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 Up to four months of age, sharing a bed with an adult or pet was the
most common factor involved in sleep-related deaths, the analysis
found. For babies between four months and one year old, the biggest
risk was rolling over into an object in the crib or on the bed.
“These findings make sense when taking into account an infant's
development in the first year: Infants less than four months old do
not have the strength to move their head when an adult moves in a
way that covers the infants mouth,” said lead author Dr. Jeffrey
Colvin.
“Infants at around the age of four months are beginning to roll over
to their stomach and it is possible that the infants in our study
rolled over, but into a soft object such as a pillow or stuffed
animal and were suffocated,” said Colvin, a pediatrician at
Children’s Mercy Hospitals and Clinics in Kansas City, Missouri.
The researchers looked at a national database of infant deaths in 24
states, including more than 8,000 babies who died from SIDS,
accidental suffocation or strangulation in bed between 2004 and
2012.
They considered the age, gender and ethnicity of the baby as well as
sleeping in a bed with another person or animal or having objects
like a pillow, blanket or stuffed toy in the bed. The data also
differentiated between babies sleeping in cribs, playpens, car seats
or strollers, in adult beds or on a person.
About 70 percent of babies were sharing a bed at the time of death,
according to the results published in Pediatrics. For younger
infants, 74 percent of deaths were associated with bed sharing,
compared to 59 percent of older infants.
About a third of the babies had an object in the sleeping
environment, usually blankets or pillows. Objects were present for
40 percent of older infant deaths, compared to 34 percent of younger
infant deaths.
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All these factors are risks for all infants, but some are more
likely for younger and some for older infants, Colvin said.
“And no matter what the age group, many infants die when exposed to
risk factors such as bed sharing, soft bedding and the prone or side
sleeping positions,” said Dr. Eve R. Colson, professor of Pediatrics
at the Yale School of Medicine in New Haven, Connecticut.
“From my own practice I know that older infants can begin to roll
and move around freely so we need to remind families to place
infants in safe environments for the entire first year,” Colson, who
was not part of the new study, told Reuters Health by email.
Little can be done to prevent an infant from rolling over in the
crib, he said, since wedges, positioners and rolled towels can cause
suffocation and entrapment and should not be used. But rolling over
can be made safer.
When the infant is awake and playing, keep her on her stomach, which
will help strengthen back and arm muscles so that when she is prone,
she is able to turn her head and breathe, he said. Place her on her
back for sleep.
Once children are old enough to turn over in the night, you can let
them keep sleeping that way and should not reposition them, said
Patricia G. Schnitzer, an associate professor at the Sinclair School
of Nursing at the University of Missouri in Columbia.
Schnitzer also wasn't involved with the study.
“Equally important, parents should ensure that there are no objects
in the sleep area, especially pillows, blankets, and stuffed toys,”
Colvin said.
SOURCE: http://bit.ly/1mDjerK Pediatrics, online July 14, 2014.
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