At least 15 Southern Tier babies, most of them from Broome County, have suffocated over the last two years, some at the hands of their parents sleeping with them.
The rash of preventable infant deaths, including one in late March, has shown an urgent need for more education about putting babies to bed, officials said.
"We thought what was occurring here was higher than what we would typically expect," said Sharon Chesna, executive director of Mother & Babies Perinatal Network, a nonprofit advocacy agency.
Comparing numbers is difficult because the deaths are generally ruled as sudden infant death syndrome (SIDS) -- a broad category with no single explanation. There were an average of 115 SIDS deaths per year in the state between 2001 and 2004, according to figures from the New York State Center for Sudden Infant Death.
The scope of the problem locally came to light with a review of 21 infant deaths since 2005 by Dr. James Terzian, a pathologist at Lourdes Hospital. While five of the deaths were caused by congenital disease and one was from abuse, 15 showed telltale signs of something technically called "an asphyxial mechanism."
More simply, it's something that obstructs breathing.
Working with detailed police reports showing circumstances -- including how and where infants were found -- Terzian determined 15 deaths were due to "improper bedding" scenarios.
That could be as simple as an infant falling asleep face down on a soft pillow, or wriggling against a large stuffed animal that becomes lodged against its face. Crib bumpers or heavy loose blankets can also be lethal.
In some cases, the death comes with an exhausted parent asleep in a couch or chair, perhaps with an arm resting heavily across a snuggling newborn, or a baby slipping off a bed and getting wedged between a wall and a mattress.
The fatal mistakes often begin with nurturing intentions.
"These are loving parents trying to do the right thing," Chesna said.
Not all sudden infant deaths are preventable. Some are related to congenital birth defects that go undetected and some remain unexplained circumstances of nature. But Terzian's study, and others like it, show inadvertent suffocation is routinely claiming small lives.
"They are too small to struggle enough to get noticed," Terzian said. "They don't make much noise."
Putting babies to sleep in couches and chairs is generally accepted as a very bad idea, although not everybody knows this, experts say. Agency officials, doctors and nurses say people also should understand that simply putting babies to sleep face down, even in otherwise safe environments, raises the risk of SIDS. Other things, such as blankets, pillows and stuffed animals, add to that risk.
The fatalities have led to a national "back to sleep" campaign, which emphasizes placing the baby on his or her back on a firm mattress in an approved crib. Extras, such as crib-bumpers, blankets and stuffed animals, are discouraged.
"We haven't gotten the message to people," Terzian said.
Local officials are making stronger efforts to educate expectant and new parents during prenatal and delivery classes and postpartum home visits, said Kathy Cerny director of Home Health Services for the Broome County Department of Health. But it doesn't stop there.
"The message has to get out to everybody," she said, noting that day care providers, grandparents, relatives and babysitters are being targeted through outreach programs.