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New Health Department Report Looks at Sleep-Related Infant Injury Deaths in New York City, 2016–2020

Sleep-Related Injury Mortality Rate Among NYC Infants Remains Steady Since 2012, At 32.9 Deaths Per 100,000 Live Births

Racial And Ethnic Inequities Persist, Often Driven By Structural Racism, Poverty, And Housing Inequality

April 25, 2025 — The sleep-related infant injury death rate in New York City has remained steady since 2012, according to a new report from the NYC Health Department. “Sleep-related injury deaths among infants in New York City, 2016–2020” finds a total of 185 sleep-related injury deaths of infants younger than one year old, a rate of 32.9 deaths per 100,000 live births.

“Every New Yorker should have the opportunity to thrive, but in this report, we again see a pattern of unfair and sometimes deadly sleep-related injuries among some NYC children.” said Acting Health Commissioner Michelle Morse. “Educating parents and caregivers about safe sleep is necessary, but insufficient. We must also connect our families to life-saving resources like safe housing, breastfeeding support, and safe-sleep essentials like portable cribs and wearable blankets. We rely on and value our strong partnership with Administration for Children’s Services to provide parents and caregivers with the education and care they need.”

“Keeping our youngest New Yorkers safe starts with supporting parents and caregivers. That’s why we work to ensure they have the resources and information they need to put their babies to sleep safely,” said NYC Administration for Children’s Services Commissioner Jess Dannhauser. “We know babies sleep safest when they are alone, on their backs, and in their own crib or bassinet free from soft objects, loose bedding, stuffed animals, toys or other items that could increase the risk of suffocation. Thank you to DOHMH and the ACS Office of Child Safety and Injury Prevention for all of their efforts to support caregiving New Yorkers, including by offering portable cribs, wearable blankets, and other safe-sleep related necessities.”

Racial and ethnic inequities in sleep-related infant injury mortality rates persist, often driven by structural racism, poverty and housing inequality. In 2016–2020, the rate of sleep-related injury deaths among infants born to Black mothers (63.6 per 100,000 live births) was more than 4 times that of white mothers (15.3 per 100,000 live births) and Asian/Pacific Islander mothers (11.6 per 100,000 live births). Factors such as lack of heat, presence of rodents or pests, and lack of space due to overcrowding influence a caregiver’s decisions about how and where to place a baby to sleep. These factors must be considered in intervention efforts.

Sleep-related injury deaths among infants are defined as infant deaths (during the first year of age) due to select injury causes (accidental suffocation and strangulation in bed, unspecified threat to breathing, and undetermined causes) when the infant was asleep when last seen alive, with one or more unsafe environmental risk factors (unsafe sleep position, unsafe sleep surface or location, excess bedding, and bed-sharing) present at the time of death.

From 2016–2020 in New York City, there were a total of 2,289 deaths among infants less than 1 year of age. Injury was the third leading cause, accounting for 11 percent of all infant deaths. Among these injury deaths, 83 percent were sleep related.

Additional Risk Factors

Infants ages four months or younger are at the highest risk of sleep-related injury death. These babies lack the body strength to move out of dangerous situations and may have health conditions that make them more vulnerable.

The circumstances of 75 percent of all sleep-related injury deaths among infants involved an unsafe sleep surface or location, 74 percent included excess bedding, 53 percent involved bed-sharing, and 39 percent included an unsafe sleep position.

The rate of sleep-related injury death in preterm infants (less than 37 weeks gestation) was nearly 2.5 times higher than the rate of sleep-related injury deaths in full-term infants (37 weeks or more gestation).

Infants born to mothers who did not have a high school degree or who had only a high school degree had a rate of sleep-related injury death that was 3 times higher than mothers with at least some college education.

Recommendations

The Health Department urges caregivers and parents to follow these recommendations for safe sleep:

  • Place infants on their backs for sleep in their own sleep space with no other people.
  • Use a crib, bassinet, or portable play yard with a firm, flat mattress, and a fitted sheet.
  • Avoid sleep on a couch or armchair or in a seating device, like a swing or car safety seat (except while riding in the car).
  • Keep loose blankets, pillows, stuffed toys, bumpers, and other soft items out of the sleep space.
  • Breastfeed if it is possible
  • Avoid smoking.

For more safe sleep information, visit the following online resources or call 311.

Resources

New York City offers the following free resources to help pregnant and parenting families:

New York City Mayor Eric Adams has announced details of “NYC Baby Boxes,” a program to support local families by alleviating early financial stress for new parents. The collection of postpartum and newborn supplies includes diapers and wipes, clothing, bathing and feeding supplies, and a guide to NYC new family resources.

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MEDIA CONTACT: PressOffice@health.nyc.gov