20171324.

Return to footnote 102 referrer

Footnote 103

Ip S, Chung M, Raman G, Trikalinos TA, Lau J. A summary of the Agency for Healthcare Research and Quality's evidence report on breastfeeding in developed countries. Breastfeed Med. 4, 2009, (suppl 1):S17–s30.

Return to footnote 103 referrer

Footnote 104

Hauck FR, Thompson JMD, Tanabe KO, Moon RY, Vennemann MM. Breastfeeding and reduced risk of sudden infant death syndrome: a meta-analysis. Pediatrics. 128, 2011, (1):103–10.

Return to footnote 104 referrer

Footnote 105

Vennemann MM, Bajanowski T, Brinkmann B, et al and Group, GeSID Study. Does breastfeeding reduce the risk of sudden infant death syndrome? Pediatrics. 123, 2009, (3):e406–10.

Return to footnote 105 referrer

Footnote 106

McIsaac KE, Moineddin R, Matheson FI. Breastfeeding as a means to prevent infant morbidity and mortality in Aboriginal Canadians: A population prevented fraction analysis. Can J Public Health / Rev can sante publique. 106, 2015, (4):e217–22.

Return to footnote 106 referrer

Footnote 107

Health Canada, Canadian Paediatric Society, Dietitians of Canada, and Breastfeeding Committee for Canada. Nutrition for Healthy Term Infants. [Online] 2012. [Cited: 03 01, 2021.] https://www.canada.ca/en/health-canada/services/canada-food-guide/resources/infant-feeding/nutrition-healthy-term-infants-recommendations-birth-six-months.html.

Return to footnote 107 referrer

Footnote 108

Li DK, Willinger M, Petitti DB, Odouli R, Liu L, Hoffman HJ. Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): population based case-control study. BMJ. 332, 2006, (7532):18–22.

Return to footnote 108 referrer

Footnote 109

Hauck FR, Omojokun OO, Siadaty MS. Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis. Pediatrics. 116, 2005, (5):e716–23.

Return to footnote 109 referrer

Footnote 110

L'Hoir MP, Engelberts AC, van Well GTJ, et al. Dummy use, thumb sucking, mouth breathing and cot death. Eur J Pediatr. 158, 1999, (11):896–901.

Return to footnote 110 referrer

Footnote 111

Mitchell EA, Taylor BJ, Ford RPK, et al. Dummies and the sudden infant death syndrome. Arch Dis Child. 68, 1993, (4):501–4.

Return to footnote 111 referrer

Footnote 112

Mitchell EA, Blair PS, L'Hoir MP. Should pacifiers be recommended to prevent sudden infant death syndrome? Pediatrics. 117, 2006, (5):1755–8.

Return to footnote 112 referrer

Footnote 113

Vennemann M, Bajanowski T, Brinkmann B, et al. Sleep Environment Risk Factors for Sudden Infant Death Syndrome: The German Sudden Infant Death Syndrome Study. Pediatrics. 123, 2009, (4);1162–70.

Return to footnote 113 referrer

Footnote 114

O'Connor NR, Tanabe KO, Siadaty MS, Hauk FR. Pacifiers and Breastfeeding: a systematic review. Arch Pediatr Adolesc Med. 163, 2009, (4):378–82.

Return to footnote 114 referrer

Footnote 115

Minozzi S, Amato L, Bellisario C, Ferri M, Davoli M. Maintenance agonist treatments for opiate-dependent pregnant women. Cochrane Database Syst Rev. 2013, (12):CD006318.

Return to footnote 115 referrer

Footnote 116

O'Leary CM, Jacoby PJ, Bartu A, D'Antoine H, Bower C. Maternal alcohol use and sudden infant death syndrome and infant mortality excluding SIDS. Pediatrics. 131, 2013, (3):e770–8.

Return to footnote 116 referrer

Footnote 117

Strandberg-Larsen K, Grønboek M, Andersen AM, Andersen PK, Olsen J. Alcohol drinking pattern during pregnancy and risk of infant mortality. Epidemiology. 20, 2009, (6):884–91.

Return to footnote 117 referrer

Footnote 118

Hauck FR, Tanabe KO. Beyond "Back to Sleep": Ways to Further Reduce the Risk of Sudden Infant Death Syndrome. Pediatr Ann. 46, 2017, (8):e284–90.

Return to footnote 118 referrer

Footnote 119

Blair PS, Sidebotham P, Evason-Coombe C, Edmonds M, Heckstall-Smith EM, Fleming P. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. BMJ. 339:b3666, 2009.

Return to footnote 119 referrer

Footnote 120

Giroud C, De Cesare M, Berthet A, et al. E-Cigarettes: A Review of New Trends in Cannabis Use. Int. J Environ Res Public Health. 2015, Vols. 12(8), 9988–10008.

Return to footnote 120 referrer

Footnote 121

National Academies of Sciences, Engineering, and Medicine. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Washington, D.C.: National Academies Press.

Return to footnote 121 referrer

Footnote 122

Vennemann MM, Hoffgen M, Bajanowski T, Hense HW, Mitchell EA. Do immunisations reduce the risk for SIDS? A meta-analysis. Vaccine. 25, 2007, (26):4875–9.

Return to footnote 122 referrer

Footnote 123

Muller-Nordhorn J, Hettler-Chen CM, Keil T, Muckelbauer R. Association between sudden infant death syndrome and diphtheria-tetanus-pertussis immunisation: an ecological study. BMC Pediatr. 15, 2015, (1):1.

Return to footnote 123 referrer

Footnote 124

Moon R, Task Force on Sudden Infant Death Syndrome. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. Pediatrics. 2016, Vol. 138, (5) e20162940.

Return to footnote 124 referrer

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