VANCOUVER - The chairman of a death review panel in British Columbia found himself facing familiar figures as he looked at the number of babies who died unexpectedly in their sleep in the province in the past five years.
An average of 23 infants under the age of one died suddenly while sleeping each year between 2013 and 2018, the same rate that was identified in a 2014 panel report, despite a suite of recommendations the previous members had made.
Michael Egilson of the BC Coroners Service was the chairman on both panels and said it demonstrated to him that there's still work to be done to better support new and vulnerable parents.
"Because things were very similar, it's trying to think, so why might that be?" he said in an interview on Tuesday. "I think that engaging and supporting young vulnerable families is a tough one."
The new panel studied 141 sleep-related sudden infant deaths and found infants continued to die under the same circumstances identified by the earlier panel that looked at deaths between 2008 and 2012.
The new report, called "Sleeping Safely," says the deaths disproportionately affect vulnerable young families with risk factors, such as exposure to tobacco, while a combination of sleep positions and health issues may increase the danger.
Vulnerable families are those who experience a larger burden of illness and distress than others, which can include parents who are low-income, young, lack social support networks, use substances, or experience problems with housing, domestic violence or mental health. Vulnerable infants include those born underweight, preterm, with poor health or with prenatal substance exposure.
Egilson was joined on the panel by 19 experts working in areas like youth services, child welfare, maternal health, medicine, law enforcement and Indigenous health.
It found gaps in capacity for delivering universal health services and for providing enhanced services to vulnerable families.
It recommends additional support from public-health nurses and other trained providers for expectant women and families with infants, and consistent, accessible messages related to infant sleep practices.
It also calls for a provincial approach to the review of infant deaths, including expanded investigative protocols.
Sharon Sponton, who worked as a public-health nurse around Smithers, B.C., until 2010, said she would often visit new mothers soon after a birth.
"When a baby dies in the first year of life, it's extremely devastating. It's a terrible event for the whole family," said Sponton, who now works full time as treasurer for the B.C. Nurses Union. "As a nurse you're part of that process of helping them through what they're going through."
Most families appreciate the visits where she would examine the baby and mother and offer suggestions like putting them to sleep on their backs on mattresses that aren't too soft or with too much bedding.
New babies can be overwhelming as it is, but it's confusing when friends and family members offer conflicting advice that isn't always medically sound.
"The thing about having a baby is everyone has an opinion," she said.
Health Minister Adrian Dix was unavailable for an interview but the Ministry says in a statement that it supports the panel's findings and recommendations.
Public health professionals work closely with expecting and new parents in B.C. through the Safer Infant Sleep program, which includes recommendations to parents to avoid sharing a bed with their babies, not to smoke in the house and to breastfeed where possible.
The previous death panel's report also made recommendations aimed at improving investigative practices and data collection for investigators, including coroners and first responders.
It called for guidelines to be established for genetic testing in coroner investigations and identifying audiences and messaging around safe sleep practices.
Egilson said the government has made progress on each of those recommendations but getting the message to the most at-risk parents remains a challenge.
While every baby's death is a tragedy, Egilson noted that the rate of unexpected sudden deaths of babies in B.C., where a total of about 44,000 babies are born each year, remains lower than other provinces.
"Certainly, there's always more work to be done but I think some of those numbers also suggest there's also lots of good things being done," he said.