Most suffocating deaths among babies under one year of age occur because babies' breathing patterns are blocked by things like pillows, blankets, sofa cushions, or mattresses for adults, according to a US study.
Unintentional suffocation is the leading cause of injury and death among babies under one age in the United States, researchers in pediatrics noted. For the study, researchers surveyed 1812 cases of sudden unexpected child death (SUID) in the national registry between 2011 and 2014.
A total of 250 cases, or 14%, include choking. About 69% of these suffocating cases are caused by soft pavements such as pillows and blankets, or babies sleeping on mattresses for adults or pillows on the couch that can not be as solid as crèche mattresses.
"Among soft foot deaths over half of children aged 5 to 11 months, airways have been blocked by blankets, compared to less than a third of younger children," said lead author Alexa Erk Lambert of US Centers for Disease Control and Prevention in Chambly, Georgia.
Often the older babies in the study, who were strangled by the blankets, tangled in them, Lambert said by email.
"It is likely that these older, more developed children are mobile enough to get stuck in blankets but are still not coordinated enough to get rid of them," Lambert notes.
For babies up to four months of age, pillows cause strangulation almost twice as often as the older babies in the study.
"Younger babies may be deprived of the mobility and strength of the neck needed to lift their heads to prevent obstruction of the airways, especially when placed on the side of the pillow," says Lambert.
Nearly one in five suffocating deaths in the study occurred when sleeping babies were strangled by another person, which can happen when parents sleep with babies on a couch or in an adult bed. And 12% of these cases are due to "jamming" when babies are trapped between two objects such as a mattress and a wall.
"Smaller babies are less inclined to fall into a closed position because they are less mobile and can not turn around themselves," says Lambert.
"Babies who were suffocated by overlapping were the youngest and had a higher proportion prematurely born than babies who were suffocated by a soft pad or jam," Lambert added.
To prevent SUID, doctors advise parents to sleep babies without blankets or other soft padding or toys that could pose a risk of suffocation. Ideally, babies should be in their own nursery or swing in the guardian's room.
Joint sleep, with babies in the cradle to the mother's bed, can help reduce the risk of SUID, said Dr. Lorry Feldman-Vinte of Rowan University's Cooperational Medical School in Camden, New Jersey.
"This not only reduces the risk of SUID but also facilitates breastfeeding," said Feldman-Vinte, who did not participate in the study.
But co-sleep is not safe when it comes to babies sharing an adult bed.
"What we do not recommend is bedding because there is evidence that it can cause suffocation by mechanisms such as layering," Feldman-Wynter warned. "If the baby is taken to bed, for example, to breastfeed, then there should be no soft pavements, and the mattress should be firm and away from the wall – to prevent clogging."
One of the limitations of the study is that it is based on evidence of death certificates that have no specific data on the sleep environment, and may be inconsistent in how they classify death from suffocation, the authors of the study noted.
However, the results offer new evidence of the risks faced by babies of different ages, said Dr. Michael Goodness, director of Newborn Services at York Hospital WellSpan Health in Pennsylvania.
"We have long known that babies need to be in a safe sleeping environment, meaning that there are no pillows, soft pads, blankets, armor pads, head restraints – all that is associated with an increased risk of SIDS deaths and suffocation , Gudstein, who did not participate in the study, said by email. "The most dangerous place for the baby to sleep is on the couch – the risks increase up to 70 times!"
Source: http://bit.ly/2vhtr6Q Pediatrics, online on April 22, 2019