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Yvonne T. Maddox, Ph.D. - Upper Marlboro, Maryland
When an infant dies suddenly after birth, parents need to understand why. When answers to these sometimes difficult questions are hard to come by, the loss can be even more inexplicable and devastating.

"Infant mortality is defined as the death of a child before his or her first birthday, and in recent years, the infant mortality rate in the U.S. has been declining. But we must do better," said Dr. Yvonne T. Maddox. "In the U.S., the infant mortality rate is seven deaths per every 1,000 births. That's 27,000 infant deaths per year. And in the African American community, the figures are twice as high -- 14 deaths per every 1,000 births."

Several factors can cause infant mortality, including congenital abnormalities and birth defects; prematurity and low birth weight; acute respiratory distress syndrome; infections; and Sudden Infant Death Syndrome (SIDS).

SIDS is the sudden, unexplained death of a baby. Despite its prevalence, the exact cause is still unknown. "I strongly believe SIDS is developmental," Maddox said. "It's the leading cause of death in babies after 1 month, but most SIDS deaths occur under 6 months of age."

According to Maddox, recent research connects some instances of SIDS to the area of the brain that helps control breathing and awakening during sleep. If this area is underdeveloped in a baby who becomes tangled in loose bedding, the baby may not be signaled to turn his or her head for oxygen and may, therefore, suffocate. "It is imperative that babies are positioned on their backs while sleeping -- even while napping -- to reduce the risk of suffocation," Maddox said.

However, the culture and traditions many African Americans were handed down encourage parents to place babies on their stomachs to sleep, said Maddox. Some are afraid babies will choke or regurgitate and then suffocate if they're placed on their backs, and some believe babies will develop flat spots on the backs of their heads from sleeping on their backs. Maddox said both are highly unlikely.

"Through our 'Back to Sleep' campaign, we've created culturally competent materials that take these traditions into account, while raising SIDS awareness in African American communities," said Maddox.

Maddox noted other methods for reducing the risk of SIDS include prenatal care for the mother-to-be, using a safety-approved crib with a firm mattress, not smoking before or after birth and not allowing others to smoke around a child, getting a child well-baby checkups, not wrapping a baby too tightly or dressing a child too warmly, and not sharing a bed with a baby or putting a baby to bed with a sibling.

"Parents want to keep their babies safe, and I am proud that our educational efforts help them do that," said Maddox, who also chairs the Women's Fellowship at her church. "We are on a journey to save our babies through research and education, and we will continue until no baby dies of SIDS."

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