Client: US Public Health Service, National Institute of Child Health and
Human Development (NICHD), American Academy of Pediatrics (AAP), the
SIDS Alliance, and Association of SIDS and Infant Mortality Program
PR Team: In-house(s) with support from Porter Novelli and
Fleishman-Hillard Campaign: "Back to Sleep"
Time Frame: June 1994 - present
Budget: Approximately $725,000, plus contributions of individual
Child-health advocates have learned that it not only takes a village, but a corporate sponsor or two to reduce infants' risk of Sudden Infant Death Syndrome (SIDS).
Researchers are not sure precisely why back sleeping reduces SIDS risk, but one theory is that babies who sleep facedown may rebreathe exhaled air with a high concentration of carbon dioxide. SIDS babies may have a defect in the part of the brain that senses carbon dioxide buildup in the blood.
When child-health advocates teamed up to let new parents know that back sleeping reduces SIDS risk, the results were astonishing. But rather than drop the ball as the SIDS rate plummeted, activists decided to continue to pursue audiences resistant to change their infants' sleeping practice.
Many parents and caregivers of the nearly 4 million babies expected yearly will not put their children to sleep on their backs. In fact, recent studies have shown the risk of SIDS to be double for African-American infants, and two-and-a-half times greater for Native Americans (compared to Caucasians).
Grandparents and other senior caregivers are still resistant to the recommended change. Additionally, a disproportionate one-fifth of all SIDS deaths occur in day care.
Initially, parents were reached through feature stories, advice from pediatricians, brochures in doctor's offices and hospitals, publicity of a nationwide toll-free information/referral hotline, and a series of ads. Porter Novelli launched the initial radio, TV, and print campaign that propelled the issue onto the national agenda from 1995 to 1997.
Fleishman-Hillard, in its work with Procter & Gamble's Pampers Parenting Institute, put "Back to Sleep tabs on diapers. P&G then tapped Wal-greens for "Back to Sleep in-store promotions.
In the past 18 months, advocates enlisted the help of national African-American sororities, the NAACP, the Coalition of 100 Black Women, and the Congress of National Black Churches to give presentations to school boards, churches, and community groups. SIDS activists are also collaborating with Indian Health Services to deliver the message to Native American populations.
New PSAs targeting senior caregivers, using such phrasing as "safe sleep for my grandbaby, are being diffused in senior centers, as well as nontraditional venues like beauty parlors. All 270,000 licensed day-care centers in the US received a mailing on the importance of back sleeping.
Crediting the saturation of the campaign's message and resultant change in parental practice, the National Center for Health Statistics reported a 42% drop in SIDS death rates as of 1998, and the newest data suggests the decline may now be at 50%. That translates to 2,000 babies' lives saved.
Other studies have shown that infant stomach sleeping in the US has decreased from 70% before the campaign, to 21% in 1997. While it is too early to see results of the new phase of the campaign, the response to the day-care mailing was "overwhelming, generating three to four times the original amount in additional requests, says John McGrath, chief of public information and communications at the NICHD.
Despite this progress, SIDS remains the major cause of death among infants one month to one year of age. "A decade ago, we were losing 6,000 babies a year to SIDS. Now it's about 2,500, but even one baby a year is too many, says Marian Sokol, PhD, chair of the SIDS Alliance. "As the numbers go down, it's difficult to get attention for the cause," she adds.
Ultimately, the campaign aims to talk in terms of prevention - not risk reduction. Researchers are broadening the campaign to study the full spectrum of safe sleep for infants.
"We hope to see a complete elimination of the disparity of the rate of SIDS cases between African-American and Caucasian populations, and continue the decline in SIDS overall, says McGrath.