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American Academy of Pediatrics Annual Meeting

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Tipper Gore


November 4, 1997

Thank you Dr. Alexander, and members of the American Academy of Pediatrics.

I am honored to be here with you today to continue the discussion on an issue of critical importance to American families -- Sudden Infant Death Syndrome -- and how we can work together to continue to reduce the risk across the many communities of caregivers.

I am here today not only as the national spokesperson of the "Back to Sleep" campaign. I am also here as a woman who has seen first-hand the heartbreak and confusion that a SIDS death can cause, having watched several friends who have lost children to SIDS try to piece their lives back to together and make sense of this syndrome that continues to mystify us.

And, I am here as a mother who remembers with absolute clarity what it was like to be a new parent. To Al and I, our first baby seemed so fragile and mysterious, and we were filled with so many questions about how to best care for her.

I remember talking to friends and family to learn everything we could about raising and caring for our children. But it was the advice of our pediatrician that was gospel.

And for good reason. As we've seen with the Back to Sleep campaign, your advice can save lives.

As I listened to Dr. Alexander just now, I was struck by how far the Back to Sleep campaign has come in such a short period of time.

As my friend and colleague Secretary of Health and Human Services Donna Shalala so aptly noted, the Back to Sleep campaign is one of the must successful public-private campaigns in history.

And this great success would not have been possible without you -- the front-line messengers of the Back to Sleep campaign.

As recently as five years ago, the conventional wisdom was that babies should sleep on their stomachs, and nearly 5,000 babies succumbed to SIDS each year.

This year, nearly 1,600 fewer babies will die of SIDS thanks to your work with the Department of Health and Human Services to spread the message that placing infants on their backs to sleep can reduce the risk of SIDS.

As Dr. Alexander pointed out, since this campaign began, SIDS rates have dropped by nearly 40 percent and while we don't yet know exactly what causes SIDS, we do have perfect evidence of how best to reduce it.

But despite this progress, we still have work to do.

Nearly 3,000 babies still die of SIDS each year, and too many parents and other caregivers are not following the Back to Sleep recommendations. In countries like Australia, where infant sleep position has changed from mostly stomach sleeping to mostly back sleeping, SIDS rates have declined by more than 50 percent.

But reaching this goal will require no less than a fundamental change in the conventional wisdom, which has evolved over the years from putting babies to sleep on their stomachs, then their sides and backs, and now just their backs.

Confusion on this issue is understandable. Recent news reports have heightened the confusion as they report that multiple incidents of SIDS in a single family raise the alarm for child abuse. As you know so well, nothing is more devastating for a new parent than the death of their child. And that devastation is compounded when the parent is viewed with suspicion. I hope that when law enforcement investigates a SIDS death, they continue to do so thoroughly, as they have in the past, but also with sensitivity. And we need to help parents understand that the majority of SIDS deaths are not misdiagnosed and that the best way to protect their children is to follow the Back to Sleep message.

And that's what the next phase of the Back to Sleep campaign is all about. It's about making back sleeping as routine for all parents as changing diapers and baby talk. It's about making sure that everyone who cares for babies knows and follows the Back to Sleep message -- including siblings, day care workers, baby sitters, nannies and grandparents. It's about educating all Americans -- all races, all ethnicities, all social classes -- about SIDS and what they can do to reduce the risk. It's about dispelling enduring myths that keep some caregivers from following the Back to Sleep message -- like back sleeping will cause a baby to choke, or to develop flat spots on their heads.

And most of all, it's about sending everyone who cares for babies a clear, consistent message about infant sleep position: place our babies on their backs to sleep. It can help to save their lives.

To help accomplish these goals, we announced a new phase of the Back to Sleep campaign, which I am honored to lead, designed to reach a larger audience of caregivers.

Reaching parents and health care professionals will remain a primary and ongoing goal. But this new phase of the Back to Sleep campaign will work to build on the success we've made together so far by targeting four key groups: daycare workers, minority groups with the highest rates of SIDS, older Americans, and the private sector.

First and foremost, we need to reach child care workers. And according to our most recent estimates, 50 percent of mothers with infants under one year of age are in the workforce. And more infants than ever are leaving their homes to spend at least part of their day in a child care setting.

With more babies receiving care from someone other than their parents, we need to be sure that child care providers know and are following the Back to Sleep message. This check should work two ways. Parents should be sure their baby's child care provider knows the importance of back sleeping, and child care providers should pass the message along to the parents of the children they serve.

To encourage this process, the Back to Sleep campaign is working to reach day care providers across the country with brochures and the latest research on SIDS and how to reduce the risk. You can help by making sure that child care centers receive the Back to Sleep message through your innovative partnership with the Maternal and Child Health Bureau at the Department of Health and Human Services -- the Healthy Child Care America campaign. And each of you should tell the parents of children you serve to make sure that everyone who cares for their baby should know and follow the Back to Sleep message.

Second, the Back to Sleep campaign is working to devise culturally sensitive ways to reach minority groups with the highest rates of SIDS. African-Americans are two and a half times more likely to die of SIDS than white babies, and Native Americans are nearly three times more susceptible.

While we still don't know the root causes of these discrepancies, Back to Sleep will work closely with these communities to expand outreach and spread awareness. You can help by giving extra attention to spreading the Back to Sleep message to your minority patients.

Third, Back to Sleep is reaching out to grandparents and older Americans. So much of what we learn about how to care for our children is passed down from generation to generation. And new moms and dads can get conflicting information from their parents and their pediatricians. I hear stories time and again about new parents placing their babies on their backs to sleep, only to hear from their parents or grandparents that stomach sleeping is best for babies, since that was the conventional wisdom in their day and age. That's why we're focusing on reaching older Americans so that parents receive a consistent message on infant sleep position.

Already, we've worked with the American Association of Retired Persons to get the Back to Sleep message to their members. But you can help by explaining to new parents that the Back to Sleep recommendation is new, and that older members of their families were probably told that babies should sleep on their stomachs. Arming new parents with this knowledge may help them resist their own parents' adamant claims that stomach sleeping is best for babies, as well as help educate the older generation.

And finally, we must reach caregivers where they work, live and shop. That's why the Back to Sleep campaign is reaching out to the private sector, to tap into their vast resources.

Just last March, I announced the Back to Sleep campaign's first corporate partner -- the Gerber Products Company -- which unveiled a new outreach program that has sent the Back to Sleep message to 2.7 million parents of infants across the nation. And, in the coming months, we hope to enlist additional partners to help devise creative new strategies to spread the Back to Sleep message.

So we have new allies in this second phase of the Back to Sleep campaign. But you are still the leading voice; the must trusted word; the indispensable contact with parents.

That's why your continued involvement in all aspects of the Back to Sleep campaign is critical if we are to reach our goal of having at least 90 percent of all infants sleeping on their backs. Please help us by distributing Back to Sleep brochures to the parents you serve, and by making discussions of infant sleep position as much a part of baby care as immunizations and well-baby check-ups. Please help us by devising creative ways to spread the Back to Sleep message in your community. And please help us by continuing to exhibit the extraordinary leadership you've shown so far.

Together, we can save lives.

Thank, you.

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