Wednesday, 29 September 2010

SIDS: New Zealand

Sudden unexpected death is extremely rare for babies protected by the safety formula. Photo: File.

Sudden unexpected death is extremely rare for babies protected by the safety formula. Photo: File.

The tragic deaths of two Tauranga babies have prompted the coroner to warn parents of the risk of sharing a bed with their infant.

The inquests of the 4-month-old babies, who died within a month of each other last year, were held at Tauranga yesterday.

The names of the babies and their parents were suppressed.

Coroner Dr Wallace Bain said it was important to get the warning out about the risks of bed-sharing.

In the first case, the baby had been sleeping between its teenage mother and the mother's younger sibling.

But when the mother woke in the morning, her son was not breathing. She immediately started CPR and an ambulance was called, but the baby could not be saved.

The court heard evidence that the baby had been wheezing, and only a month earlier had spent a few days in hospital being treated for a respiratory virus.

The pathologist said the post-mortem findings were consistent with an "asphyxial mode of death", and consistent with consideration of a sudden infant death syndrome.

The baby's parents were not present in court.

In the second case, the baby's father had placed his son into his wife's arms while she was lying in bed.
All three went to sleep.

But when the mother woke at 4am, she found her baby lying face up between her and her husband. He was not breathing, was cold to the touch, and had no pulse.

She immediately started CPR and an ambulance was called.

The pathologist who performed the post-mortem examination said the baby's death was consistent with asphyxia.

The baby's mother told the coroner that sleeping with her baby was a cultural practice.

But she had since had another child, and her new baby slept in its own cot with a monitor.

The coroner applauded that decision, and said it was important to tell other parents about the need for separate, safe sleeping places for little babies. The mother, who attended with the baby's father, agreed.

It's not the first time the risks of parents bed-sharing with babies has been highlighted.

Dr Bain said he and the Wellington coroner dealt with at least a dozen similar co-sleeping deaths in 2008, and there continued to be cases all around the country.

Dr Bain reserved his decision in relation to the cause of death of both infants.

The issue of safe sleeping practices has also been raised by health officials in Christchurch following the destructive earthquake two weeks ago.

Dr Pat Tuohy, Ministry of Health chief adviser child and youth health, said many babies are sleeping in makeshift beds away from their own homes - and this meant some might be placed to sleep in dangerous places. Dr Tuohy said there were three things parents and caregivers should remember wherever and whenever baby sleeps.

"They should be face-up, face-clear and smoke-free."

The doctor also warned parents who were tired, or had consumed alcohol, not to share a bed with their baby, because it put the baby at high risk of being suffocated.

"Sudden unexpected death is extremely rare for babies protected by this safety formula."

The Ministry of Health is recommending its "Safety formula" to reduce the chances of babies dying in their sleep:

FACE UP: Babies should sleep on their back. In this position it's easier for them to breathe and allows their strong gag and swallow reflexes to protect them if they spill. A clear face protects babies from suffocation.

FACE CLEAR: Babies need to be in a safe place, and shouldn't sleep on a couch or a bed with bedding or pillows that could block breathing.

SMOKE-FREE: All smoking harms babies, especially in pregnancy. Smoking takes oxygen and weakens vital systems as babies develop. When born, babies need extra protection, especially those born early.

Risks of sharing a bed with your baby 

Plunket advises parents on its website that bed-sharing increases the risk of sudden infant death syndrome (SIDS). If a parent wants to share a bed with their baby, it was important to:

* Have a smoke free pregnancy and home.
* Make sure that your baby sleeps on its back.
* Ensure that the adults in the bed have not been using alcohol or drugs, or are particularly tired.

Plunket also advises ensuring that bedding does not cover the baby's face or bed, the baby can't become wedged between or under others, and the baby doesn't get too heated or cold.
The risks of bed sharing are greater for premature and low birth weight babies and those who have been exposed to smoke, Plunket says.
"Most babies who die of SIDS share a bed with others, and have been exposed to smoke during pregnancy and after birth."
La Leche League New Zealand spokeswoman Lisa Manning said many New Zealand parents from different cultural backgrounds shared sleep with their babies, for all or part of the night.
"Rather than condemning what is an important strategy used by some to make parenting easier and more pleasurable, accurate messages on how to safely share sleep and when to avoid it need to be given."
Ms Manning said British research by Helen Ball had found that mothers who slept next to their breastfed babies were sensitive to their baby's presence during the night.
They maintained a safe sleeping position which protected the baby's from over-lying. 

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