City of Austin

AUSTIN, Texas – Accidental suffocation or strangulation in bed (ASSB) is the leading cause of injury-related death for infants under 12 months of age in Austin and Travis County. A new report published by Austin Public Health (APH) highlights the importance of safe sleep practices to prevent these tragic deaths.

“The data we found shows that many of these deaths are avoidable,” said Austin-Travis County Health Authority Dr. Desmar Walkes. “It's crucial that we continue to educate families about safe sleep environments to protect our most vulnerable residents. The safest way for a baby to sleep is alone, on their back, and in a crib free of blankets, pillows or stuffed animals.”

The report used data from the Travis County Medical Examiner’s Office for non-natural infant deaths between 2018 and 2023. The data includes 51 infant deaths in Travis County, where risk factors for ASSB were present. Of these, 40 occurred in Austin and were recorded by the Office of Vital Records with causes of death such as “suffocation,” “positional asphyxia,” or “undetermined.” In all cases, the infants were found in unsafe sleep environments, as defined by the American Academy of Pediatrics’ 2022 safe sleep recommendations.

Key Findings:

• 47% of ASSB deaths occurred in infants under three months old.
• 68% were in an adult bed. 61% of infants were bed-sharing with another person.
• 84% of cases involved blankets; 71% involved pillows.
• African American infants were disproportionately represented in ASSB deaths.
• 39% of infants were not placed on their backs to sleep.

Although no deaths during this period were attributed to Sudden Infant Death Syndrome (SIDS), the risk factors and prevention strategies for SIDS and ASSB are the same. 

Local Resources:

APH’s Injury Prevention Program provides educational presentations on safe sleep and leads the Austin/Travis County Safe Sleep Coalition.  APH collaborates with community hospitals, clinics and other community organizations to provide cribs to qualifying families. Cribs are subject to eligibility and availability.

Family Connects supports parents by providing nurse home visits at no cost to families. These trained nurses perform comprehensive health and wellness assessments for you and your newborn in the comfort of your home.

Texas Health and Human Services provides education and resources at GetParentingTips.com.

Safe sleep guidelines include:

• Placing babies on their backs to sleep every time;
• Using a firm, flat sleep surface such as a crib, bassinet or pack n play®
• Keep soft bedding, blankets, and toys out of the crib.

The American Academy of Pediatrics has a collection of safe sleep tools and resources on their website.

You can read the full report here.