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OP-ED: Safe Sleep for Your Baby

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OP-ED: Safe Sleep for Your Baby

February 17, 2017

In the early 1900s, we mistakenly believed Sudden Infant Death Syndrome (SIDS) was due to an oversized thymus gland which put pressure on an infant’s trachea, blocking the infant’s ability to breathe.  Back then, infants with these (mistakenly diagnosed) oversized thymus glands were prescribed radiation therapy to “treat” this malady.   Alas, if we only knew then what we know now, we could have prevented an entire cohort of individuals who later went on to die of cancer!

SIDS is defined as the sudden death of an infant less than 1 year of age that remains unexplained after a thorough case investigation.

We’ve come a long way in our knowledge about SIDS. Yet we still don’t yet fully understand what causes infants to die in their sleep. However, with the contribution of Public Health epidemiologists, we do know many of the risk factors that contribute to an infant being at greater risk.

The “Triple-Risk Model” provides the most accepted theory as to how SIDS deaths occur.  Three factors must be present to make a determination of SIDS: 1) the infant must have an underlying vulnerability in his/her ability to regulate her breathing 2) the infant must be in a critical period of development when the central nervous system is rapidly maturing, and 3) there must be an external stressor that increases the infant’s vulnerability to breathing homeostasis.

We’ve made significant progress in reducing the number of infants dying of SIDS.  The national Back to Sleep Campaign (initiated in 1994) saw a 50% reduction in number of infants who died from SIDS. Since this campaign’s initial success, rates have relatively plateaued, suggesting we need to reinforce current preventative measures and address additional modifiable risk factors to prevent future infant deaths.

Non-modifiable risk factors are those inherent characteristics that can’t be changed. For example, we know that boys are more likely to die of SIDS than girls, African American and Native American/Alaskan Native infants are more likely to die of SIDS than Hispanic, Asian, or White infants, and infants between the ages of 1-4 months are more likely to die of SIDS than older or younger infants.

Modifiable risk factors are those that you CAN change.  Specific steps you can take to reduce the risk of sleep-related infant deaths include:

  • Stop smoking – Now is the best time to quit.
  • Always put your infant on his back to sleep.
  • Place your infant’s feet at the foot of the crib. This way he’s less likely to wriggle down under a blanket and cover up his face.  Consider using a sleep sack in place of a blanket.
  • Breastfeed your infant.
  • Offer your infant a pacifier at bedtime/naptime (If you are breastfeeding, wait until breastfeeding is going well before offering your infant a pacifier).
  • Have your infant sleep in the same room as you, but not in your bed. This is especially important if you are a “heavy” sleeper, if you are impaired through use of drugs or alcohol, or if you sleep with other children or pets.
  • Modify your infant’s sleep environment:
    • A “bare” sleep environment is safest. Remove soft bedding, pillows, crib bumpers, and stuffed toys from your infant’s crib to prevent suffocation. Don’t let your infant sleep on other soft furniture such as couches or beanbags.
    • Make sure there are no gaps larger than two fingers between the sides of the crib and the mattress.
    • Locate the crib away from a window blind, curtain cord, or baby monitor cord – infants can strangle on these cords.
    • Always use a firm mattress. Air mattresses, water beds, and super soft mattresses can block an infant’s airway.
    • Use newer (within the last 10 years) cribs, bassinets, or sleep boxes that are in good condition. Don’t use cribs that are broken, modified, or older than 10 years as infants can strangle to death if their bodies pass through the gaps in the rails while their heads remain entrapped.   Check to see if your crib has been recalled.
    • Keep the room temperature at a comfortable temperature for you. Your infant should be dressed in no more than one additional layer than an adult would wear.

Oregon SIDS Facts

  • SIDS is the leading cause of death among infants between 2-12 months of age.
  • 32 infants died of SIDS in 2010
  • Mortality has decreased by 42% from 1.19 per 1,000 live births in 1992 to 0.69 per 1,000 live births in 2002. It was at 0.7 per 1,000 live births in 2010
  • In 2010, SIDS accounted for 14.2% of Oregon’s total infant deaths and 40.3% of all post neonatal deaths.

Source:  https://public.health.oregon.gov/BirthDeathCertificates/VitalStatistics/annualreports/Volume2/Documents/2010/ChapterSevenNarrative.pdf

For more information:

National Institutes of Health Safe Sleep: https://www.nichd.nih.gov/sts/about/Pages/default.aspx

Oregon Health Authority Safe Sleep: www.healthoregon.org/safesleep

Sew your own sleep sack pattern and directions: http://public.health.oregon.gov/HealthyPeopleFamilies/Babies/Documents/sleepsack.pdf

Interactive Safe Sleep Environment Infographic: https://www.nichd.nih.gov/sts/about/environment/room/Pages/default.aspx

 

Kathy Cooley, RN MPH
Home Visiting Manager
281 LaClair Street Coos Bay, OR 97420
541-266-6726 | kathy.cooley@chw.coos.or.us
Crisis Line: 541-266-6800
Coos County is an Affirmative Action/EEO | TTY Relay: 7-1-1

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