The explanation for this alarmingly high regional SIDS rate is unclear, however, three risk factors were prominent in many of these deaths. Many were associated with the infant sleeping on his or her stomach at the time of death. Maternal smoking and exposure to secondhand smoke was also seen with some of these deaths. The Committee is glad to see that area hospitals are now electively offering expanded newborn screening for fatty acid and other metabolic defects. The 1999 SCAD death reemphasizes the need for more comprehensive newborn screening as part of the mandated South Dakota newborn screening program.
Motor vehicle related deaths continue to be a major cause of childhood accidental deaths.
The use of seat belts continues to be a major prevention goal. This death, and that of the following child, both raised questions regarding the necessity of recognizing depressive symptoms in both children and their care givers along with related questions of appropriate firearm safety and storage. This speaks well for our region and the low incidence of lethal violence related to raising children. Physical child abuse, however, does exist in our community and we will have to continue to work hard to assure that abusive child abuse homicides do not occur in the future. However, the child was sleeping on a dangerously soft and potentially confining surface such that the possibility of suffocation could not be adequately excluded.