Sudden Infant Death Syndrome - Essay Example

Sudden Infant Death Syndrome Order No. 262959 No. of pages: 4 Premium 6530 SIDS has the capa to change ones life forever! It is said to be one of the worst tragedies a parent has to face when he/she comes to find their sleeping child dead for no reason. Such a tragedy leaves them a totally new person for the rest of their lives as they blame themselves and others for the tragic event. According to (Willinger et al, 1991) ‘SIDS is the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.’ In the Maternal Child Health Journal (2007) an article titled “efficacy of a SIDS Risk Factor Education Methodology” spoke of a study conducted on SIDS risk reduction methodology that was community based. The article declared that for several decades now there has been decline in this disease. Rates of infant mortality have declined for several decades (Hoyert DL, Mathews TJ, Menacker F, Strobino DM, Guyer B., 2006, MacDorman MF, Atkinson JO. 1997). However there has been a lot of controversy where the extent of the decline in SIDS has not been accurately gauged. The primary factor contributing to the decline in the rates of SIDS, is alluded to prone sleeping which is considered to be a risk marker. In allowing the public to learn of many of the risk factors efforts were underway in public education. Some of these risk factors are smoking during the pre and post natal period, the improper positioning of infants in their cradles, the infant sharing the bed with its parents, covering the child’s head while asleep, over- dressing the infant and improper bedding. The study included an intervention program imparted to parents by trained hospital staff. This was an effective strategy because it helped to increase the knowledge of the parents and thereby reduce the risk factors that may be involved. This study had its own limitations in the sense that many of the participants had given up partially completed tests which could not be used for the collection of data. Moreover the samples for the study were obtained from two various locations. It was also noted that about 15% of the parents still had doubts about the deficiency of the program and so infant care education needed to be improved in order to improve infant care. In yet another journal article of Early Child Development, titled ‘Infant Temperament Characteristics related to sudden infant death syndrome and its risk factors’ Igor A. Kelmanson, (2005) brings to our notice, the three primary components that are closely associated with SIDS. They are – 1) System, 2) Minor sickness and 3) Surroundings. The prevailing view equates temperament with behavioral style. As has been postulated (Thomas & Chess, 1977), it is the ‘how’ of behaviour as opposed to the ‘what’ (abilities or development) or the ‘why’ (motivations). Out of the nine dimensions of characteristics, temperament is considered to be one of the most important factors for SIDS, ‘known as the sudden, unexpected death of an Infant, that occurs against a background of relative clinical well-being and remains unexplained after the performance of a thorough autopsy (Bergman et al., 1970). In a scientific study undertaken, two groups participated and both were asked to complete the ‘Early Infancy Temperament Questionnaire’ (Medoff-Cooper et al., 1993). The babies who died of SIDS showed very minimal movement when awake in their cradle or when feeding. The babies in the other group showed a lot of activity when not sleeping and even protested when carried by another person who was not the caregiver. The babies with SIDS were also reported to being less physically active, more breathless and exhausted during feeding, and having less intense reactions to environmental stimuli and more abnormal cries than their siblings or peers from general population (Naeye et al., 1976; Einspieler et al., 1988). In a third Journal article titled ‘Sudden Infant Death Syndrome: can gastro-esophageal reflux cause sudden infant death?” Thach BT highlights the fact that it is quite common in SIDS victims that gastric contents may be found in the lungs and air passages during the time of post mortem examination. This has always been a subject of controversy whether it could be the sole cause or a contributory factor leading to death. While a small amount of effortless regurgitation, or functional gastro-oesophageal reflux (GOR), is common during infancy and usually does not cause ill effects, an excessive regurgitation may sometimes serve as a manifestation of pathogenic GOR leading to diseases such as failure-to-thrive, coughing, choking, aspiration, apnea and/or bradycardia and oesophagitis (Sheikh et al., 1999). Presently, most of the authorities look at aspiration to be the result of “agonal” processes and hence it is irrelevant in causing death. Experimental and clinical evidence obtained recently indicate that infants who are on the verge or very near death due to a variety of obvious conditions, more often than not “auto-resuscitate” which automatically brings about a rapid and complete recovery. A study was carried out to evaluate the association of repetitive regurgitation of healthy 2 to 4 month old infants and their temperamental features. Out of the 198 infants, 10 infants were reported to have repetitive regurgitation. Results showed that there was a significant association between repetitive regurgitation and infant distractibility. The infants with SIDS were much less distractible. Therefore such a condition needs a lot of extra effort on the part of the parent to soothe the baby when irritable, fretful and when exhibiting other distressed behavior patterns. An alternative opportunity may be a ‘reverse causality’, in that fretful infants may have a higher frequency of regurgitation, particularly due to the incompetence of lower oesophageal sphincter combined with the increased intra-abdominal pressure from crying or straining (Fonkalsrud & Ament, 1996). On the other hand, while experimenting with animals, it was found that aspiration of either saline or water into the air passages was found to prevent auto-resuscitation. Therefore, the results of these findings go to prove that the aspiration of gastric contents should definitely be reconsidered as one of the contributing factors for deaths in SIDS victims. References Bergman, A. B., Beckwith, J. B. & Ray, C. G. (1970) Proceedings of the Second International Conference on Causes of Sudden Death in Infants (Seattle, WA, University of Washington Press) Einspieler, C., Widder, J., Holzer, A. & Kenner, T. (1988) The predictive value of behavioural risk factors for sudden infant death, Early Human Development, 18, 101–109. Fonkalsrud, E. W. & Ament, M. E. (1996) Gastroesophageal reflux in childhood, Current Problems in Surgery, 33, 1–70. Hoyert DL, Mathews TJ, Menacker F, Strobino DM, Guyer B. Annual summary of vital statistics: 2004. Pediatrics. 2006; 117(1):168–83. Kelmanson, I. A., Erman, L. V., Litvina, S. V. & Adulas, E. I. (2002b) Quality of infant care and behavioural characteristics in 2–4-month-old infants, Pädiatrie und Grenzgebiete, 41, 453–459. MacDorman MF, Atkinson JO. Infant mortality statistics from the 1997 period linked birth/infant death data set. Natl Vital Stat Rep.1999;47(23):1–23. Medoff-Cooper, B., Carey, W. B. & McDevitt, S. C. (1993) The Early Infancy Temperament Questionnaire, Journal of Developmental and Behavioral Pediatrics, 14, 230–235. Naeye, R. L., Messmer, J., Specht, T. & Merritt, T. A. (1976) Sudden infant death syndrome temperament before death, Journal of Pediatrics, 88, 511–515. Sheikh, S., Stephen, T., Howell, L. & Eid, N. (1999) Gastroesophageal reflux in infants with wheezing [in process citation], Pediatric Pulmonology, 28, 181–186. Wulbrand H, McNamara F, Thach BT. The Role of arousal related brainstem reflexes in causing recovery from upper airway occlusion in infants. Sleep. 2008 Jun 1;31(6):833-40. PMID: 18548828 [PubMed - indexed for MEDLINE] American Sudden Infant Death Syndrome www.sids.org/ndefinition.htm Willinger M, Ko CW, Hoffman HJ, Kessler RC, Corwin MJ. Factors associated with caregivers’ choice of infant sleep position, 1994–1998: the National Infant Sleep Position Study. JAMA. 2000; 283(16):2135–42. Read More