Sudden Infant Death Can Occur in Child Seats, esp When Not In Car and Adult Asleep

MedicalResearch.com Interview with:

Jeffrey Colvin, MD, JDDepartment of PediatricsChildren's Mercy HospitalKansas City, MO 64111

Dr. Colvin

Jeffrey Colvin, MD, JD
Department of Pediatrics
Children’s Mercy Hospital
Kansas City, MO 64111 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Prior studies have found that infants spend an average of 5-6 hours a day in sitting devices. Sitting devices include car seats, swings, infant seats, and strollers.

Given how much time infants are spending in sitting devices, we wanted to know if sleep-related infant deaths (such as Sudden Infant Death Syndrome or “SIDS”) was occurring in those devices. We examined over 10,000 infant sleep-related deaths from 45 states. We found that 3% (or 348) of the deaths occurred in sitting devices. Two-thirds of the deaths in sitting devices were in car seats. What was most surprising was that less than 10% of the deaths in car seats occurred in cars. Instead, the great majority occurred in the child’s home or the home of a relative, friend, or babysitter. In 1/3 of the deaths in car seats, the supervising adult was asleep.  Continue reading

Soft Bedding such as Blankets and Pillows Can Suffocate Babies

MedicalResearch.com Interview with:

Alexa B. Erck Lambert, MPHDB Consulting Group, Inc, Silver Spring, MarylandCenters for Disease Control and Prevention, Contractor

Dr. Erck Lambert

Alexa B. Erck Lambert, MPH
DB Consulting Group, Inc, Silver Spring, Maryland
Centers for Disease Control and Prevention Contractor 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Unintentional suffocation is the leading cause of injury death among infants under 1 year old in the US. This study investigates cases in CDC’s SUID Case Registry that were assigned the category of explained suffocation with unsafe sleep factors per CDC’s SUID Case Registry classification system, which was developed to consistently differentiate SUID cases into well-defined categories (including no autopsy or death scene investigation, incomplete case information, no unsafe sleep factors, unsafe sleep factors, possible suffocation with unsafe sleep factors, and explained suffocation with unsafe sleep factors) using standardized criteria and definitions. Cases classified as possible and explained suffocation were assigned one more mechanisms to which the airway obstruction was attributed including soft bedding, wedging, overlay and other – other was excluded from this analysis.

Most explained suffocations (69%) were attributed to soft bedding like a blanket or a pillow followed by overlay (19%), and wedging (12%). Although explained suffocation deaths represent a small proportion of all sudden unexpected infant deaths (14%), these losses are particularly tragic because they can be prevented by placing a baby to sleep in a safe environment.  Continue reading

Full-Term Infant Deaths in US Remain High, Many From Suffocation

MedicalResearch.com Interview with:

Neha Bairoliya, Ph.D. Harvard Center for Population and Development Studies Cambridge, MA 02138

Dr. Bairoliya

Neha Bairoliya, Ph.D.
Harvard Center for Population and Development Studies
Cambridge, MA 02138

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: While the high prevalence of preterm births and its impact on infant mortality in the US have been widely acknowledged, recent data suggest that even full-term births in the US face substantially higher mortality risks compared to European countries with low infant mortality rates.

In this paper, we use the most recent birth records in the US to more closely analyze the primary causes underlying mortality rates among full-term births. We show that infants born full-term in the US face 50%-200% higher risks of infant mortality compared to leading European countries.

The two main drivers of these high relative risks are increased risk of mortality due to congenital malformations, which patients cannot really do much about other than ensuring adequate screening during pregnancy, and high risk of sudden unexpected deaths in infancy, which should largely be preventable through appropriate sleeping arrangements. While we do not have data on actual sleeping arrangements from our study, other data sources suggest that a substantial number of babies continue to sleep on their tummy; we also found a shockingly large number of babies dying from suffocation, which suggests that parents either use covers that are not safe, or let children sleep in their own beds.

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Despite Safe Sleeping Recommendations, Infant Suffocations Continue To Rise

MedicalResearch.com Interview with:
Guoqing Hu, PhD
Department of Epidemiology and Health Statistics
Xiangya School of Public Health
Central South University
Changsha, Hunan, China
   On behalf of the authors

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We’ve known for some time that suffocation is a leading cause of death for American infants – in fact, it is the cause of over 3/4 of the injury deaths to babies under 12 months of age. We’ve also known that there are strategies, such as “safe sleeping”, that can greatly reduce the risk of a baby suffocating to death.

The surprise in our study is that the suffocation rate for infants under 12 months of age appears to be increasing in the United States over the past 15 years. More babies are dying from suffocation today than in the 1990s, and that is a significant public health concern. Think about the implications of each one of those deaths to the infant’s parents and loved ones. There are few things more devastating than losing a baby to an unintentional, or “accidental” death. There are ways we can prevent unintentional suffocations, and we need to work together to inform parents and ensure babies are kept safe to reduce those deaths, especially as rates in the US appear to be increasing. Continue reading

Mobile Message Delivery Can Help Parents Learn Safe Infant Sleep Practices

MedicalResearch.com Interview with:

Rachel Y. Moon, M.D. Division Head, General Pediatrics Professor of Pediatrics University of Virginia School of Medicine Charlottesville, VA 22908

Dr. Moon

Rachel Y. Moon, M.D.
Division Head, General Pediatrics
Professor of Pediatrics
University of Virginia School of Medicine
Charlottesville, VA 22908

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Approximately 3500 babies die suddenly and unexpectedly during sleep in the US every year. Even though there are safe sleep recommendations, many parents do not follow them because of misinformation or misconceptions.

Therefore we tested 2 complementary interventions to promote infant safe sleep practices. The first was a nursing quality improvement intervention aimed at ensuring that mothers would hear key messages and that there was appropriate role modeling of safe sleep practices by hospital personnel.

The second was a mobile health intervention, in which mothers received videos and text messages or emails with safe sleep information during the baby’s first two months of life. We randomized mothers to receive either the safe sleep interventions or breast-feeding interventions (the control interventions). Mothers who received the mobile health intervention reported statistically significantly higher rates of placing their babies on their back, room sharing without bed sharing, no soft bedding use, and pacifier use, compared with mothers who received a control intervention. Although the nursing quality improvement intervention did not influence infant safe sleep practices, there was an interaction such that mothers who received both the safe sleep nursing quality improvement intervention and the safe sleep mobile health intervention had the highest rates of placing their babies on the back.

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Swaddled Infants At Greater Risk of SIDS

MedicalResearch.com Interview with:

Dr Anna Pease Senior Research Associate University of Bristol

Dr. Anna Pease

Dr Anna Pease
Senior Research Associate
University of Bristol

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Pease:  We tried to gather evidence of whether there was an association between swaddling for sleep and SIDS. This was a review, not a new original study, but it is the first time these data have been brought together to try to quantify any risk between swaddling and SIDS. We only found 4 studies and they were quite different making it difficult to pool the results. We did find, however, that the risk of SIDS when placing infants on their side or front for sleep increased when infants were swaddled.
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SIDS: Sudden Infant Death Risk Doubles At High Altitudes

MedicalResearch.com Interview with:
David Katz, MD

Divisions of Cardiology, and Neonatology,
University of Colorado School of Medicine
Aurora, Colorado

Medical Research: What is the background for this study? What are the main findings?

Dr. Katz: Sudden infant death syndrome (SIDS) is the leading cause of infant mortality in the US between 1 month and 1 year of life.  This is the first large study to demonstrate an association between high altitude and SIDS.  In particular there is a doubling of risk above 8,000 feet of elevation relative to below 6,000 feet.

Medical Research: What should clinicians and patients take away from your report?

Dr. Katz: There is an association between high altitude residence and Sudden infant death syndrome (SIDS).  The reason for this association is still unknown, but hypoxia may be the common link.  While the population living above 8000 feet is small in the US, it is large worldwide.  Better understanding this association is of great medical importance.

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