1
|
Vincent A, Chu NT, Shah A, Avanthika C, Jhaveri S, Singh K, Limaye OM, Boddu H. Sudden Infant Death Syndrome: Risk Factors and Newer Risk Reduction Strategies. Cureus 2023; 15:e40572. [PMID: 37465778 PMCID: PMC10351748 DOI: 10.7759/cureus.40572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 07/20/2023] Open
Abstract
Sudden infant death syndrome (SIDS) continues to be one of the top causes of infant death in the U.S. Despite significant public health initiatives focused on high-risk populations to enhance sleep environments and techniques. The SIDS rate has remained stable in recent years. Risk factors and newer risk reduction strategies for SIDS are the focus of this review article. We conducted a comprehensive literature search on Medline, Cochrane, Embase, and Google Scholar until July 2022. The following search strings and Medical Subject Heading (MeSH) terms were used: "SIDS," "Sudden Infant Death" and "SUID". We explored the literature on SIDS for its epidemiology, pathophysiology, the role of various etiologies and their influence, associated complications leading to SIDS, and preventive and treatment modalities. Despite a more than 50% drop-in rates since the start of the "Back to Sleep" campaign in 1994, sudden infant death syndrome (SIDS) continues to be the top cause of post-neonatal mortality in the United States, despite continued educational initiatives that support safe sleep and other risk reduction strategies. The new American Academy of Pediatrics guidelines for lowering the risk of SIDS include a lot of emphasis on sleeping habits, bedding, and environment but also include elements that are frequently ignored (i.e., prenatal care, smoking, alcohol and drug use, and childhood vaccinations). This study highlights these less-frequently discussed aspects and identifies treatments that have produced beneficial behavioral shifts that benefit newborns as well as their mothers' health and wellbeing.
Collapse
Affiliation(s)
- Anita Vincent
- Medicine and Surgery, Karnataka Institute of Medical Sciences, Hubli, IND
| | - Ngan Thy Chu
- Paediatrics, City Children's Hospital, Ho Chi Minh city, VNM
| | - Aashka Shah
- Paediatrics and Child Health, Pramukhswami Medical College, Karamsad, Anand, IND
| | - Chaithanya Avanthika
- Pediatrics, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York City, USA
- Medicine and Surgery, Karnataka Institute of Medical Sciences, Hubli, IND
| | - Sharan Jhaveri
- Medicine and Surgery, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College (NHLMMC), Ahmedabad, IND
| | - Kunika Singh
- Paediatrics, Xinjiang Medical University, Xinjiang, CHN
| | - Om M Limaye
- Paediatrics, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, IND
| | - Himasaila Boddu
- Paediatrics, Dr. Pinnamaneni Siddartha Institute of Medical Sciences and Research Foundation, Krishna, IND
| |
Collapse
|
2
|
Bach V, Libert JP. Hyperthermia and Heat Stress as Risk Factors for Sudden Infant Death Syndrome: A Narrative Review. Front Pediatr 2022; 10:816136. [PMID: 35498814 PMCID: PMC9051231 DOI: 10.3389/fped.2022.816136] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/24/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Heat stress and hyperthermia are common findings in sudden infant death syndrome (SIDS) victims. It has been suggested that thermal stress can increase the risk of SIDS directly via lethal hyperthermia or indirectly by altering autonomic functions. Major changes in sleep, thermoregulation, cardiovascular function, and the emergence of circadian functions occur at the age at which the risk of SIDS peaks-explaining the greater vulnerability at this stage of development. Here, we review the literature data on (i) heat stress and hyperthermia as direct risk factors for SIDS, and (ii) the indirect effects of thermal loads on vital physiological functions. RESULTS Various situations leading to thermal stress (i.e., outdoors temperatures, thermal insulation from clothing and bedding, the prone position, bed-sharing, and head covering) have been analyzed. Hyperthermia mainly results from excessive clothing and bedding insulation with regard to the ambient thermal conditions. The appropriate amount of clothing and bedding thermal insulation for homeothermia requires further research. The prone position and bed-sharing do not have major thermal impacts; the elevated risk of SIDS in these situations cannot be explained solely by thermal factors. Special attention should be given to brain overheating because of the head's major role in body heat losses, heat production, and autonomic functions. Thermal stress can alter cardiovascular and respiratory functions, which in turn can lead to life-threatening events (e.g., bradycardia, apnea with blood desaturation, and glottal closure). Unfortunately, thermal load impairs the responses to these challenges by reducing chemosensitivity, arousability, and autoresuscitation. As a result, thermal load (even when not lethal directly) can interact detrimentally with vital physiological functions. CONCLUSIONS With the exception of excessive thermal insulation (which can lead to lethal hyperthermia), the major risk factors for SIDS appears to be associated with impairments of vital physiological functions when the infant is exposed to thermal stress.
Collapse
Affiliation(s)
- Véronique Bach
- PeriTox, UMR_I 01, UPJV/INERIS, Jules Verne University of Picardy, Amiens, France
| | - Jean-Pierre Libert
- PeriTox, UMR_I 01, UPJV/INERIS, Jules Verne University of Picardy, Amiens, France
| |
Collapse
|
3
|
Baddock SA, Purnell MT, Blair PS, Pease AS, Elder DE, Galland BC. The influence of bed-sharing on infant physiology, breastfeeding and behaviour: A systematic review. Sleep Med Rev 2018; 43:106-117. [PMID: 30553183 DOI: 10.1016/j.smrv.2018.10.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 11/18/2022]
Abstract
This review aimed to better understand the underlying physiology of the risks and benefits of bed-sharing. Eight databases were searched using terms relating to adult-infant/baby, bed-sharing/co-sleeping combined with outcome terms for physiology, sleep, cardiovascular, respiratory, temperature and behaviour. Of 836 papers identified, 59 papers representing 48 cohorts met inclusion criteria. Objective data using various methodologies were available in 27 papers and subjective data in 32 papers. Diverse measures were reported using variable definitions of bed-sharing. Identified physiological and behavioural differences between bed-sharing and cot-sleeping included increased behavioural arousals, warmer in-bed temperatures and increased breastfeeding duration in bedshare infants as well as differences in infant overnight sleep architecture, cardiorespiratory control and cortisol responses to stress. We concluded that many differences are context-specific, and dependent on the subjective view of the parents and their cultural values. Objective risk arises if the infant is unable to mount an appropriate physiological or behavioural response to their micro-environment. More studies in the bed-sharing setting are needed to identify infant risk, the potential benefits of a safer environment, and how bed-sharing interacts with infant care practices other than sleep.
Collapse
Affiliation(s)
| | | | - Peter S Blair
- Bristol Medical School, University of Bristol, United Kingdom
| | - Anna S Pease
- Bristol Medical School, University of Bristol, United Kingdom
| | - Dawn E Elder
- Department of Paediatrics & Child Health, University of Otago, Wellington, New Zealand
| | - Barbara C Galland
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, New Zealand.
| |
Collapse
|
4
|
Parent-child bed-sharing: The good, the bad, and the burden of evidence. Sleep Med Rev 2016; 32:4-27. [PMID: 27107752 DOI: 10.1016/j.smrv.2016.03.003] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 03/03/2016] [Accepted: 03/07/2016] [Indexed: 12/30/2022]
Abstract
The practice of parent and child sharing a sleeping surface, or 'bed-sharing', is one of the most controversial topics in parenting research. The lay literature has popularized and polarized this debate, offering on one hand claims of dangers, and on the other, of benefits - both physical and psychological - associated with bed-sharing. To address the scientific evidence behind such claims, we systematically reviewed 659 published papers (peer-reviewed, editorial pieces, and commentaries) on the topic of parent-child bed-sharing. Our review offers a narrative walkthrough of the many subdomains of bed-sharing research, including its many correlates (e.g., socioeconomic and cultural factors) and purported risks or outcomes (e.g., sudden infant death syndrome, sleep problems). We found general design limitations and a lack of convincing evidence in the literature, which preclude making strong generalizations. A heat-map based on 98 eligible studies aids the reader to visualize world-wide prevalence in bed-sharing and highlights the need for further research in societies where bed-sharing is the norm. We urge for multiple subfields - anthropology, psychology/psychiatry, and pediatrics - to come together with the aim of understanding infant sleep and how nightly proximity to the parents influences children's social, emotional, and physical development.
Collapse
|
5
|
Evaluation of the thermal insulation of clothing of infants sleeping outdoors in Northern winter. Eur J Appl Physiol 2010; 111:633-40. [PMID: 20949360 DOI: 10.1007/s00421-010-1686-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2010] [Indexed: 10/19/2022]
Abstract
It is a common practice in Northern countries that children aged about 2 weeks to 2 years take their daytime sleep outdoors in prams in winter. The aim was to evaluate the thermal insulation of clothing of infants sleeping outdoors in winter. Clothing data of infants aged 3.5 months was collected, and sleep duration, skin and microclimate temperatures, humidity inside middle wear, air temperature and velocity of the outdoor environment were recorded during sleep taken outdoors (n = 34) and indoors (n = 33) in families' homes. The insulation of clothing ensembles was measured by using a baby-size thermal manikin, and the values were used for defining clothing insulation of the observed infants. Required clothing insulation for each condition was estimated according to ISO 11079. Clothing insulation did not correlate with ambient air temperature. The observed and required insulation of the study group was equal at about -5 °C, but overdressing existed in warmer and deficiency in thermal insulation in colder temperatures (r (s) 0.739, p < 0.001). However, even at -5 °C a slow cooling (ca. 0.012 °C/min) of mean skin temperature (T (sk)) was observed. When the difference between observed and required insulation increased, the cooling rate of T (sk) increased linearly (r (s) 0.605, p < 0.001) and the infants slept for a shorter period (r (s) 0.524, p = 0.001). The results of this study show the difficulty of adjusting systematically the optimal thermal insulation for outdoor sleeping infants during northern winter. Therefore, the necessity for guidelines is obvious. The study provides information for adequate cold protection of infants sleeping in cold conditions.
Collapse
|
6
|
Ekamper P, Duin CV, Poppel FV, Mandemakers K. Heat Waves and Cold Spells and their Effect on Mortality: an Analysis of Micro-data for the Netherlands in the Nineteenth and Twentieth Centuries. ACTA ACUST UNITED AC 2010. [DOI: 10.3917/adh.120.0055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
7
|
Aslam H, Kemp L, Harris E, Gilbert E. Socio-cultural perceptions of sudden infant death syndrome among migrant Indian mothers. J Paediatr Child Health 2009; 45:670-5. [PMID: 19845839 DOI: 10.1111/j.1440-1754.2009.01593.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To explore socio-cultural influences on migrant mother decisions and beliefs regarding co-sleeping as a risk factor for sudden infant death syndrome (SIDS). METHODS Semi-structured interviews with five Indian-born women in a socio-economically disadvantaged suburb in the south-west of Sydney were conducted between September and December 2007. Transcripts were analysed using principles of discourse analysis. RESULTS Discourse analysis revealed that SIDS-related decisions and beliefs about co-sleeping as a risk factor for SIDS are constructed amid competing discourses of motherhood and child health. Mothers are either actively or unconsciously deciding how they negotiate or resist dominant Western discourses of motherhood and child health to make 'the best' health-related decisions for their children. Participants resisted acknowledging child sleep practices recommended by health practitioners, particularly recommendations to put to sleep the baby in its own cot. This resistance was expressed by constructing messages as 'inapplicable' and 'inappropriate'. Co-sleeping was constructed as a highly valued practice for its physical and social benefits to the child, mother and family by facilitating child security, breastfeeding, bonding and family connectedness. CONCLUSION This study illustrates how decisions and behaviour are shaped by socio-cultural influences embedded in discourses and context. It also shows that in-depth investigation through a social constructivist lens is particularly useful for investigating influences on knowledge acquisition, interpretation and implementation among migrant groups. A greater appreciation of the social meanings and ideologies attached to behaviours can help to ensure that the correct messages reach the correct populations, and that child health outcomes can be achieved and maintained both for overseas and Australian-born populations.
Collapse
Affiliation(s)
- Henna Aslam
- Centre for Health Equity Training Research and Evaluation (CHETRE), part of the Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of NSW, Liverpool Hospital, Liverpool BC, New South Wales 1871, Australia
| | | | | | | |
Collapse
|
8
|
Schlaud M, Dreier M, Debertin AS, Jachau K, Heide S, Giebe B, Sperhake JP, Poets CF, Kleemann WJ. The German case-control scene investigation study on SIDS: epidemiological approach and main results. Int J Legal Med 2009; 124:19-26. [PMID: 19159943 DOI: 10.1007/s00414-009-0317-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Accepted: 11/25/2008] [Indexed: 12/18/2022]
Abstract
The present study, which was part of the German SIDS Study (GeSID), enrolled sudden infant death syndrome (SIDS) cases and population controls and obtained objective scene data via specifically trained observers shortly after discovery of each dead infant. Infants who had died suddenly and unexpectedly at ages between 8 and 365 days were enrolled in five regions of Germany between November 1998 and October 2001. Shortly after discovery of each dead infant, a specially trained doctor of legal medicine visited the bereaved family at home. Data were obtained by measurements and observations. Dead infants underwent a standardised autopsy, additional information being obtained by standardised parent interviews. Investigation of the sleep environment and wake-up scene in matched controls followed the same protocol. A total of 52 SIDS cases and 154 controls were enrolled, 58% were boys, and median age of cases vs. controls was 126 vs. 129 days. Risk factors in the sleeping environment were pillow use (adjusted OR 4.3; 95%CI 1.6-11.6), heavy duvets (OR 4.4; 1.5-13.3), soft underlay (OR 3.0; 1.1-8.7), face covered by bedding (OR 15.8; 2.5-102.1) and entire body covered by bedding (OR 35.5; 5.5-228.3). Using a standardised protocol, including objective measurements of the sleep environment and a case-control design, this study was able to confirm many risk factors for SIDS.
Collapse
Affiliation(s)
- Martin Schlaud
- Department of Epidemiology, Social Medicine, and Health System Research, Hannover Medical School, Hannover, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Abstract
AIMS This study was undertaken to monitor infant care practice associated with SIDS and establish the incidence of SIDS in the UAE. METHODS A total of 996 families were recruited for the study. One questionnaire was completed during the first 7 days after delivery, and was used to collect information about the socio-demographic features, mother's medical history, delivery status and infant's medical history, and another questionnaire was completed after 12 weeks through telephone interviews of the mothers. 716 completed both questionnaires. Registers at the two hospitals, and at the Preventive Medicine Department were studied and all infant deaths in a 5-year period were recorded. RESULTS In all 18.9% of infants were placed in the prone position. Mothers preferred supine position (49.3%) to other positions when putting their babies to bed. Ninety eight percent preferred that their infant slept in the same room as the parents. On the whole, 40% occasionally shared their beds with their infants. Swaddling the babies was quite common (83.2%) and 91.9% of their mothers were also swaddled when they were babies. More than 80% of all infants used bedding duvets for their infants both in the summer and in the winter. SIDS mortality rate was 0.66 per thousand live births and contributed 7.25% to the infant mortality rate. CONCLUSION These data provide useful baseline information on child care practice and should be of immense benefit to the understanding of the risks and causal mechanisms of SIDS and to the UAE health authorities should they wish to develop strategies to reduce the risk of SIDS.
Collapse
Affiliation(s)
- Yousef Mohamed Abdulrazzaq
- Department of Paediatrics, Faculty of Medicine and Health Sciences, UAE University, PO Box 127666, Al Ain, United Arab Emirates
| | | | | |
Collapse
|
10
|
Kemp L, Harris E, Chavez R. Knowledge of sudden infant death syndrome prevention strategies in a multicultural, disadvantaged community. J Paediatr Child Health 2006; 42:441-4. [PMID: 16898882 DOI: 10.1111/j.1440-1754.2006.00894.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM This study assessed levels of maternal knowledge of sudden infant death syndrome prevention strategies in a socio-economically disadvantaged, culturally diverse population. METHODS Pregnant women (n=233) were asked to name three things they could do to reduce the risk of cot death. Answers were marked in accordance with the US National Institute of Child Health and Development guide-lines. RESULTS Of women 51.5% could correctly name two or more strategies that could reduce the risk of sudden infant death syndrome. There was significant difference by the woman's country of birth: 68.2% of Australian-born women were able to correctly identify two or more strategies, compared with only 37.3% of those born overseas (P<0.001). Most of the small number of Indigenous women included in the study were able to correctly identify two or more strategies. Year of arrival in Australia, number of previous children, age and level of education were not significantly related to women's knowledge. CONCLUSION Knowledge of sudden infant death syndrome prevention strategies was poorer in overseas-born women. Practitioners working with disadvantaged, overseas-born women should give consideration to women's knowledge of sudden infant death syndrome prevention if current low rates of sudden infant death syndrome deaths are to be maintained.
Collapse
Affiliation(s)
- Lynn Kemp
- Centre for Health Equity Training Research and Evaluation, Part of the UNSW Research Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia.
| | | | | |
Collapse
|
11
|
Liu KL, Laraque F. Higher Mortality Rate Among Infants of US-Born Mothers Compared to Foreign-Born Mothers in New York City. J Immigr Minor Health 2006; 8:281-9. [PMID: 16791538 DOI: 10.1007/s10903-006-9333-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study is to compare infant mortality rates (IMRs) between US- and foreign-born mothers in New York City. The linked live birth-infant death records from 1995 to 1998 were analyzed. Overall US-born mothers had a higher IMR than foreign-born mothers, though there were great variations in IMRs by country of maternal birth among foreign-born mothers. US-born mothers had higher IMRs compared to foreign-born mothers for several maternal/infant characteristics. Logistic regression analyses indicated that infants of foreign-born mothers were less likely to die from prematurity, Sudden Infant Death Syndrome and external causes, but were more likely to die of congenital anomalies than those of US-born mothers. Further analyses on the interactions of maternal race/ethnicity and country of birth showed variations in the IMRs of leading causes of death. Infant mortality reduction strategies should be differentially targeted to minority mothers of different countries of birth, particularly for potentially preventable causes of deaths.
Collapse
Affiliation(s)
- Kai-Lih Liu
- New York City Department of Health and Mental Hygiene, Office of Family Health, New York, New York 10013, USA.
| | | |
Collapse
|
12
|
McGarvey C, McDonnell M, Hamilton K, O'Regan M, Matthews T. An 8 year study of risk factors for SIDS: bed-sharing versus non-bed-sharing. Arch Dis Child 2006; 91:318-23. [PMID: 16243855 PMCID: PMC2065975 DOI: 10.1136/adc.2005.074674] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2005] [Indexed: 11/04/2022]
Abstract
BACKGROUND It is unclear if it is safe for babies to bed share with adults. In Ireland 49% of sudden infant death syndrome (SIDS) cases occur when the infant is bed-sharing with an adult. OBJECTIVE To evaluate the effect of bed-sharing during the last sleep period on risk factors for SIDS in Irish infants. DESIGN An 8 year (1994-2001) population based case control study of 287 SIDS cases and 831 controls matched for date, place of birth, and sleep period. Odds ratios and 95% confidence intervals were calculated by conditional logistic regression. RESULTS The risk associated with bed-sharing was three times greater for infants with low birth weight for gestation (UOR 16.28 v 4.90) and increased fourfold if the combined tog value of clothing and bedding was > or =10 (UOR 9.68 v 2.34). The unadjusted odds ratio for bed-sharing was 13.87 (95% CI 9.58 to 20.09) for infants whose mothers smoked and 2.09 (95% CI 0.98 to 4.39) for non-smokers. Age of death for bed-sharing and sofa-sharing infants (12.8 and 8.3 weeks, respectively) was less than for infants not sharing a sleep surface (21.0 weeks, p<0.001) and fewer bed-sharing cases were found prone (5% v 32%; p = 0.001). CONCLUSION Risk factors for SIDS vary according to the infant's sleeping environment. The increased risk associated with maternal smoking, high tog value of clothing and bedding, and low z scores of weight for gestation at birth is augmented further by bed-sharing. These factors should be taken into account when considering sleeping arrangements for young infants.
Collapse
Affiliation(s)
- C McGarvey
- National Sudden Infant Death Register, George's Hall, The Children's University Hospital, Temple St, Dublin 1, Ireland.
| | | | | | | | | |
Collapse
|
13
|
Wilson CA, Chu MS. Thermal insulation and SIDS-an investigation of selected 'Eastern' and 'Western' infant bedding combinations. Early Hum Dev 2005; 81:695-709. [PMID: 16023308 DOI: 10.1016/j.earlhumdev.2005.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2004] [Revised: 05/16/2005] [Accepted: 05/17/2005] [Indexed: 11/21/2022]
Abstract
BACKGROUND Differences in the incidence of SIDS between 'Western' and 'Eastern' countries has been attributed to cultural practices, which may affect the infants care and thermal environment. AIM The purpose of this work was to estimate for selected 'commonly' used bedding, sleep positions and practices in Japan, Korea and New Zealand, the intrinsic 'dry' thermal resistance of bedding. Insulation levels are also discussed in the context of published information about the thermal environment in which the bedding is likely to be used. METHOD Selected Japanese, Korean and New Zealand bedding was loosely tucked over an infant manikin in the lateral, prone and supine sleep positions. Thickness in use was measured, and intrinsic 'dry' thermal resistance estimated using the Wilson Laing model which accommodates the effect on insulation of the three-dimensional arrangement of bedding combinations during use. RESULTS AND DISCUSSION Thickness of under- and upper-bedding varied among countries with thickness and estimated 'dry' thermal resistance of the upper-bedding affected by the type/combination of bedding and the infants sleep position. Insulation levels are discussed in relation to environmental conditions within and among countries and between seasons. Further information on thermal environments, bedding combinations used and care practices within both Asian and Western countries is needed. CONCLUSIONS 'Eastern' infants appear likely to be generally covered in bedding combinations of greater insulation than those used to cover 'Western' infants in comparable seasons. Differences existed between insulation of the Japanese and Korean bedding combinations investigated. Lower rates of SIDS apparent in 'Asian' populations do not appear attributable to use of lower levels of bedding insulation only.
Collapse
Affiliation(s)
- C A Wilson
- Clothing and Textile Sciences, University of Otago, P.O. Box 56, Dunedin, New Zealand.
| | | |
Collapse
|
14
|
Thomas KA. Infant Weight and Gestational Age Effects on Thermoneutrality in the Home Environment. J Obstet Gynecol Neonatal Nurs 2003; 32:745-52. [PMID: 14649594 DOI: 10.1177/0884217503258319] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To describe infant temperature in the home environment and explore factors, particularly weight and gestational age at birth, associated with maintenance of thermal neutral temperatures in the home. DESIGN Continuous abdominal skin temperature was recorded at 1-minute intervals for a 24-hour period in both full-term and preterm infants, using a two-group exploratory design. SETTING Infants were studied in the home environment. PATIENTS/PARTICIPANTS Twenty-four preterm and 16 full-term infants were studied at approximately 44 weeks postconceptional age. MAIN OUTCOME MEASURES Abdominal skin temperature was coded as within, over, or under the thermal neutral zone, and the percentage of time in these thermal conditions was calculated. RESULTS Regression analysis was conducted, and weight, gestational age, and weight by gestational age interaction were found to be statistically significant predictors of percent of time over and under the thermal neutral zone. Smaller preterm infants were overheated, whereas heavier preterm infants were underheated. Smaller full-term infants were underheated, and heavier full-term infants were overheated. CONCLUSION Thermal care of infants in the home may be influenced by parental perception of thermal vulnerability relative to weight and gestational age at birth.
Collapse
Affiliation(s)
- Karen A Thomas
- Department of Family and Child Nursing, University of Washington, Seattle 98195-7262, USA.
| |
Collapse
|
15
|
Liamputtong P. Childrearing practices and child health among the Hmong in Australia: implications for health services. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2003; 32:817-36. [PMID: 12456127 DOI: 10.2190/ttlq-yc48-gtvq-3djh] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study of cultural beliefs and practices related to childrearing and child health among the Hmong in Melbourne, Australia, used in-depth interviews and participant observation of 27 Hmong mothers and some Hmong traditional healers between 1993 and 1998. Traditional Hmong beliefs and practices include: taking notice of the birth date and time, placing a silver necklace on the newborn, not praising the newborn, not taking the infant out during the first 30 days, breastfeeding, the infant's sharing a bed with the parents, and a soul-calling ceremony on the third day after birth. All Hmong mothers follow cultural beliefs and practices to prevent the ill-health or death of their newborn infants, but some aspects of these practices have had to be modified to suit the new living environment in Australia. Health care professionals need to acknowledge the different ways of caring for a young child among the Hmong so as to avoid misunderstandings and to provide sensitive care. Hmong beliefs and practices also have implications for health promotion campaigns and can be a valuable source of ideas in the efforts to promote infant health and reduce infant deaths in Australia and elsewhere.
Collapse
Affiliation(s)
- Pranee Liamputtong
- School of Public Health, La Trobe University, Bundoora, Victoria, Australia.
| |
Collapse
|
16
|
Nelson EA, Taylor BJ, Jenik A, Vance J, Walmsley K, Pollard K, Freemantle M, Ewing D, Einspieler C, Engele H, Ritter P, Hildes-Ripstein GE, Arancibia M, Ji X, Li H, Bedard C, Helweg-Larsen K, Sidenius K, Karlqvist S, Poets C, Barko E, Kiberd B, McDonnell M, Donzelli G, Piumelli R, Landini L, Giustardi A, Nishida H, Fukui S, Sawaguchi T, Ino M, Horiuchi T, Oguchi K, Williams S, Perk Y, Tappin D, Milerad J, Wennborg M, Aryayev N, Nepomyashchaya V. International Child Care Practices Study: infant sleeping environment. Early Hum Dev 2001; 62:43-55. [PMID: 11245994 DOI: 10.1016/s0378-3782(01)00116-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The International Child Care Practices Study (ICCPS) has collected descriptive data from 21 centres in 17 countries. In this report, data are presented on the infant sleeping environment with the main focus being sudden infant death syndrome (SIDS) risk factors (bedsharing and infant using a pillow) and protective factors (infant sharing a room with adult) that are not yet well established in the literature. METHODS Using a standardised protocol, parents of infants were surveyed at birth by interview and at 3 months of age mainly by postal questionnaire. Centres were grouped according to geographic location. Also indicated was the level of SIDS awareness in the community, i.e. whether any campaigns or messages to "reduce the risks of SIDS" were available at the time of the survey. RESULTS Birth interview data were available for 5488 individual families and 4656 (85%) returned questionnaires at 3 months. Rates of bedsharing varied considerably (2-88%) and it appeared to be more common in the samples with a lower awareness of SIDS, but not necessarily a high SIDS rate. Countries with higher rates of bedsharing appeared to have a greater proportion of infants bedsharing for a longer duration (>5 h). Rates of room sharing varied (58-100%) with some of the lowest rates noted in centres with a higher awareness of SIDS. Rates of pillow use ranged from 4% to 95%. CONCLUSIONS It is likely that methods of bedsharing differ cross-culturally, and although further details were sought on different bedsharing practices, it was not possible to build up a composite picture of "typical" bedsharing practices in these different communities. These data highlight interesting patterns in child care in these diverse populations. Although these results should not be used to imply that any particular child care practice either increases or decreases the risk of SIDS, these findings should help to inject caution into the process of developing SIDS prevention campaigns for non-Western cultures.
Collapse
Affiliation(s)
- E A Nelson
- Department of Paediatrics, The Chinese University of Hong Kong, 6/F Clinical Science Building, Prince of Wales Hospital, Shatin, Hong Kong, People's Republic of China.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Guntheroth WG, Spiers PS. Thermal stress in sudden infant death: Is there an ambiguity with the rebreathing hypothesis? Pediatrics 2001; 107:693-8. [PMID: 11335746 DOI: 10.1542/peds.107.4.693] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the role of thermal stress in the cause of sudden infant death syndrome (SIDS), and to compare risk factors with those of rebreathing. METHODOLOGY Analysis of publications concerning the epidemiology and physiology of thermal stress in SIDS. RESULTS A strong association between thermal regulation and ventilatory control was found, specifically for prolonged apnea. Infections, excessive room heat and insulation, and prone sleeping produce significantly increased odds ratios for SIDS. Although some of the risk factors for rebreathing could be explained by the effects of thermal stress, several factors for thermal stress could not reasonably be explained by the rebreathing hypothesis. CONCLUSIONS Although the risk of thermal stress is widely accepted abroad, it has received relatively little attention in the United States. The incidence of SIDS in the United States can likely be further reduced by educating the public against the dangers of overheating, as an integral part of the back-to-sleep campaign.
Collapse
Affiliation(s)
- W G Guntheroth
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington 98195-6320, USA.
| | | |
Collapse
|
18
|
Schluter PJ, Macey PM, Ford RP. The relationship between inside and outside ambient temperatures in Christchurch, New Zealand. Paediatr Perinat Epidemiol 2000; 14:275-82. [PMID: 10949221 DOI: 10.1046/j.1365-3016.2000.00264.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The objective of this study was to examine and identify relationships between hourly recorded meteorological temperature and ambient temperature, measured from within the home-sleeping environment of young infants' homes in Christchurch, New Zealand. From 1991 to 1994, home polysomnography recordings were conducted for up to 6 weeks on 32 infants aged between 2 and 24 weeks. One of the recorded signals was ambient room temperature. In total, 15735 hourly recordings of this temperature were available for analysis. The New Zealand Meteorological Service supplied hourly recordings of climatic temperature, collected over this time, from an exposed site that was considered to be representative of weather conditions for Christchurch. Temperature seasonality, hourly climatic temperature recordings and the interaction of these variables were found to be significantly related to the indoor ambient temperature recordings (all had P < 0.001). Fluctuations in hourly recorded indoor temperature appeared to lag outdoor temperature fluctuations by approximately 2 h; hence, a strong autocorrelation was identified in the regression residuals. The most parsimonious autoregression model accounted for 97% of the variability in the hourly indoor temperature measurements (r2 = 0.97). In Christchurch houses, which typically have poor thermal insulation properties, yet have no central heating capabilities, a very strong association between indoor and outdoor temperatures was clearly demonstrated.
Collapse
Affiliation(s)
- P J Schluter
- Department of Social and Preventative Medicine, The University of Queensland, Australia
| | | | | |
Collapse
|
19
|
Abstract
OBJECTIVE To described child care practices associated with an increased risk of sudden infant death syndrome (SIDS) in nonindustrialized 19th and 20th century societies. METHODOLOGY The Human Relations Area Files collection is a unique source of information on the cultures of the world. The electronic version of the Human Relations Area Files represents 200 000 pages of fully indexed cultural material on a stratified random sample of 60 nonindustrialized societies. Using various keyword combinations, texts containing information related to sleeping conditions, social interaction, temperature regulation, feeding, and smoking were identified and using structured questionnaire practices were recorded as being present, absent, or not stated. RESULTS Relevant information was identified for 53 societies. None of 4 societies mentioning sleep position used the prone position. Swaddling and restraint were commonly practiced, often for extended periods of time. Most information was available on infant feeding and the predominant pattern was of demand breastfeeding for long periods. In many of the cultures, infants are seen as being the focus of attention, in close contact with and under the constant supervision of the mother, siblings, and other relatives. CONCLUSIONS The study produced no clear evidence that these primarily nonindustrialized societies followed child care practices likely to protect against SIDS. Despite limitations, the information presented should be of interest to those involved in developing reduce the risks programs for SIDS prevention, because it highlights the considerable variation in child care practices and emphasizes that health education messages may not always be cross-culturally valid.
Collapse
Affiliation(s)
- E A Nelson
- Department of Paediatrics, Chinese University of Hong Kong, Hong Kong SAR, China.
| | | | | |
Collapse
|