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November 27, 2023

Annual Report Finds Jump in Sleep-Related Infant Suffocation and Fentanyl Related Child Fatalities

JEFFERSON CITY, MO – An alarming trend in child fatalities related to sleep related infant suffocation and fentanyl poisoning has been identified in the Missouri Child Fatality Review Program (CFRP) Annual Report for 2022.

In 2022, of all infants who died from non-medical causes, 74% were related to the infant's sleep environment. Accidental suffocation and/or strangulation in bed is the leading cause of infant injury deaths. In 2022, 79 infants died from sleep related suffocation – a 22% increase from 2021.

"Losing even one infant to a preventable cause is tragic," said Robert Knodell, Director, Missouri Department of Social Services. "We recognize that parenting an infant can be stressful and overwhelming. Parents are often looking for any way they can to sooth their child, however, it is imperative they understand that not following the ABCs of safe sleep is dangerous and can be potentially fatal for their child."

Parents and caregivers can promote safe sleep by following the ABCs of safe sleep – alone, back, crib. There should be nothing in the crib except for the infant and a fitted sheet. The crib should not contain any toys or soft bedding such as blankets, bumper pads, or pillows. To learn more about safe sleep visit

In addition to rise in safe sleep fatalities, Missouri saw a shocking trend in deaths from poisonings, specifically related to Fentanyl.

In 2022, the deaths of 43 children were linked to Fentanyl or Fentanyl mixed with other drugs. Of those, 20 were between the ages of 15 and 17, while 20 were under age 5. The overall number of Fentanyl related child deaths nearly doubled, with deaths for children under age 5 increasing by more than 500%.

"As children become mobile and enter a phase of development where they are explorers of their environments it is especially important for caregivers to make sure that all medications and substances are locked up and out of reach." Said Dr. Terra Frazier, Associate Program Director, Child Abuse Pediatrics Fellowship Program at Children's Mercy Kansas City and Chair of the State Child Abuse and Neglect Review Panel. "Many caregivers underestimate what children will find and put in their mouth. With many poisons help can be sought once it is known that an ingestion occurred however, fentanyl is so potent and dangerous for young children that by the time a caregiver realizes what has happened it may be too late. Anytime a caregiver suspects that a child may have been exposed to a poison they should seek medical care immediately and clearly communicate their concerns to the medical team. Rapid administration of naloxone can be lifesaving!"

In response, the CFRP State Panel is organizing a fentanyl subcommittee to take a deep dive across the executive state departments and make recommendations around preventing these tragedies, and how Missouri can amplify those efforts.

Child fatalities due to unsafe sleep and fentanyl are both 100% preventable.

The State CFRP panel is made up of members from child protection disciplines who have the opportunity to respond immediately to an identified risk or circumstance by means of further investigation, providing services and initiating prevention strategies.

You can review all Child Fatality Review Program Annual reports by visiting our website.

The Department of Social Services strongly encourages anyone who suspects child abuse or neglect to call the toll-free hotline at 1-800-392-3738. The Missouri Child Abuse and Neglect Hotline is answered 24-hours a day, every day, all year round. Together, we are all responsible for the safety and well-being of Missouri's most vulnerable population.

The mission of the Department of Social Services is to empower Missourians to live safe, healthy, and productive lives.


Media Contact

Caitlin Whaley