News
Fan use linked to lower risk of SIDS
Using a fan to circulate air seemed to lower the risk of sudden infant death syndrome in a study of nearly 500 babies, researchers reported Monday. Placing babies on their backs to sleep is the best advice for preventing SIDS, a still mysterious cause of death.
Experts also recommend a firm mattress, removing toys and pillows from cribs, and keeping infants from getting too warm.
Such practices helped slash U.S. SIDS deaths by more than half over a decade to about 2,100 in 2003. But SIDS remains the leading cause of death in infants ages one month to one year.
"The baby's sleeping environment really matters," said study senior author Dr. De-Kun Li of the Kaiser Permanente Division of Research in Oakland, Calif. "This seems to suggest that by improving room ventilation we can further reduce risk."
SIDS is the sudden death of an otherwise healthy infant that can't be attributed to any other cause. These babies may have brain abnormalities that prevent them from gasping and waking when they don't get enough oxygen.
The new study, published in October's Archives of Pediatrics & Adolescent Medicine, offers another way to make sure babies get enough air.
More research is needed, said Dr. Fern Hauck of the University of Virginia in Charlottesville, but she said that because fan use is in line with theories, it may be worth considering.
"This is the first study that we know of that has looked at this issue," said Hauck, a member of the American Academy of Pediatrics SIDS task force.
Researchers interviewed mothers of 185 infants who died from SIDS and mothers of 312 infants of similar race and age. Moms answered dozens of questions about their baby's sleeping environment.
Researchers took into account other risk factors and found that fan use was associated with a 72 percent lower risk of SIDS. Only 3 percent of the babies who died had a fan on in the room during their last sleep, the mothers reported. That compared to 12 percent of the babies who lived.
Using a fan reduced risk most for babies in poor sleeping environments.
The study involved infants in 11 California counties. It was supported by grants from the National Institutes of Health.
AP
Head Covering May Increase SIDS Risk
Babies who die from sudden infant death syndrome (SIDS) are often found with their heads covered by bedding, and now new research suggests that this covering usually precedes death and may, in fact, be causally related.
This finding supports current recommendations to avoid head covering as a means of reducing the risk of SIDS, lead author Dr. Edwin A. Mitchell, from the University of Auckland in New Zealand, and colleagues note in the June issue of Pediatrics.
They point out that in UK guidelines, a "feet to foot" approach (placing the infant's feet at the foot of the cot) is recommended as a strategy to prevent the infant from sliding underneath the bedding. Despite this recommendation, it was unclear if head covering, which is seen in roughly 25% of SIDS cases, contributed to death or if it was an agonal event, according to the report.
To answer this question, the researchers analyzed data from 393 SIDS cases in the New Zealand Cot Death Study (1987 to 1990) and from 333 cases in a German SIDS case-control study (1998 to 2001).
Overall, 15.6% of infants in the New Zealand study and 28.1% in the German study had their heads covered, the report indicates.
Infants whose heads were covered were often very sweaty, the researchers found, which suggests that the covering occurred before death. Older infants were more likely than younger ones to have their head covered, which likely reflects motor development.
In both studies, head covering correlated with the occurrence and severity of thymic petechiae. By contrast, head covering was not associated with the position the child was placed to sleep, or with the position the child was found in at death.
While the new findings support SIDS prevention strategies, research is "urgently" needed on how best to prevent head covering, the authors conclude.
Ramaz Mitaishvili
Car Seat Inserts Keep Baby Breathing
Babies travelling in car seats should be provided with additional support to prevent blocking of their airway, research suggests.
A research team from The University of Auckland, Auckland Hospital and the New Zealand Cot Death Association found that breathing problems were significantly reduced when young infants were placed in a car safety seat with a foam insert in it, designed to help the infant’s head to lie upright in a natural position instead of slumping forward.
The research team have worked with Dunlop Foams to develop the foam insert which holds the infant’s body forward with a slot for the protruding back of the head. This allows the head to lie upright even when the baby falls asleep, keeping the baby’s airway open. The insert was designed to protect infants until they are about nine months old, when infants’ jaws become stable.
“Car seats are absolutely necessary for the safety of all small children, but the seat should be made as safe as possible for very young children,” says Dr Shirley Tonkin of the NZ Cot Death Association. “We reported last year in the British Medical Journal that some healthy full term babies had severe stop breathing attacks while they were sleeping in their car seats. By using a foam insert that allows the infant’s head to sit upright, the airway is kept open and the baby is kept safe. A side benefit is that babies seem to sleep more comfortably, but babies should still not be left to sleep unattended.”
“Babies are not shaped like little adults,” says Professor Alistair Gunn of the University’s Departments of Physiology and Paediatrics. “Young babies have relatively much bigger heads than adults and they stick out behind the line of the back. At the same time they have very short necks so that their chins are almost on their chests, and their muscles are less well developed. Because standard infant car seats have flat backs, when an infant is properly strapped in place, the flat back of the seat pushes on the back of the head, which is bent forward, so that the chin is pressed against the chest. Because babies have very mobile jaws, the chin is easily pushed backward, with tongue inside it constricting the airway.”
This study, funded by the H.B.Williams Turanga Trust, monitored healthy full-term babies for 30 minutes restrained in a car seat with the foam insert and 30 minutes without the insert. The infants were monitored for breathing and heart rate, nasal airflow and blood oxygen levels. The research found use of the insert reduced the number of breathing problems. The results are published in the medical journal Acta Paediatrica.
The research team is looking to start a new study, funded by the Auckland Medical Research Foundation and the National Child Health Research Foundation, monitoring babies over a longer period of time to see if sleeping in a car seat over the equivalent of a long car journey (around three hours) produces the same problems as shorter periods and if the insert remains effective over these longer periods. The research team is looking for volunteers with healthy, full term babies between 5 and 10 days of age. For more information, contact Dr Christine McIntosh on 021 105 3144.
The Dunlop Foams Happi car seat inserts are available from Baby Factory and Para Rubber stores across New Zealand. The inserts are available in two styles, one for car “capsules” and one for car seats.
Contact
Emma Timewell, Communications Adviser Ph: 09 373 7599 ext 83258 Email:
Professor Alistair Jan Gunn Ph: 09 373 7599 ext 86763 Email:
Dr Shirley Tonkin, New Zealand Cot Death Association Ph: 09 520 3551
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