Reduction in mortality from sudden infant death syndrome in New Zealand: 1986-92.

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Abstract
Mortality from sudden infant death syndrome (SIDS, or cot death) in New Zealand has been high by international standards (4/1000 live births). Within New Zealand the rate is higher in Maori than in non-Maori (predominantly European infants) and higher in South Island than in North Island. The National Cot Death Prevention Programme aims to reduce the prevalence of four modifiable risk factors for SIDS, namely infants sleeping prone, maternal smoking, lack of breast feeding, and infants sharing a bed with another person. The aim of this study is to describe the total postneonatal and total SIDS mortality in New Zealand from 1986 to 1992. Official publications from 1986 to 1990 and preliminary death notifications for 1991 and 1992 were examined. Deaths from all causes in the postneonatal age group (28 days to 1 year) and the total number of deaths from SIDS irrespective of age decreased markedly in 1990 and has continued to decrease. This decrease occurred particularly in non-Maori groups, in South Island, and in the winter months. The proportion of infants sleeping in a prone position has decreased from 43% to less than 5%. This suggests that the prone position is causally related to SIDS. The mechanism appears to be related directly or indirectly to environmental temperature.