Mattresses, microenvironments, and multivariate analyses

What is the mechanism of SIDS? Clues from epidemiology

The cause of sudden infant death syndrome (SIDS) is unknown. Many mechanisms have been postulated, although thermal stress, rebreathing of expired gases and infection/inflammation seem the most viable hypotheses for the causation of SIDS. Deaths from SIDS have reduced dramatically following the recommendation not to place infants to sleep prone. Epidemiological data have shown that prone sleeping position is more risky in winter, colder latitudes, higher altitudes, if the infant is unwell or has excessive bedding or clothing. This suggests prone sleeping position involves either directly or indirectly a thermal mechanism. SIDS caused by an infective/inflammatory mechanism might be associated with deaths occurring during the night. Rebreathing of expired gases, airway obstruction, long QT syndrome and other genetic conditions may explain a small number of sudden unexpected deaths in infancy.

Is the mattress important in helping babies keep warm?--Paradoxical effects of a sleeping surface with negligible thermal resistance

BACKGROUND

Heavy wrapping and head covering are risk factors for Sudden Infant Death Syndrome. A new mattress construction, PurFlo, has extremely low thermal resistance, and when used with an infant sleeping bag minimizes the risk of head covering.

AIM

To investigate the thermal balance and metabolic rate of infants sleeping on a conventional mattress or a Purflo mattress in infant sleeping bags.

METHODS

A longitudinal study of thermal balance of infants during day-time sleep on both mattress types in thermoneutral and cool conditions at ages 3 weeks (n = 24), 3 months (n = 22) and 5 months (n = 18).

RESULTS

In thermoneutral conditions axillary temperatures in quiet sleep were lower on the conventional mattress than on the PurFlo mattress (p < 0.05, Wilcoxon test). On lowering room temperature to 15-16 degrees C axillary temperatures fell, particularly in the older babies, and at each age were lower on the conventional mattress than the Purflo (differences 0.14-0.72 degrees C, p < 0.05, Wilcoxon test).

CONCLUSION

In both thermoneutral and cool conditions, infant temperatures were higher on the PurFlo than the conventional mattress. The more deformable surface of the PurFlo mattress may lead to more effective insulation by the sleeping bag despite a lack of mattress insulation.