Avoid SIDS: say no to tummy sleeping
and these other risk factors
We’ve all heard by now how dangerous it can
be to put your baby to sleep on his tummy. Tummy sleeping has been associated
(along with other factors) with Sudden Infant Death Syndrome (SIDS), and since
the 1990s, healthcare professionals have advised parents to stop putting their
babies on their tummies to sleep, and the incidence of SIDS has decreased by a
whopping 50 percent. However, in developed countries SIDS still remains the
leading cause of death for infants aged one month to one year.
Back sleeping
Parents started putting their babies to
sleep on their backs and another problem arose: positional plagiocephaly, or
flat head syndrome. Because babies’ skulls are soft and pliable, if they spend
too much time lying or sitting with the backs of their heads resting against a
surface, such as in a cot or car seat, the shape of their skulls can actually
change. In some severe cases babies have to wear helmets to relieve the
pressure on one part of their skull!
In
some severe cases babies have to wear helmets to relieve the pressure on one
part of their skull
American doctors were in favor of back
sleeping until very recently. It was felt that a large portion of the
population would not buy wedges to keep their baby in the side-sleeping
position, and the baby could easily roll over from his side onto his tummy,
therefore increasing the incidence of SIDS once again. It was therefore felt
that the back position would be safer. Flat head syndrome has now changed that
advice in favor of side sleeping.
In Europe and South Africa, parents have
been advised to practice the side position for some time. Those of us who know
a little bit about anatomy will know that this is without doubt the safest
position for your baby.
Side sleeping
When you are on your side, as long as you
are breathing, the airway is maintained (or kept open) because the tongue is
lifted off the back of the throat. This is the case even if your baby should
lose consciousness, let’s say in the case of a febrile convulsion, for example.
If a baby is on his back and for some
reason loses consciousness, his tongue will fall back and can close the airway
and the baby will then stop breathing.
If a baby is on his back without elevation
of the back and the head and he vomits, the vomit can flow down his trachea (airway)
and into his lungs. If there is mucus in his vomit, as is common with babies,
this could be thick enough to block his airway if he were on his back. If the
baby were sleeping on his side, the solid matter would simply drain out of his
mouth.
This
is the case even if your baby should lose consciousness, let’s say in the case
of a febrile convulsion, for example.
The American Heart Association and the
Resuscitation Council of South Africa teach us to turn a breathing but
unconscious patient into the “recovery position” (a side-lying position) so
that he can continue breathing and so that his airway won’t be blocked by
vomit. This advice is obviously intended for a very compromised patient who may
have had a seizure, heart attack or stroke. But if we do that for a compromised
patient, surely we should do the same for our new babies and ensure they are
slept in the safest position possible?
A wedge is imperative! You can get
inexpensive wedges from any baby store. They consist of two triangles, one long
and one short, with a piece of Velcro in the middle to adjust the width. The
baby needs to be very snug between the two wedges. Don’t worry about room to
move your baby has been very happy in a small space in your tummy for a long
time. Babies are secure in a snug space. Remember to alternate between putting
your baby to sleep on his left and right side though, to avoid a flattened
face!
A
wedge is imperative! You can get inexpensive wedges from any baby store.
A breathing monitor is a wonderful
invention which gives you peace of mind that if anything goes wrong, causing
your baby to stop breathing, you will be alerted immediately. A breathing
monitor should be used until two years of age, as SIDS can occur up to that
age. However, education goes hand in hand with a reliance on modern-day
technology. It is pointless to use a monitor if you don’t know how to do CPR on
your baby. Make sure you have attended an infant CPR course for optimum safety.
There are other factors that can contribute
to or reduce SIDS, too. Be aware of the following:
Dummies
This is a controversial topic as some
breastfeeding experts feel dummy use can interfere with breastfeeding. Many
mothers manage to breastfeed successfully even though they are giving their
baby a dummy, though.
When the baby has a pacifier in his mouth,
the tongue is pushed down and held in position which therefore prevents it
slipping back and occluding the airway. This even happens when he is sleeping,
which is the most vulnerable time for SIDS. The Maternal and Child Health
Journal (Vol 16 issue 3) found that “pacifier use at sleep time decreases
SIDS”. A population-based case control study in California found pacifiers
reduced the risk of SIDS for every category of maternal and infant factor
examined, e.g. for breastfed babies as well as formula-fed babies.
When
the baby has a pacifier in his mouth, the tongue is pushed down and held in
position which therefore prevents it slipping back and occluding the airway.
It was also found that with dummy use, the
incidence of SIDS was reduced even if the parents allowed their babies to sleep
prone (on their tummies) or with soft, fluffy bedding or practiced bed-sharing.
The research found that pacifiers used at sleep times may reduce the risk of
SIDS by as much as 90 percent. The American Academy of Pediatrics’ task force
on SIDS recommends parents use dummies at sleep times.
