Transcript Safer sleeping presentation by CDOP Manager July 2014

SIDS
Not ‘cot death’
Definition
• Sudden death of an infant under 1 year
• Remains unexplained after
– Case investigation
– Autopsy
– Examination of death scene
– Review of clinical history
• Persistent rate since dramatic fall after
1991
Who’s at Risk?
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Boys>girls
Multiple births
Prematurity
LBW
Aged 6 wks to 6 months
Minor illness
Parental unemployment
Young mother
Lower SC
Smoking in pregnancy
Unsafe sleeping
Risk Factors
Factors associated
with an increased
risk of SIDS
Unsafe sleeping
position
Smoking
Factors associated
with an decreased
risk of SIDS
Room sharing
Unsafe sleeping
environments
 Bed sharing &
sofa sharing
 Temperature
 Bedding &
mattresses
Dummy use
Breast feeding
Safe Sleeping
• Safe Sleeping Test, from Foundation of
Sudden Infant Deaths
• Identify 7 risks of SIDS from the picture
Sleeping Position
• Babies placed to sleep on their front or
side are at significant increased risk of
SIDS
• 2 studies have shown that side sleeping
is particularly risky if baby was born
before 37 weeks gestation
• Babies who usually sleep on their back
but are placed on their front or side are at
high risk of SIDS
(Lullaby Trust May 2013)
Unsafe Sleep Environments
• Meta analysis of studies published in 2012
showed an increased risk of SIDS in bed
sharing infants
• Studies have found that sharing a sofa
with an infant is also associated with an
extremely high risk of SIDS
• Bed sharing with a baby if either parent is
a smoker significantly increases the risk of
SIDS
(Lullaby Trust May 2013)
Other Recommendations
• Baby’s head should be uncovered while sleeping
• Babies should be placed on their back in the ‘feet to
foot’ position
• Use of pillows, quilts & duvets should be avoided
• Babies should sleep on frim flat mattress which is clean
& in good condition
• The safest place for the baby to sleep for the 1st 6
months is in a cot/crib in the same room as the parents
• Medical advice should be sought if a baby shows signs
of illness that persist for more than 24 hrs
(Lullaby Trust May 2013)
Sudden Unexpected Deaths in
Infancy
Between April 2008 and March 2014 across Central
Bedfordshire, Bedford Borough and Luton there have
been a total of 26 deaths of babies which were sudden
and unexplained.
16 of 26 babies who died were boys. This is in keeping
with research which shows that boys appear to be more
at risk than girls. (Epidemiology of SIDS and explained
sudden infant deaths. CESDI SUDI Research Group
.Leach CE, Blair PS, Fleming PJ, Smith IJ Platt MW,
Berry PJ, Golding J.)
Age of Babies at Death
Age range of deaths 2 weeks to 31 weeks
42% died between 10-13 weeks
National statistics show that babies are more likely
to die during cooler months however the data for
Bedford Borough, Central Bedfordshire and Luton
is fairly evenly spread throughout the year
although a slight peak has been observed in the
second quarter of the year.
Smoking
• 1 in 4 women smoke during part of their pregnancy
• Maternal smoking dramatically increases the rate
of SIDS, miscarriage & stillbirth
• Estimated if all women stopped smoking in
pregnancy the SIDS rate would be reduced by up
to 40-50%
• Smoking 1-9 cigarettes a day in pregnancy= 4x
more likely to have SIDS
• Risk of SIDS increased by bed sharing when either
parent smokes
• Postnatal passive smoking also puts a baby at
risk
(Lullaby Trust May 2013)
Alcohol & Drugs & Bedsharing
• Risk of SIDS found to be increased when bed
sharer has used alcohol or drugs or is overtired
• One study showed where mother had consumed
2 or more units of alcohol in last 24hrs there
was substantial increase risk in SIDS when bed
sharing
• Use of illegal drugs increased the risk 11 fold
even when baby was room sharing. Risks when
drug using mother is bed sharing is ‘inestimably
large’
(Lullaby Trust May 2013)
SIDS Cases Reviewed by CDOP
Modifiable factors were identified in all of the
sudden unexpected deaths reported to CDOP.
These included:
• unsafe sleeping practices, majority of babies
were not in a cot/Moses basket at the time of
their final sleep.
• smoking (56% of cases)
• drug/alcohol misuse.
In some cases there was more than one
modifiable factor identified.