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NOTEWORTHY WEDNESDAY!

Every now and then I write about SIDS (Sudden Infant Death Syndrome).

It is frightening for parents to even think about this happening but there are American Academy of Pediatrics‘ recommendations to follow to lessen the risk of SIDS .

SIDS is considered by some professionals to be a disease. Here is what  Norman Lewak, Clinical Professor of Pediatrics at UCSF …  had to say:

SIDS is a real disease. The “Triple Risk Model for SIDS is described in the Technical Report that accompanies the Policy Statement on-line edition only. Thanks to the work of Hannah Kinney of Boston Childrens, we know that SIDS infants have lesions in the respiratory center of the brainstem. This is the first risk pre-exiting respiratory center lesion. The second risk is the vulnerable developmental age, peaking at 2-4 months, in which CNS respiratory control changes. The third risk is an “environmental trigger“–an environmental event that blocks continued respiratory activity.This trigger appears to many of us to be deep sleep brought on by increased comfort from increased warmth. Prone sleep has been proven to increase warmth. The pacifier effect is most likely caused by an increase in activity, thus a lighter sleep.http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2284/reply#content-block

Some AAP recommendations to prevent SIDS are:

  • supine sleeping position
  • a firm sleep surface
  • breastfeeding
  • room sharing without bed sharing
  • consider using a pacifier which leads to a lighter sleep
  • avoid soft bedding
  • avoid overheating of the room where baby sleeps
  • avoid exposure tobacco smoke, alcohol and illicit drugs

According to recent information, SIDS  a disease which can be triggered by other environmental factors such as sleeping on soft surfaces, or stomach sleeping. These situations can set off a reaction whereby an infant ceases breathing due to an abnormal increase in his/her CO2 level. SIDS is not “suffocation”.

Every parent-to-be should be given information about SIDS prior to delivery and any questions should be answered by nurses or pediatricians early in the newborn period.

It is easier to follow sleeping guidelines when they are explained and make sense as to why they are important and how they can make a difference in the prevention of SIDS. Of course unfortunately, there are never any guarantees but parents can do their best with the knowledge that they have to prevent a tragedy.

There is so much to being a parent … children are precious… we are their protectors…just as we use car seats to protect them in the car we should protect them when we put them to sleep.

SIDS is down, but back-sleeping is just part of the message – USATODAY.com.

Replies to SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment.

SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment.

http://pediatrics.aappublications.org/content/128/5/e1341.full

Related posts:

Safe Sleep for Your Baby

SIDS…Sudden Infant Death Syndrome

Sudden Infant Death Syndrome (SIDS)

Sudden Infant Death…Most Common on New Year’s 

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NOTEWORTHY WEDNESDAY1

This week I have seen this PSA (Public Service Announcement) and three media discussions associated with it. The consensus of what I have read  and heard is that this PSA is inappropriate and uses “shock” value to relate an important message to parents concerning “co-sleeping“.

Do we really need this type of photo to make a statement against co-sleeping?

What do you think?

Well, I visited Milwaukee‘s website and found some helpful “safe sleep” resources and information related to infant deaths in Milwaukee.

It is my opinion that Milwaukee is trying desperately to reduce infant mortality but are they trying too hard? Will they lose the attention of the very group that they are aiming to help educate with this poster.

The City has had a Safe Sleep Sabbath this past October 11th, where churches participated in a safe sleep for baby program to educate parents about the danger of not putting baby to sleep in an appropriate environment but more importantly it provided information about what was appropriate and safe for infants.

Safe Sleep Sabbath – Sunday, October 9, 2011 Act now to overcome one major problem that is killing our babies: infant sleep death. Infant mortality: The number of infants who die before their first birthday.

Okay …great…now what what else could be done to decrease infant mortality due to poor and unsafe sleeping conditions?

Since we know that in Milwaukee, SES  (socio-economic status) is also related to infant mortality it might be helpful to have culturally sensitive educational materials and discussions about safe sleep for infants.

It would also be advantageous if this discussion did not confuse co-sleeping with unsafe sleep environments for babies.

Let’s keep the discussion going but in a more positive format.

Social workers are doing what they can in Milwaukee as evidenced in this piece from the Sentinel.

Lets here it for  education…education…education…rather than scare tactics and scapegoating “co-sleeping”.

This is a very multifaceted problem that needs to be combatted with a multifaceted action plan.

 

In Milwaukee around 20% of infant mortality is attributable to a combination of Sudden Infant Death Syndrome (SIDS),  and Sudden Unexplained Death in infancy (SUDI).  Of these deaths the majority die in an unsafe sleep environment.

The City of Milwaukee Health Department strongly advises parents NOT to share a bed with their infant. This is based on an American Academy of Pediatrics 2011 Policy Statement which states that the risk of SIDS has been shown to be reduced when the infant sleeps in the same room as the mother, but the AAP recommends that infants not share a bed with parents or anyone else, due to increased risk.

Co-Sleeping Defined

The term “co-sleeping” can be confusing, as it is used both to refer to sharing a bed and sharing a room. To clarify the distinction, many pediatric experts now refer to “bed-sharing” (referring to a infant who is sleeping in the same bed, couch, or other surface where parents or others are sleeping), and “room-sharing” (referring to a infant who is sleeping in the parents’ room, but in their own crib or bassinet).


Safe Sleep Guidelines

Parents should:

  • Put baby to sleep on their back. Babies who sleep on their backs are safer.
  • Provide a separate but nearby sleeping environment, meaning: babies should share a room with their parents, but not a bed. The risk of SIDS is reduced when the infant sleeps in the same room as the mother.
  • Never put a baby to sleep on a couch or a chair. A crib, bassinette or cradle that conforms to the safety standards is recommended.
  • Make sure that the only item in the crib is a mattress, covered by a tight-fitting sheet. No bumper pads, blankets or toys.
  • Never lay a baby down on or next to a pillow.  Pillows are extremely dangerous for infants as they can cause suffocation.
  • Do not ever use infant sleep positioners.  The FDA says there have been 12 known deaths associated with these products. 
  • Dress the baby in a one-piece sleeper to keep them warm in winter.
  • Keep the room at a temperature that is comfortable for the whole family. But the house should not be too warm.
  • Never smoke in a house where an infant or child lives.

The American Academy of Pediatrics Task Force has found that rates of bed-sharing are increasing, especially as we encourage breastfeeding. But the conclusion of the task force is that bed-sharing, as practiced in the US and other Western countries is more hazardous than the infant sleeping on a separate sleep surface. It is recommended that infants not share a bed with adults.  Infants may be brought into bed for nursing or comforting, but should be returned to their own safe space to sleep when the parent is ready to return to sleep.


Resources


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SIDS Follow-up

“Researchers analyzed a database of 129,090 deaths from SIDS from 1973-2006 and 295,151 other infant deaths during that time period. They found that the highest number of deaths from SIDS occur on New Year’s Day: They spike by almost a third above the number of deaths that would be expected on a winter day.

The study doesn’t prove that anything is the cause of the SIDS deaths. (The number of other kinds of infant deaths didn’t spike significantly on New Year’s Day.) However, the researchers point out that there’s plenty of drinking on New Year’s Eve. They point to research that says the number of people involved in alcohol-related car crashes skyrockets on New Year’s Eve, well beyond any other day of the year.”

via Sudden Infant Deaths Most Common on New Year’s – iVillage.

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NOTEWORTHY WEDNESDAY!

Baby’s sleeping environment and the importance of it cannot in my opinion be overemphasized!

Sudden Infant Death Syndrome (SIDS) is a frightening thought to anyone especially to the parents of infants.

A study in the Archives of Pediatric Adolescent Medicine has reported the use of a ceiling fan in a baby’s room was associated with a reduced risk of SIDS.

  • Fan use during sleep was associated with a 72% reduction in SIDS
  • fan use in warmer room temperatures was associated with a greater reduction in SIDS risk compared with cooler room temperatures
  • the reduction associated with fan use was greater in infants placed in the prone or side sleep position vs supine
  • Fan use was associated with a greater reduction in SIDS risk in infants who shared a bed with an individual other than their parents vs with a parent
  • Finally, fan use was associated with reduced SIDS risk in infants not using pacifiers but not in pacifier users

Fan use may be an effective intervention for further decreasing SIDS risk in infants in adverse sleep environments.

This research was out of Kaiser Permanente based in Oakland, CA and is an important finding as the cause of SIDS remains unknown. It still is the leading cause of death in infants from one month to one year. The actual number of cases may be under-reported as these deaths are sometimes attributed to other causes.

Other preventative measures are to have:

  • a firm crib mattress
  • no cloth crib bumpers,
  • no soft toys or pillows in the crib.

References:

Arch Pediatr Adolesc Med — Abstract: Use of a Fan During Sleep and the Risk of Sudden Infant Death Syndrome, October 2008, Coleman-Phox et al. 162 (10): 963

http://www.injuryboard.com/printfriendly.aspx?id=248968

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SIDS…this is one of the most frightening topics for any parent to think about much less discuss. But since The American Academy of Pediatrics recommended that infants be put to sleep on their backs and not on their stomachs there has been quite a dramatic reduction in deaths from SIDS. In 2004 the incidence of SIDS was 1 in 1,800 babies would succumb to “sudden infant death” which was a drop from 1984 when it was 1 in 700.

SIDS is defined as the death of a healthy child before his first birthday. What is currently worrisome is the infant death rate from SIDS has remained fairly stable over the last several years and that the rate now is similar to that of 1998. There is uncertainty as to why this is…perhaps a difference in how these deaths are reported . One of the reasons is thought to be an increase in co-sleeping.

No matter what the reason, the fact that the rate is stable is not something that can be tolerated without taking some action.

It is thought that some babies are not able to arouse normally from sleep and then become oxygen deprived as they rebreathe their own carbon dioxide. This occurs more often when babies sleep on their stomachs. Increases in carbon dioxide slows down the heart rate and eventually leads to a respiratory then cardiac arrest.

So what are some of the things that a parent can do to prevent this from happening?

Here a few of the recommendations that appeared in an article in the January 2010 “Parents Magazine”

  • Babies are safest in their own sleeping space, crib, bassinet, or a co-sleeper attached or near to the parents’ bed.
  • American Academy of Pediatrics advises against bedsharing.
  • Put your baby to sleep flat on his back, babies put to sleep even on their sides tend to roll onto to their tummies thus increasing their risk for SIDS
  • Keep the crib free of soft objects, pillows, quilts and toys for the entire first year of baby’s life
  • If you need crib bumpers use ones with breathable holes only
  • Stop smoking during pregnancy and do not smoke after the baby is born…this increases a baby’s risk for SIDS
  • Do not share your bed with your infant for the entire first year of your baby’s life
  • Keep your baby in your room …there has been research that has found a decrease in the risk of SIDS when the mom is nearby at least in the first 6 months of life.
  • Give baby a pacifier…babies who suck on a pacifier do not sleep as soundly therefore reducing their risk of SIDS by two thirds compared to babies who sleep without a pacifier.
  • Breastfeed…in some studies done recently breastfeeding has been found to be protective but the reason this is so is still unclear.
  • Keep baby’s room cool at around  68 degrees. A fan on in the room has also been found to be SIDS preventative as it keeps air flowing in the room and therefore less carbon dioxide will build up around the baby’s face.
  • Avoid wedge-shape sleep positioners…baby can slide off and suffocate against it.
  • Involve caregivers….this is very important as it is found that baby’s who are used to sleeping on their backs are more prone to SIDS if put to sleep on their stomachs, as they are not used to the build up of carbon dioxide around them. Well meaning caregivers may think they are doing a good thing by letting baby sleep on their stomachs. Make sure to inform them of the importance of back sleeping.

Hopefully this has been informative and taken some of the fear and worry from you by becoming aware of what you can do to help prevent SIDS.

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