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Can we reduce episodes of haemoglobin desaturation in full-term babies restrained in car seats?
Shirley L Tonkin1, Christine G McIntosh, Gillian M Nixon
1New Zealand Cot Death Association, P.O. Box 28177, Auckland, New Zealand.
Insights
A foam insert for infant car seats can reduce episodes of oxygen desaturation in newborns. This simple device helps maintain a neutral head position, improving infant safety during travel.
Area of Science:
- Neonatal care
- Pediatric safety
- Respiratory physiology
Background:
- Infant car seats can cause head flexion, leading to airway obstruction and reduced oxygen saturation (SpO2).
- Full-term infants are susceptible to SpO2 desaturation due to positional effects in car seats.
Purpose of the Study:
- To evaluate the efficacy of a foam insert in preventing SpO2 desaturation in infants.
- To determine if the insert reduces apnea frequency and severity.
Main Methods:
- Eighteen healthy full-term infants were studied in car seats with and without a foam insert.
- Continuous polygraphic recordings of respiratory rate, heart rate, nasal airflow, and SpO2 were obtained for 30 minutes per condition.
Main Results:
- The foam insert significantly reduced the rate of apneas associated with SpO2 falls greater than 5% (p=0.03).
- A severe apnea episode with >30% SpO2 fall occurred only in the car seat without the insert.
Conclusions:
- A car seat insert promoting a neutral head position may decrease mild SpO2 reduction episodes in some newborns.
- This intervention offers a potential safety improvement for infants during car travel.
Objectives:
To determine whether episodes of haemoglobin oxygen (SpO2) desaturation in full-term infants restrained in car seats can be reduced by a simple foam plastic infant car seat insert designed to push the body forward, with space for the protuberant occiput to lie behind the spine, and so reduce flexion of the infant's head on the trunk.
Methods:
Eighteen healthy full-term babies were evaluated while restrained in an infant car safety seat with, and without, the foam insert. Infants were monitored in each position for 30 min with continuous polygraphic recording of respiratory and heart rate, nasal airflow and SpO2.
Results:
Placement of the insert in the car seat was associated with a significant reduction in the rate of apneas with a fall in SpO2 >5% (median, interquartile range: 4.4 (0, 10.6) vs. 9.2 (5.4, 15.2) events per hour, p=0.03). The one clinically severe episode of apnea, with a fall in SpO2 of more than 30%, occurred in the car seat without the insert.
Conclusions:
A car seat insert that allows the newborn's head to lie in a neutral position during sleep may reduce the frequency of mild episodes of reduced SpO2 in some full-term newborn babies.
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