Sudden Infants Death Syndrome and Arizonas Prevention Programs - Essay Example

Sudden Infants Death Syndrome Arizona's Prevention Programs College SIDS in Arizona According to the Center for Disease Control's Division of Vital Statistics, the top five causes of infant mortality in the United States are, in descending order: congenital malformations, deformations and chromosomal abnormalities; short gestation and low birth weight; Sudden Infant Death Syndrome (SIDS); newborns affected by complications of placenta, core and membranes; and deaths caused by unintentional injuries. (pg. 10) When this data is analyzed further by examining ages at death within the infancy group, SIDS is the leading cause of death in Postneonatal infants, that is infants over 27 days old but less than one year. (Bartos, pg. 1) In this paper I will be presenting information on SIDS including: general information about the syndrome; research conducted and results; and national and state wide programs initiated to reduce the number of SIDS deaths; and evaluate the effectiveness of these programs based on infant mortality rates. Sudden Infant Death System Background Information As stated, SIDS in the leading cause of postneonatal infant death in the United States. On a national level SIDS claims the life of approximately 6,000 children a year. In Arizona, SIDS is responsible for 50 deaths a year, most occurring when the child is between two and four months of age. (Nauman, pg. 1) What is unique about this condition is that it can not be diagnosed prior to the infant's death. SIDS typically can not be diagnosed until all other possible causes have been ruled out through autopsy, medical history of the infant and parents has been reviewed, and lastly, the scene of the infant's death has been thoroughly investigated. Due to the very nature of the syndrome, SIDS is sometimes called crib death. Unfortunately, in the case of SIDS, an apparently healthy infant is placed in bed to sleep and is later discovered dead, leaving the grieving parents wondering what they did wrong and how it could have been avoided. "SIDS kills one in every five-hundred babies. That reckoning comes out to one baby dying of SIDS every hour of the day. After 30 years of research, scientists still cannot find one definite cause or causes for SIDS. Another little known fact is that more children die of SIDS in one year than those who die of cancer, heart disease, pneumonia, child abuse, AIDS, cystic fibrosis and muscular dystrophy combined during their first 14 years." (Nauman, pg. 1) These statistics coupled with the inability to diagnose the syndrome until the infant has already succumbed make SIDS a terrifying possibility for parents to consider. Although no known cause has been identified, ongoing research which will be discussed later has yielded clues as to which infants may be at a greater risk to die of SIDS. Infants in this high risk category include: infants who sleep in a prone position; infants who are not carried full term, commonly referred to has premature; infants born with a birth weight of three and half pounds or less; babies whose mothers smoked during pregnancy or those who are exposed to second hand smoke after birth; infants born to mothers who were drug addicts, specifically, cocaine, heroine or methadone; babies whose mother consumed alcohol during pregnancy; infants whose mother had had none or late prenatal care; the second or succeeding infant born to a mother under the age of 20; infants whose sibling(s) died of SIDS; and infants who previously experienced a life threatening event. Through analyzing research data it has been shown that "African-American infants are twice and Native American infantsare about thrice as likely to die of SIDS than Caucasian infants. More boys than girls fall victim to SIDS." (Kids Health, n.p.) In general, research, to date, has been able to eliminate factors which are not responsible for SIDS, but no causal effect has yet to be identified. Through various studies it has been shown that the following are NOT causes of SIDS: lack of love; suffocation, vomiting or choking; heredity; immunizations, vitamin deficiencies or hormone imbalances; allergies or infections; from exposure to another infant who died of SIDS, implying SIDS is not contagious; and SIDS is not case specific to any one economic or social level. (Nauman, n.p.) This complex syndrome will require much case specific research to isolate the cause(s). Understanding the incidences across all variables is necessary for researchers to focus their studies and reach data driven conclusions. However, each study leads us closer to understanding SIDS. Based on this, preventative programs have been initiated both nationally and state wide to reduce the frequency of SIDS. SIDS Preventative Programs and Analysis of Effectiveness In 1994, on a nationwide level, based on the American Academy of Pediatrics' (APP) recommendations the U.S. Public Health Service (PHS) , the SIDS Alliance, the Association of SIDS and Infant Mortality Programs and the APP launched the 'Back to Sleep' program. (Dr. John Kattwinkel, n.p.) The focus of this program is to educate parents and other caregivers of infants research indicated that the positioning of infants while sleeping has a direct impact on the number of SIDS deaths. The 'Back to Sleep' program recommends that infants be placed on their back to sleep. Research had shown that there was a strong likelihood that sleep positions had a direct effect on Postneonatal infant mortality, contributing to SIDS. Convincingly, studies have shown that infants placed on their belly to sleep were 12.9 times more likely to die than infants place on their backs. (McEntire, pg. 1) The Arizona Department of Health Service's Annual Report of Child Fatalities (CFRA) yearly publishes infancy mortality rates. In 1995 there were 78 SIDS deaths in Arizona. In 2003, which is the most current report available, the death rate due to SIDS was 33, a reduction of 40% nationally and 45% statewide. Each year the Department of Health thoroughly investigates each child's death. The report concluded that this significant reduction in yearly SIDS deaths was primary due to public awareness of the importance of sleep positioning of infants through the AAP 'Back to Sleep' program. (CFRP, n.p.) Arizona SIDS foundation launched a 'Sleep Safe' campaign in 1994. Although the 'Back to Sleep' campaign has significantly reduced the incidence of SIDS fatalities, Arizona researchers have hypothesized that much more can be done. "A lot of parents think 'If my baby is asleep on his back, we don't have to worry about SIDS,' Sales (study co-author) said. What we are showing is there are other sleep associated risk factors, such as inappropriate bedding or sleep surfaces that play a role." (More Sleep, n.p.) Using data derived from CFRP results researchers concluded that of the 134 infants who died between 1999 and 2001 from SIDS and suffocation and/or asphyxiation, a staggering 72% of those deaths could have been prevented if all the precautions had been followed not just ensuring the infant was placed on his back. (More Sleep, n.p.) Increasing the awareness of such risks as bedding, bed sharing and type of sleep surface potentially could result in far fewer deaths. Results of this study were released in May of 2005 and are much too early to attach statistical significance to the new program; but, given data implications and if properly launched and disseminated the Arizona 'Sleep Safe' campaign should yield a significant reduction in infant mortality. In March of 2001, the Arizona Department of Health Services (ADHS) instituted the 'Health Arizona 2010' initiative. Within the program are specific guidelines to be met with regard to infant mortality - a goal of 6.0 by 2010. Infant mortality is a figure derived by dividing the total number of infant deaths in a given year by 1000. The Arizona Infant Mortality Rate in 2001 was 6.9 above the target identified in the 'Healthy Arizona 2010" initiative. (Bartos, pg. 3) In order to reach these targets Arizona has set up several programs targeting infant mortality. 'Health Start' is an outreach program designed to provide education and support services to pregnant and post partum women residing in high risk areas within the state. Specific statistical data on the benefits of this program have not been measured. However, the logical conclusion when analyzing the 'Back to Sleep' campaign and similar educational programs, an initiative such as this, which supplements, by concentrating efforts on statistically high risk areas, these proven programs is sound. The Arizona Chapter of the March of Dimes has long been at the forefront, marshalling the elimination of infant deaths. They have designated top priority to ensure every woman of child bearing years has access to health insurance. Their second priority is to prevent birth defects and infant mortality. (AZ March of Dimes, n.p.) While neither of these specifically state SIDS as a priority both are directly linked to research data as high risk areas for SIDS death. A recent study to investigate the correlation between low birth weight and premature births and SIDS found that "since 1989, a more pronounced decrease in the incidence of SIDS has been observed than in previous years. For instance, between the year 1991 and 1995, overall Postneonatal SIDS mortality decreased from 1.30 to .87 deaths per 1000 live births." (Freeman, Pg. 1) This reduction supports the theory that proper prenatal care reduces the frequency of low birth weight/premature infants logically reducing the risks of SIDS. However, in Arizona, premature and low birth weights continue to rise. According to March of Dime statistics in 1990 10.2% of all births fall into this category while in 2000 it rose to 11.6%. (AZ March of Dimes, n.p.) The ADHS needs to gain more ground reduce this trend. Although the direct impact of the final Arizona program to reduce SIDS deaths cannot be measured, its significance is worthy of mention. ADHS instituted the Arizona Child Fatality Review Program (ACFRP) in 2001 where each case of infant death is thoroughly investigated. Through this detailed analysis of each death; meticulous record keeping; and analysis and publication of findings, researchers are better equipped to see possible links to SIDS and establish research initiation. There is a possibility that Programs such as ACFRP will significantly reduce the time it takes to find a cure for SIDS. Final Remarks There is much to learn about SIDS. Even after years of research, there is still no known cause or cure. However, research is continuing and strides are being made. Each study eliminates possible causes. Documented results of findings and accurate mortality statistics, as those instituted by the state, will continue to enable research to continue. While we wait for the cause and cure to be discovered, communication is the key to reducing mortality rates. Through dissemination of public findings and recommendations and sharing of research data amongst researchers, more and more families will be saved from experiencing one of the most devastating experiences known - loss of their precious child. Bibliography American SIDS Institute, (n.d.) Research. Retrieved November 3, 2005, from http://www.sids.org/ Anderson, Robert N. and Smith, Betty L. (November 2003) National Vital Statistics Reports. Volume 53, Number 17. Retrieved November 2, 2005 from www.cdc.gov/nchs/data/nvsr/nvsr53/nvsr53_17.pdf Arizona Safe Sleep Campaign (n.d.) The Arizona Sudden Infants Death Foundation Retrieved November 3, 2005 from http://www.azsidf.org/ Bartos, Rene. (October 2003) Infant Mortality in Arizona. Arizona Department of Health Services, Office of Women's and Children's Health. Retrieved November 1, 2005 From www.azdhs.gov/phs/owch/infant_mortality.doc Child Fatality Review Program. (n.d.) Arizona Department of Health Services, Division of Public Health Services, Office of Women's and Children's Health. Retrieved November 3, 2005 from http://www.azdhs.gov/phs/owch/cfr.htm Dr. John Kattwinkel and 'Back to Sleep' Honored by Discovery Health Channel Medical Honor. (n.d.) American Academy of Pediatrics Press Release. Retrieved November 3, 2005 from http://www.aap.org/advocacy/releases/julysleep.htm Malloy, Freeman M. (2000). Birth Weight- and Gestational Age-Specific Sudden Infant Death. American SIDS Institute. Retrieved November 1, 2005 from http://www.sids.org/nmontharticle0403.htm March of Dimes, Arizona Chapter (2005) Retrieved November 2, 2005 from http://www.marchofdimes.com/arizona/4761.asp McEntire, Betty. (2005) But my baby doesn't like sleeping on his back. Can't I let him sleep on His tummy American SIDS Institute. Retrieved November 1, 2005 from http://www.sids.org/nfeaturedques.htm More Sleep-Caused Infant Deaths Preventable. May 14, 2005. The Women's National Health Information Center. Retrieved on November 4, 2005 from http://www.4women.gov/News/English/525708.htm Nauman, Eileen. (1997) What Alternative Medicine Care Givers Need to Know. Natural Health a Longevity Resource Center. Retrieved November 2, 2005 from http://www.all-natural.com/sids.html Sudden Infant Death Syndrome. (n.d.) Kids Health for Parents Retrieved November 3, 2005 From http://kidshealth.org/parent/general/sleep/sids.html Read More