NEWARK—While deaths from Sudden Infant Death Syndrome (SIDS) have declined dramatically since the American Academy of Pediatrics (AAP) recommended all babies should be placed on their backs to sleep in 1992, sleep-related deaths from other causes, including suffocation, entrapment and asphyxia, have increased.
As Chair of the New Jersey Metro Regional Child Fatality Review Board, which collects data on infant and child deaths in New Jersey for the Centers for Disease Control (CDC), Dr. Elizabeth Hodgson knows firsthand the tragedy these families experience when a baby dies from an unexpected cause. Essex County, New Jersey, has the highest number of unexpected infant deaths during sleep, which includes deaths from SIDS, from suffocation due to unsafe bedding, and from accidents during co-sleeping with a parent or a sibling.
“It breaks my heart every month to see this report and know that every parent on that list would do anything to get that child back,” says Dr. Hodgson, Medical Director of the Metropolitan Regional Child Abuse Diagnostic and Treatment Center (Metro RDTC) at Children’s Hospital of New Jersey (CHoNJ), located at Newark Beth Israel Medical Center. “If we can increase awareness about the hazards, young lives can be saved and tragedy prevented.”
The increase of these preventable tragedies has led the AAP to recently expand its guidelines on safe sleep for babies, with additional information on creating a safe environment for their babies to sleep.
“In particular, the AAP has added four new recommendations about infant sleep safety that will assist parents and caregivers in preventing SIDS,” reports Dr. Hodgson. “The previous guideline of placing infants on their back to sleep is still the best SIDS prevention, and the new guidelines supplement that recommendation.”
The four important additions to the AAP recommendations include:
- No co-sleeping with infants. This will prevent tragic death from overlying/suffocation by rolling over onto an infant. This will also prevent other injuries that can occur, such as falls form beds, which cause a significant number of fractured skulls in infants.
- Bumper pads should not be used in cribs. There is no evidence that bumper pads prevent injuries, and there is a potential risk of suffocation, strangulation or entrapment.
- Breastfeeding is recommended and is associated with a reduced risk of SIDS.
- Infants should be immunized. Evidence suggests that immunization reduces the risk of SIDS by 50 percent.
Co-sleeping is a major risk for babies, reports Dr. Hodgson.
“Families may be surprised to know that even sleeping with a sibling can result in an infant being crushed or pushed from the bed, resulting in trauma or death,” she adds.
Many new parents are anxious to create the most visually pleasing and comfortable nursery for their newborns, but that may include a crib festooned with bumper pads and fluffy blankets that might actually put the baby at risk of suffocation.
“Parents should rethink the beautiful crib filled blankets, fluffy bedding, pillows, stuffed animals, and colorful bumpers,” says Dr. Hodgson. “The best crib environment would include a firm surface free of any potential entrapment hazards.”
CHoNJ Educates Families and Staff about Safe Sleep Practices
To further assist families, CHoNJ has created the “Rock-a-Bye-Baby” Safe Sleep Campaign to reduce infant deaths from unsafe sleep practices. This project, a quality improvement initiative in the Newark Beth Israel Pediatric Clinic at the Family Health Center, involves a sleep practices/risks questionnaire given to families with infants under the age of one in their care. After taking the questionnaire, families are educated about safer sleep practices. In addition, residents and staff at CHoNJ will receive an annual training by the NJ SIDS Center about safe sleep/sleep risks and Safe Sleep” PowerPoint presentations will also be given to parents and caregivers in the clinic setting, parenting classes, and at prenatal classes.
Children’s Hospital of New Jersey and the AAP revisit previous recommendations and provide the following advice for parents and caregivers for creating a healthy and safe sleep environment for newborns:
- Always place your baby on his or her back for every sleep time.
- Use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep.
- The baby can sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing).
- Keep soft objects or loose bedding out of the crib, including pillows, blankets, and bumper pads.
- Wedges and positioners should not be used.
- Pregnant woman should receive regular prenatal care.
- Don’t smoke during pregnancy or after birth.
- Breastfeeding is recommended.
- Offer a pacifier at nap time and bedtime.
- Avoid covering the infant’s head or overheating.
- Do not use home monitors or commercial devices marketed to reduce the risk of SIDS.
- Supervised, awake tummy time is recommended daily to facilitate development and minimize the occurrence of positional plagiocephaly (flat heads) as a result of putting the baby on his or her back to sleep.
The Metro RDTC is one of four legislatively mandated RDTCs in New Jersey which conducts medical and psychosocial evaluations for the diagnosis and treatment of suspected victims of child abuse and neglect. The mission of the RDTC is to provide a sensitive and caring setting for children and their families in which they can receive professional and compassionate therapeutic interventions. The Metropolitan RDTC works in close collaboration with and is co-located at Wynona’s House Child Advocacy Center.
Children’s Hospital of New Jersey, located at Newark Beth Israel Medical Center and part of the Barnabas Health, is the state’s premier hospital caring for children. For a referral to a pediatrician or pediatric specialist, call 1-888-SBHS-123.
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