Infant mortality is often used as a standard measure of a population’s health. The leading causes of infant death in Washington include birth defects, SIDS (Sudden Infant Death Syndrome), and disorders related to prematurity and low birth weight. A number of factors contributed to improvements in infant mortality in Washington in the 1990s and early 2000s: implementation of the First Steps Program in 1989; new treatments for lung disease associated with prematurity; and the Back to Sleep media campaign which has sought to reduce rates of SIDS by telling mothers to place their babies on their backs for sleep.