Nursing Pillows in the Sleep Environment and Sudden Unexpected Infant Deaths - Georgia, January 2013-December 2022.

Abstract

A sudden unexpected infant death (SUID) is defined as the sudden and unexpected death of an infant (a child aged <1 year) whose cause of death was not obvious before investigation. Pillows used to support infants during feeding, often referred to as nursing pillows, have been identified as a potential hazard in sleep spaces for infants. Georgia county-level Child Death Review (CDR) data from the Pediatric National Fatality Review Case Reporting System were analyzed to ascertain whether nursing pillows were found in the sleep space of infants who died of SUID. Among 1,685 SUID cases in Georgia during 2013-2022, a nursing pillow was found in the sleep space of 84 (5%) infants. Among these, 86% of infants who died with a nursing pillow present were aged <4 months, 40% were aged <2 months, and 55% were Black or African American. A total of 56% of the deaths occurred in an adult bed, and all but one (99%) occurred in association with bed sharing. Among the 84 deaths, the nursing pillow was found under the infant in 58 (69.1%) cases, next to the infant in 14 (16.7%) cases, on top of the infant in two (2.4%) cases, and tangled around the infant in one (1.2%) case. This analysis indicates that nursing pillows are being used in ways other than their intended use as an aid in feeding. Since April 2025, newly manufactured nursing pillows must have labels indicating the potential risk associated with using them in infants' sleep spaces; however, many nursing pillows in use or still on the market lack such labeling. Warning consumers of risks associated with using nursing pillows in infant sleep environments, in addition to continued education and outreach about safe infant sleep, could help reduce SUIDs.