SAFE SLEEP FOR NEWBORNS Rocky Mountain Children’s Health Foundation Mary Kohn, MD May 13, 2019
Goal of this lecture is to empower new parents with tools to avoid unexpected infant death
S.I.D.S. V. S.U.I.D.S.
Two o Type pes of Infant ant Death ath during ing Sleep p in babi bies unde der 1 r 1 year ar of age ■ S.I.D.S .D.S ■ S.U.I.D. ■ “Sudden Infant Death ■ “Sudden Unexpected Infant Syndrome” Death” ■ Also known as “Crib Death” ■ This refers to accidental, sleep-related deaths in ■ SIDS is the unexplained otherwise healthy and quiet death of an newborns. otherwise health newborn, usually during sleep ■ Most commonly, smothering or entrapment
Both SIDS & SUIDS are parents’ worst nightmares But, there are things that you can do to prevent them
What is SIDS? ■ Baby is put to bed and dies quietly in her sleep. ■ Otherwise healthy infant ■ Peaks between 1 and 4 months of age ■ 90% occur in first 6 months of life ■ More common in infants exposed to cigarette smoke before and after birth ■ More common in premature babies and babies who are very small at birth ■ No evidence of illness or smothering on post-mortem exam
What causes SIDS? Unknown Many hypotheses over the years: Not the cat’s fault! Not smothering Not caused by reflux or aspiration Does not seem to be caused by infection Does not seem related to heart disease
Current thinking is that it is associated with immaturity of arousal function of baby’s brain
What is SUIDS? ■ These are deaths that are caused by accidents related to sleep. ■ Smothering ■ Entrapment ■ Choking
Data ■ Nearly 4 million babies born in U.S. in 2018 ■ 3500 babies under one year of age died of SIDS or SUIDS ■ Chances of any baby dying of either is 8 per 10,000 ■ Not common but tragic ■ Often preventable
PREVENTION STRATEGIES SIDS & SUIDS Different causes but same prevention strategies
Prevent ntion ion Strat rategie ies ■ Breast feeding ■ Smoking & alcohol ■ Overheating ■ Sleep position ■ Fans, ventilation ■ Sleep surface ■ Immunizations ■ Sleep location ■ Commercial devices ■ Bedding ■ Home monitors ■ Pacifier ■ Swaddling
BREAST FEEDING Breast-fed babies are more easily awakened
Position ■ Back-To-Sleep Campaign by NIH in 1992 ■ “Safe to Sleep” is current program
Note that decline in SIDS deaths corresponds to change in recommendation for Back to Sleep
Sleep surface should be a firm mattress
Location ■ Same room ■ Separate surface ■ 6-12 months
VARIOUS OPTIONS
Baby Box Inexpensive alternative
Bedding ■ Use fitted crib sheet of appropriate size ■ Avoid “soft stuff in crib” – Pillows – Stuffed toys – Bumper pads ■ No loose blankets ■ Beware of cords, curtains that are close by
DECORATING IDEAS FROM PINTEREST
KHLOE KARDASHIAN’S BABY NURSERY
Pacifiers Have been shown to decrease the likelihood of SIDS May be due to increased arousal- baby is not as deeply asleep If it falls out of baby’s mouth, don’t replace it, still protective Don’t start until breast feeding is well-established
Cigarette smoking Major r risk factor b before e and d after er birth Exposure t to tobacco cco smok oke decrease ses a s arousa sal Cau auses bab abies to be smal aller, als also a a risk f fac actor for SIDA Secon cond-hand nd sm smoke is s also so a risk sk It is is estimat ated t that at one-third of SI SIDS DS dea deaths could be e prevented if all all mat aternal sm smoking ng d dur uring ng pregna nanc ncy was as eliminated.
Overheating Rule of thumb: Baby only needs one more layer of clothing than an adult in the room needs
Won’t baby get cold? Swaddle Sleep Sack Footie pajamas
PLEASE KEEP THESE GUIDELINES Not all products IN MIND WHEN marketed for newborns are truly EVALUATING safe or necessary PRODUCTS
Baby monitors are not advised- not effective and lots of “false alarms”
Rock and Play Sleeper Made by Fischer Price Soft-sided sling that rocks baby to sleep Recalled on April 11, 2019 by Consumer Products Safely Division 32 deaths have been associated with the product Babies rolled over while unrestrained and were unable to breathe due to their position
Snoo Sleeper- based upon AAP recommendations but check the price!
■ Following the AAP guidelines is the best way to protect your newborn from both SIDS and accidental sleep- related death.
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