Practicing pediatric medicine is really a privilege; to see children grow and become individual personalities and to spend most of our day helping children and parents deal with the occasional childhood illness and adolescent crisis is both rewarding and a joy.
Sadly, pediatric medicine can sometimes become profoundly tragic. A loss of a child is rare but so difficult partly because it is so unexpected. Crib death (also referred to as Sudden Infant Death syndrome or SIDS) is one of those events which are devastating to the parents and also has an effect on nurses, physicians and all who devote their career to caring for the child.
This sudden event of SIDS occurs in infants, usually under one year of age. The infant is often found by their parents, unresponsive and not breathing. Many times, there have been no warning signs or illness. Sadly, when this situation occurs, many have already passed away before arrival to the hospital. Even after a full post-mortem review, the exact cause of death is often not known. I believe it is somehow related to the immaturity of the newborn infant’s neurologic respiratory center and its responsiveness to situations of mild airway obstruction. Today, SIDS continues to be the leading cause of death in children between one-month and one-year of age and results in nearly 4,000 deaths per year in the United States. Most cases of SIDS occur in infants between one-month and fourmonths of age. The risk of SIDS is reduced dramatically for children over one-year of age.
Recent research has demystified this condition and has led to important steps parents and caregivers can take to prevent SIDS. The most important advance came in the mid-80s with the discovery that infants who sleep on their stomach are at much higher risk for SIDS. New Zealand was the first country to launch a formal “Cot death prevention program” and in 1986 formally advised placing infants on their “Back to sleep.” By 1991, they were able to demonstrate a nearly 40 percent reduction in SIDS throughout the country. Since that time many countries have adopted similar prevention programs based on the New Zealand study and have seen similar results. This simple safety step of “Back to sleep” became even more of an imperative with the observation that the higher the rate of infant back sleeping, the less the risk of SIDS.
Today all new parents are advised in the nursery on the steps they can take to prevent most (but not all) cases of SIDS. At Rochester General Hospital and at Newark-Wayne Community Hospital, we participate in the New York State Department of Health “Safe Sleep for Baby” initiative and ask our parents to follow the ABCs of Safe Sleep.
These simple basic steps of “Safe Sleep for Baby” can help prevent SIDS: A for Alone That is, to put the baby on his/her back and not sleep with adults or other children. We want parents to share your room, not your bed. Nothing should be in a baby’s crib except the baby; no blankets, bumpers, toys or pillows.
B for Back Put babies to sleep on their backs, not on their side or on their tummies. When they are awake “tummy time” is great for interacting.
C for Crib Always use an approved crib or bassinet. Use a firm mattress and a fitted sheet. If the baby falls asleep on a bed or the couch move him or her to the crib to finish sleeping. Instead of a blanket use a one piece sleeper.
Other infant safety advice we give to new mothers is to encourage breast feeding, not let anyone smoke around your baby, never use a car seat or baby swing in place of a crib, and don’t keep the nursery warmer than the other rooms in your house.
Even today, 90 infants die in New York State of SIDS annually. We know that unsafe sleeping conditions leave infants vulnerable so remember the ABCs of Safe Sleep and we all can prevent many of cases of sudden unexpected infant deaths.
Michael Jordan, MD, MS-HQSM, CPE, FAAP, Chief of Pediatrics at Newark-Wayne Community Hospital is board-certified in Pediatric Medicine.
He attended the College of Human Medicine at Michigan State University and completed his residency training at the University of Rochester. In addition to his leadership role as chief of Pediatrics at Newark-Wayne, he is the medical director of Rochester Regional Medical Group and is also chair of Rochester General Medical Group’s Quality Committee. He works in the Sodus Rochester General Medical Group Pediatric office. To send questions on children’s health, please email Wendy Fisher, Pediatric Practice Manager at wendy.fisher@rochestergeneral.org and write “Ask a Doc” in the subject line. To schedule an appointment, call 315- 483-3214.
