SIDS - newest guidelines for prevention
The following is a Q&A with Dr. JJ on Hallmark's Home & Family re: Sudden Infant Death Syndrome and the newest guidelines published October 2016 from the American Academy of Pediatrics National Conference.
Q: SUDDEN INFANT DEATH SYNDROME IS A VERY REAL AND TRAGIC PROBLEM THAT ALL FAMILIES FACE BUT THERE ARE SOME NEW WAYS TO HELP PREVENT THIS FROM HAPPENING?
Dr. JJ: Yes, approximately 3500 infants die annually in the United States from sleep-related infant deaths, including sudden infant death syndrome, ill-defined deaths and accidental suffocation and strangulation in bed. I recently attended the Academy of Pediatrics national conference where is it now strongly recommended that babies sleep in the parent’s room, in their own crib for at least 6 months, ideally 12 months. This can reduce SIDS related deaths by as much as 50%
Q: HOW DOES THIS REDUCE THE CHANCES?
Dr. JJ: The reason: parents are nearby and within earshot to detect changes in baby’s movement, breathing, or can hear a struggle for breathing sooner. There is evidence that sleeping in the parents’ room is most likely to prevent suffocation, strangulation, and entrapment that may occur when the infant is sleeping in the adult bed. The result, SIDS rates and unexpected events like respiratory distress, seizures, are attended to earlier, improving outcomes. That means the parents room should be smoke free, well ventilated, and the child should not, under any circumstances, sleep in the parent’s bed. Recommendations for the sleep environment remain the same. So for parents traveling with babies under a year, especially if staying at hotels or other locales, renting a crib or taking a pack and play for a safe sleep environment is key in keeping baby sleep-safe.
Q: BUT WHAT ABOUT THE OTHER 50 PERCENT?
Dr. JJ: Sadly, I know first-hand about losing a loved one. My nephew passed away when he was just 6 months old. It is important to realize there are many factors that can cause SIDS.
Q: WHAT ARE SOME OF THE MAJOR CAUSES?
Dr. JJ: A combination of physical and sleep environmental factors can make an infant more vulnerable to SIDS. These factors may vary from child to child. Physical factors associated with SIDS include: Brain abnormalities. Some infants are born with problems that make them more likely to die of SIDS. Low birth weight. Premature birth or being part of a multiple birth increases the likelihood that a baby's brain hasn't matured completely, so he or she has less control over such automatic processes as breathing and heart rate. Respiratory infection. Many infants who died of SIDS had recently had a cold, which may contribute to breathing problems. The items in a baby's crib and his or her sleeping position can combine with a baby's physical problems to increase the risk of SIDS. Examples include: Sleeping on the stomach or side. Babies who are placed on their stomachs or sides to sleep may have more difficulty breathing than those placed on their backs. Sleeping on a soft surface. Lying face down on a fluffy comforter or a waterbed can block an infant's airway. Draping a blanket over a baby's head also is risky. Sleeping with parents. While the risk of SIDS is lowered if an infant sleep in the same room as his or her parents, the risk increases if the baby sleeps in the same bed partly because there are more soft surfaces to impair breathing.
Q: AND IT IS IMPORTANT THAT A FAMILY MEMBER OR FRIEND WHO IS BABYSITTING KNOW THE CHILD CAN’T SLEEP IN THE SAME BED.
Dr. JJ: Yes, be sure to let anyone who is going to watch your child for any period of time know ahead of time to try and reduce the risk of SIDS.
M: WHAT ARE OTHER WAYS TO REDUCE THE RISK OF SUDDEN INFANT DEATH SYNDROME?
Dr. JJ: Back to sleep for every sleep. The supine sleep position does not increase the risk of choking and aspiration in infants, even those with gastroesophageal reflux, because infants have airway anatomy and mechanisms that protect against aspiration
Use a firm sleep surface. Infants should be placed on a firm sleep surface (eg, mattress in a safety- approved crib) covered by a fitted sheet with no other bedding or soft objects to reduce the risk of SIDS and suffocation. Infants should not be placed for sleep on beds, because of the risk of entrapment and suffocation.
Breastfeeding is recommended. Breastfeeding is associated with a reduced risk of SIDS
Keep soft objects and loose bedding away from the infant’s sleep area to reduce the risk of SIDS, suffocation, entrapment, and strangulation.
Consider offering a pacifier at nap time and bedtime. Although the mechanism is yet unclear, studies have reported a protective effect of pacifiers on the incidence of SIDS
Avoid smoke exposure during pregnancy and after birth. Both maternal smoking during pregnancy and smoke in the infant’s environment after birth are major risk factors for SIDS
Avoid overheating and head covering in infants