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A National Action Plan for Child Injury Prevention:
Reducing Suffocation Injuries in Children

Photo: mom looking at baby in a crib

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Unintentional suffocation—which also includes strangulation and choking on food or other objects—killed 1,176 U.S. children in 2010. Most of these children (77%) were less than one year old.1 In 2011, more than 22,000 children were treated in the emergency department for nonfatal unintentional suffocation. One-third of these children were less than one year old.2 Most infant suffocation deaths and injuries occur as a result of unsafe sleeping environments; older children may have suffocation, entrapment or strangulation incidents on playground equipment.  Suffocation risks are predictable and preventable.

A National Action Plan

The Centers for Disease Control and Prevention (CDC) is committed to preventing child injury by supporting solutions that will save lives. The National Action Plan for Child Injury Prevention (NAP) was developed by CDC and more than 60 stakeholders to spark action across the nation. The overall goals of the NAP are to raise awareness about the problem of child injury and the effects on our nation, offer solutions by uniting stakeholders around a common set of goals and strategies, and mobilize action to reduce child injury and death.

The NAP contains six domains that include goals and actions based on what we know, where we need to go, and how we can get there. See below for examples of what can be done to further reduce suffocation-related injuries among children.

Data and Surveillance—includes the ongoing and systematic collection, analysis, and interpretation of child health data for planning, implementing, and evaluating injury prevention efforts.

  • Implement and use data systems, such as child death review, to collect more detailed information on the circumstances of infant suffocation. This can help with understanding incidence, designing prevention programs, and evaluating efforts.
  • Identify ways to collect information on emerging hazards, such as participation in risky activities like the choking game. This can help with understanding prevalence and consequences and shaping prevention efforts.

Research—includes research gaps and priorities in risk factor identification, interventions, and program evaluation, and dissemination strategies needed to reduce injuries.

  • Conduct research to determine which safety messages motivate belief and behavior change.
  • Conduct research to determine how to motivate at-risk populations to seek out and learn how to prevent suffocation such as providing safe sleep environments.

Communication includes effective strategies to promote injury prevention to target audiences through designing messages and information and delivering them through relevant channels.

  • Collaborate with police and media to use child injury news stories to relay prevention messages.
  • Disseminate prevention messages through multiple channels, including day care centers, schools, and pediatricians’ offices.

Education and trainingincludes organized learning experiences for increasing knowledge, attitudes, and behavior change conducive to preventing injuries.

  • Encourage widespread CPR training for older children, parents, day care providers and caregivers.

Health systems and health careincludes the health infrastructure required to deliver quality care and clinical and community preventive services.

  • Counsel parents on the importance of safe sleeping strategies at all well-child exams.

Policy—includes laws, regulations, incentives, administrative actions, and voluntary practices that enable safer environments and decision making.

  • Support evidence-based practices and policies to provide environments and activities that reduce the risk of suffocation such as promoting the Safe to Sleep Campaign, and playground design and maintenance efforts to reduce entrapment, suffocation and strangulation.

Moving Forward Together

Everyone—including parents, health care providers, educators, and community members—can take steps to prevent injury where they live, work, and play. We all have a part to play in the NAP and in protecting our children—America’s future.

To learn more about CDC’s work in child injury prevention, find references, or get your copy of the National Action Plan, visit


  1. Gilchrist J, Ballesteros M, Parker E. Vital Signs: Unintentional Injury Deaths Among Persons Aged 0–19 Years — United States, 2000–2009. MMWR 2012;61:270-6.
  2. CDC. Web-based Injury Statistics Query and Reporting System (WISQARS). Atlanta, GA: US Department of Health and Human Services, CDC; 2009. Available at Accessed May 13, 2012.
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