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Circumstances leading to a change to prone sleeping in sudden infant death syndrome victims
A Côté1, T Gerez, R T Brouillette
1Jeremy Rill Centre for SIDS, Division of Respiratory Medicine, McGill University, Montreal, Canada.
Insights
Unaccustomed prone sleeping is a significant risk factor for sudden infant death syndrome (SIDS). Many SIDS victims were placed in the prone position shortly before death, often by secondary caretakers.
Area of Science:
- Pediatrics
- Public Health
- Sleep Medicine
Background:
- Unaccustomed prone sleeping is a known risk factor for sudden infant death syndrome (SIDS).
- Limited data exists on caretaker-induced sleep position changes in SIDS cases.
Purpose of the Study:
- To investigate the timing and reasons for sleep position changes to prone in SIDS victims.
- To identify circumstances surrounding unaccustomed prone sleeping in infants who normally slept non-prone.
Main Methods:
- Case series analysis of 157 SIDS victims in Quebec, Canada (1991-1997).
- Data collected via questionnaires administered to parents and caretakers.
- Focus on infants originally sleeping in non-prone positions.
Main Results:
- 139 of 157 SIDS cases were found in the prone position; 93 usually slept prone.
- 34 non-prone sleepers were changed to prone before death; 18 turned prone independently for the first time.
- For 21 infants, the change to prone occurred within a week of death; 16 died on their first or second prone sleep.
- Non-parental caretakers initiated the prone sleep change in 56% of cases.
Conclusions:
- Public health campaigns should highlight the risks of unaccustomed prone sleeping.
- Education on safe sleep practices must include both parents and secondary caretakers.
Context:
In addition to usual prone sleeping, unaccustomed prone sleeping represents a significant risk factor for sudden infant death syndrome (SIDS). However, little information is available regarding the circumstances leading caretakers to change the infant's sleep position to prone position in SIDS victims.
Objective:
To determine, in a population of SIDS victims, the timing of a change to prone sleeping and the reason for that change in infants who were originally nonprone sleepers.
Design And Setting:
Case series analysis from a questionnaire administered between 1991 and 1997 to parents and other caretakers of SIDS victims in the province of Quebec (Canada).
Subjects:
One hundred fifty-seven SIDS cases occurring in the province during the study.
Results:
Of the 157 SIDS cases studied, 139 were found in the prone position, although only 93 infants usually slept prone. Of the 64 nonprone sleepers, 34 had been changed to prone by the parents or another caretaker before death, and 18 had apparently turned to prone for the first time. In the 34 cases changed to prone, the change occurred <1 week before death for 21 infants; for 16 of those infants, death occurred the first or second time that they slept prone. In 56% of the cases changed from a nonprone to prone sleeping position, a caretaker other than the parents had precipitated the change.
Conclusions:
Ongoing campaigns to decrease the risk of SIDS should emphasize the risk of unaccustomed prone sleeping to both parents and secondary caretakers.
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