NurseWeek: Some hospitals may be courting SIDS

Some hospitals may be courting SIDS
Activists decry putting newborns on their sides

By Julia McNamee Neenan
HealthScout Reporter
March 6, 2001


	You've read the article. Now tell us what you think. What To Do To best protect your babies from SIDS, Pettit advises, put them on their backs when they sleep. You can help build their muscles and prevent flattened heads by giving them tummy time when they're awake and you're nearby, she adds. For more information on SIDS, visit the National Institute of Child Health & Human Development or the American SIDS Institute or check out KidsHealth, sponsored by the Nemours Foundation. For more on the Back to Sleep campaign, visit the National Institutes of Health. Or, you might want to read previous HealthScout articles for news of recent research on SIDS.

(HealthScout). Hospitals in Iowa are putting babies at higher risk for dying in their sleep by following out-of-date guidelines, claims a child advocacy group.

Babies are safest when they sleep on their backs, not on their sides and definitely not on their stomachs, according to the most recent research on sudden infant death syndrome, or SIDS.

But the American Academy of Pediatrics, an association of doctors who treat children and young adults, continues to say in its guidelines that it's OK to put babies on their sides to sleep. And these guidelines form the basis for government brochures that hospital nurses cite when explaining why they put babies on their sides.

"The majority of hospitals in Iowa place babies on their sides instead of on their backs, and we would prefer them to be placing babies on their backs in newborn nurseries as an example to newborn parents and grandparents visiting," says Stephanie Pettit, executive director of the Iowa SIDS Alliance.

The problem, she says, is that many younger and less-educated women––whose babies already are at higher risk for SIDS––see their babies sleeping on their sides in the hospital and figure that's the preferred method.

"What do they see in the hospital but the baby on its side?" she asks. "And what do they do?"

SIDS is the leading cause of death in babies older than 1 month. Nearly 3,000 infant deaths are attributed to SIDS each year, but that number represents a great improvement over the more than 5,000 deaths annually that occurred before the government initiated its Back to Sleep campaign in 1994.

Researchers now believe that babies die of SIDS because their brains don't arouse them, as they should, when the babies are breathing in too much carbon dioxide.

Having babies sleep on their backs best protects them from this risk, Pettit says.

And while sleeping on the side is safer than the stomach, a baby still could roll onto its stomach at any time, she says.

Studies estimate that babies are anywhere from two to four times as likely to die when they sleep on their sides as when they sleep on their backs, according to a study by the Iowa SIDS group that appears in this month's issue of Pediatrics.

Still, about 90 percent of all Iowa hospitals continue to put babies on their sides, says Pettit, who authored the research. And other hospitals around the country seem to be doing the same, she says.

Of the Iowa hospitals surveyed, 51 percent said they hoped to prevent the babies from throwing up and then choking, the study says. Another 38 percent cited a 1996 federal brochure that offers side sleeping as an alternate––though not preferred––position.

But Pettit says other studies show that aspiration is not a danger for babies older than a few hours and without serious health problems. In Iowa, for example, since the Back to Sleep campaign began, she says, not one baby sleeping on its back has died from choking on its own vomit.

A revised federal brochure on this sleep-position issue, which is being sent to hospitals nationwide, no longer includes a photo of a baby sleeping on its side and emphasizes that the back position is safest, says Andrea Furia, a writer/editor with the National Institutes of Health.

But the brochure still includes the side position as an alternate, she says.

That's because the pediatrician's association has not changed its guidelines, and the Back to Sleep campaign has no choice but to follow the guidelines, Furia says.

"Nurses are a big challenge to us, to get through to them," Furia says. "They really think the baby's going to choke."

The pediatrician's group revised its guidelines last year and is unlikely to do so again any time soon, a spokesman says.

"We struggled with this, and there are still some folks out there who feel more comfortable with the side position," says Michael Malloy, MD, a professor of pediatrics at the University of Texas and a member of the task force that established the guidelines.

"The reality is that the side position offers less risk than the prone," Malloy says. But he acknowledges that studies show sleeping on the back is least risky.

And what does he tell his own patients?

"I tell them to put the babies on their backs," Malloy says. And does he tell them the side position is an alternative? "No."

This is a News story from HealthScout, a service of Rx Remedy, Inc.