Sleeping position and sudden infant death syndrome (SIDS): effect of an intervention programme to avoid prone sleeping

Markestad, Trond; Skadberg, Britt T.; E, Hordvik; Morild, Inge; Irgens, LM

doi:10.1111/j.1651-2227.1995.tb13653.x

Cited by 89 publications

(71 citation statements)

References 17 publications

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“…Soft bedding increases the potential of rebreathing, [1][2][3][4][5][6] a pathway through which SIDS may occur. 7 Pillows, quilts, comforters, and other soft objects are hazardous when placed under the infant [8][9][10][11][12][13][14][15] or loose in the infant's sleep area, 10,12,[15][16][17][18][19][20] increasing SIDS risk up to 5-fold, 13,15 and up to 21-fold when the infant is placed prone. 15 However, use of soft bedding and surfaces is common.…”

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confidence: 99%

Decisions of Black Parents About Infant Bedding and Sleep Surfaces: A Qualitative Study

et al. 2011

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OBJECTIVE: The goal of this qualitative study was to examine factors influencing decisions by black parents regarding use of soft bedding and sleep surfaces for their infants. METHODS: We conducted focus groups and individual interviews with black mothers of lower and higher socioeconomic status (SES). Mothers were asked about many infant care practices, including sleep surface and bedding. RESULTS: Eighty-three mothers were interviewed, 73 (47 lower and 26 higher SES) in focus groups and 10 (7 lower and 3 higher SES) in individual interviews. The primary reason for using soft surfaces was infant comfort. Parents perceived that infants were uncomfortable if the surface was not soft. Many parents also interpreted “firm sleep surface” to mean taut; they were comfortable with and believed that they were following recommendations for a firm sleep surface when they placed pillows/blankets on the mattress as long as a sheet was pulled tautly over the pillows/blankets. The primary reasons for using soft bedding (including bumper pads) were comfort, safety, and aesthetics. In addition to using bedding to soften sleep surfaces, bedding was used to prevent infant rollover and falls, particularly for infants sleeping on a bed or sofa. Some parents used soft bedding to create an attractive space for the infant. CONCLUSIONS: Many black parents believe that soft bedding will keep their infant safe and comfortable. There is much misunderstanding about the meaning of a “firm” sleep surface. Additional educational messages apparently are needed to change parental perceptions and practices.

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confidence: 99%

Decisions of Black Parents About Infant Bedding and Sleep Surfaces: A Qualitative Study

et al. 2011

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“…The supine sleeping position is recommended for infants in all western countries due to the increased risk of cot death among infants sleeping prone (e.g. AAP 2000 ;Beal 2000;Dwyer 1996;Esmail et al 1995;Fleming et al 1990;Gibson et al 2000;Markestad et al 1995;Scragg, et al 1996;Willinger et al 2000). Although recommended in the US until recently, the lateral sleep position has been discouraged for UK infants for around a decade, as several case-control SIDS studies have indicated that sleeping on the side is associated with a greater risk of SIDS than supine sleep (Fleming et al 2000;Scragg and Mitchell 1998;Skadberg et al 1998;Wigfeld et al 1992).…”

Section: Discussionmentioning

confidence: 99%

Parent-infant bed-sharing behavior

Ball

2006

Hum Nat

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Ball, H. L. (2006) 'Parent-infant bed-sharing behavior : e ects of feeding type, and presence of father.', Human nature : an interdisciplinary biosocial perspective., 17 (3). pp. 301-318. Further information on publisher's website:http://dx.doi.org/10.1007/s12110-006-1011-1Publisher's copyright statement:The original publication is available at www.springerlink.com Additional information: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. breastfeeding families were filmed for 3 nights (adjustment, dyadic and triadic nights) for 8 hours per night. For breastfed infants, mother-infant orientation, sleep position, frequency of feeding, arousal and synchronous arousal were all consistent with previous sleep-lab studies of mother-infant bed-sharing behaviour, but significant differences were found between formula and breastfed infants. While breastfeeding mothers bed-shared with their infants in a characteristic manner that provided several safety benefits, formula-feeding mothers bedshared in a more variable manner with consequences for infant safety. Paternal bed-sharing behaviour introduced further variability. Epidemiological case-control studies examining bed-sharing risks and benefits do not normally control for behavioural variables that an evolutionary viewpoint would deem crucial. This study demonstrates how parental behaviour affects the bed-sharing experience and indicates that cases and controls in epidemiological studies should be matched for behavioural, as well as socio-demographic, variables.

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“…Subsequent to a change in body position or movements during sleep, infants may happen to slip under the bedding, 13,14,37,38 and a situation for CO 2 rebreathing and risk of overheating may occur. 10,13,19 Although most infants in the present study woke up when covered, there was a striking difference in subsequent behavior depending on the infants' body position.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been shown that infants sleeping on the side may be able to pull the cover over the head, 13 and that they may roll from the unstable side position to prone. 13,14,37,38 The inability to remove the cover while prone and subsequent awakening and struggling may increase the likelihood of overheating, exhaustion, and a face down position with CO 2 rebreathing, all possible contributors to SIDS.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13] We have previously shown that a significant number of SIDS victims are found with their head covered by bedding and usually in the prone position. 14 The purpose of the present investigation was to study the effect of getting the head covered by bedding on CO 2 accumulation around the face, behavior, and physiologic responses in sleeping infants, and to compare outcome measures for the prone and supine sleeping positions.…”

Section: N 1944 Abramsonmentioning

confidence: 99%

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Consequences of Getting the Head Covered During Sleep in Infancy

Skadberg

Markestad

1997

Pediatrics

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ABSTRACT. Objective. To study the consequences of getting the head covered by bedding (fiber quilt) on carbon dioxide (CO 2 ) accumulation around the face, behavior, and physiologic responses during prone and supine sleep in infants to add understanding to why victims of sudden infant death syndrome are often found under the bedding.Methodology. Of 33 healthy term, usually nonprone sleeping infants, behavior and computerized polysomnography were successfully recorded for 30 during prone and supine sleep at 2 1 ⁄2 months and for 23 prone and 25 supine at 5 months.Results. For both ages and body positions, covering the head resulted in significant CO 2 accumulation around the face, fewer apneas (3 to 10 seconds), shorter duration of apneas after sighs, higher heart and respiratory rates, and peripheral skin temperature. Differences were generally greater at 2 1 ⁄2 than at 5 months. While covered, the prone position was associated with higher CO 2 levels close to the face, slightly higher transcutaneous PCO 2 , and higher heart rates and peripheral skin temperatures than the supine position. In the supine position 23% were able to remove the cover from the head at 2 1 ⁄2 and 60% at 5 months, whereas only 1 infant of 5 months managed to remove the cover when prone.Conclusions. The observed responses are consistent with a potential for distress when the head is covered, particularly when placed prone. Probably most important with respect to sudden infant death syndrome is the infants' inability to remove the bedding from the head upon awakening from prone sleep. Pediatrics 1997;100(2). URL: http://www.pediatrics.org/cgi/content/ full/100/2/e6; behavior, CO 2 rebreathing, hyperthermia, SIDS, sleeping position. 3 Although the concentration of carbon dioxide (CO 2 ) in the atmosphere is .03% to .04%, the exhaled air of infants contains 4% to 5% CO 2 , 4 and it has been speculated that under certain conditions, such as sleeping face down on soft bedding, extensive CO 2 accumulation around the infant's face may result in rebreathing, asphyxia, and suffocation. 3,5,6 The possibility of CO 2 rebreathing has mainly been studied in experimental in vitro and animal models, 3,5-10 whereas studies in infants are limited. 11-13We have previously shown that a significant number of SIDS victims are found with their head covered by bedding and usually in the prone position.14 The purpose of the present investigation was to study the effect of getting the head covered by bedding on CO 2 accumulation around the face, behavior, and physiologic responses in sleeping infants, and to compare outcome measures for the prone and supine sleeping positions. SUBJECTS AND METHODS SubjectsThirty-three infants (17 girls and 16 boys) were recruited for an overnight sleep study both at 2 1 ⁄2 (mean, 74 days; range, 71 to 79 days) and 5 (mean, 152 days; range, 147 to 158 days) months of age. The ages were chosen to correspond with the age of highest risk for SIDS (2 1 ⁄2 months) and a period of significantly lower risk (5 months) in Norway. 15 Only t...

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Sleeping position and sudden infant death syndrome (SIDS): effect of an intervention programme to avoid prone sleeping

Cited by 89 publications

References 17 publications

Decisions of Black Parents About Infant Bedding and Sleep Surfaces: A Qualitative Study

Decisions of Black Parents About Infant Bedding and Sleep Surfaces: A Qualitative Study

Parent-infant bed-sharing behavior

Consequences of Getting the Head Covered During Sleep in Infancy

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