Sudden Infant Death Syndrome - Essay Example

? Sudden Infant Death Syndrome al Affiliation) Sudden Infant Death Syndrome Sudden infant death syndrome is the sudden loss of life of an infant below the age of one year that cannot be explained by allusion to historical norms or even after causes- of- death examination mechanisms like autopsy, studying of the scene of the occurrence and revisiting of the clinical history. The syndrome tops the charts in the list of causes of deaths to infants of the age mentioned above. There has been a decline in the occurrence of the Syndrome in the United States and Canada but in other countries the progress of SIDS has either stagnated or is declining (Hunt & Fern, 2006). There are many factors related to the occurrence of SIDS and range from pathophysiological, socio-demographic to pregnancy-related and infant sleep practices among others. To be particular, they include smoking of mothers during pregnancy, low birth weights, low ages usually 2 to 4 months, male infants, prematurity, lack of pacifiers at sleep, ethnicity of infants, inadequate prenatal care and precarious sleeping positions in a list of many others. There were similarities in outcomes on the autopsies done on the SIDS related infant deaths especially their lungs and parts of their brain (Hunt & Fern, 2006) Sleeping In the precarious position has majorly been pointed out as being among the main contributors to the cause of SIDS (Richardson, Walker & Horne, 2008). Many countries have taken the heed to deal with this problem considering that it can be easily amended especially in comparison to factors like ethnicity background of the infants and so far some countries have noted significant declines in SIDS related death. They include Australia, United States and New Zealand whose interventions to ensure infants receive maternal help to sleep in less prone positions, that is, the supine position. The same can happen in many other countries but this has not taken place. In Brazil, for example, mothers do not use the supine position, either because they are not given the information by proper means and sources that are responsible for so and also for the fact that even the medical practitioners lack the necessary knowledge and tactics to combat the syndrome (Silveira, Cauduro & Justo, 2009) According to a research in Brazil, most mothers who were taught how to put their babies to sleep, did so in the supine position, as taught, upon the research assistants follow ups to their home ,using doll models( Silveira, Cauduro & Justo, 2009) .This shows that if people were to receive enough education, be it prenatal or antenatal, and also, the health practitioners had the same information, especially in this case, on SIDS, things would hopefully be a little different. But after much is emphasized on the importance of the sleeping position to a child, there is another side to this story considering that this has never been proved especially the true mechanisms as to why the prone sleeping position is likened with SIDS (Richardson, Walker & Horne, 2008). In response to this statement, the probability of the involvement of a paralyzed arousal response from slumber has become a proposal. This view has been supported by studies on autopsies on the brainstem. These studies have shown abnormalities in the aforementioned section in SIDS infants especially in the areas in charge of control and awakening of heart- respiratory system. As such, a research was conducted to investigate the outcomes of precarious sleep on form of both the induced and unexpected arousal reaction from the infants. There were two types of arousals used, that is the cortical and the sub-cortical one for different response mechanisms used and there was an upward change in the level of the former arousal on the health term infants and a decrease in the latter (Richardson, Walker & Horne, 2008). This was done at 2-3 months old infants. In a nutshell, the research was drawing allusions to the cortical arousals increasing as a mechanism to protect the infants from prone sleeping positions. It thus tried to show that there was a relationship between cortical arousals and SIDS where, if the arousals are not full or complete, may be used to explain the reason many SIDS are linked to the vulnerable sleeping position, especially at the age of 2 to 3 months (Richardson, Walker & Horne, 2008) Another issue that comes into view when there is SIDS is bed sharing between parent and child. Contrary to any opposition to this habit, there are no sufficient scientific facts to demonstrate the adverse effects associated with parent/child co-sleeping especially when safety measures are put in place. The American Academy of Pediatrics had from 1992 discouraged bed sharing between parent/child citing views that it added to the risk for SIDS through the chance of the following five things occurring to the infant. One, the parent might overlay the infant or secondly be turned into a vulnerable position. The infant might also overheat, get entangled by free bedding or become asphyxiated by a garments of an adult smoker and only recommended room sharing back recently (Sobralske & Gruber, 2009). Apart from the above raised issues in relation to co-sleeping, the habit is viewed as a healthy one in different parts of the world and creates a good bond between parent and child. Its benefits include, good breastfeeding habit, hindrance to prone position for the sleeping infant. It also allows the improvement of monitoring from the mother and increases the frequency of infant arousals (Sobralske & Gruber, 2009). Countries like Sweden and the Sami families in Norway do not oppose it, and the same is the case to 58% of parents in Shanghai and Hong Kong in China, Japan and sparsely in the United States. The habit is said to have been connected to socioeconomics in African Americans mostly those in Missouri. Nurse Practitioners should first look into certain factors before advising parents on this situation. If parents prefer co-sleeping, then the NP’s should advice them fully on doing so safely and dictate the risks to them. They should also consider the cultural preferences too if any. Both methods have pros and cons but if the NP’s intervene and after considering the parental and cultural factors and giving them the risks and benefits, parents will be able to make sound decisions for their children.( Sobralske & Gruber, 2009) Among the many recommendations given to deal with the control of SIDS include the use of pacifiers also known as dummies or soothers. There have been many studies in support of this belief despite the lack of evidence biologically that explains the mechanism beneath it as in different fields this “soothers” are believed to bring harmful effects. As aforementioned, it is not understood how pacifiers work to reduce the risk of SIDS or the other way round on their absence. Despite that, there have been postulations on the probable mechanisms. These mechanisms include the decreasing of the arousal threshold, inhibiting of the vulnerable sleeping position, ensuring that the oropharyngeal airway is aptly protected and finally that the gastro esophageal reflux is reduced. Their use varies in different countries greatly as it does within. In the European countries there has been much use of them (Mitchell, Blair & L’Hoir, 2006). The other probable advantages of these “dummies” use are control of discomfort especially when the blood is being sampled and dental malocclusion lowering. As with most things that have advantages, the case is the same for pacifiers. Most of them are unclear and they include the decrease of breastfeeding as the use of pacifiers escalate, dental malocclusion, symptoms like otitis media, oral yeast infection and accidents ranging from strangulation if the pacifiers are corded to airway obstruction (Mitchell, Blair & L’Hoir, 2006). There is surmountable and strong evidence that pacifiers work against the increase of the risk of SIDS but its use should also well balanced to handle the obvious risks like the seemingly possible decrease in the breastfeeding period. Pacifiers should be given at the right time and parents should have enough information on their use too (Mitchell, Blair & L’Hoir, 2006). References Hunt, C. E., & Fern R. (2006). Sudden death infant syndrome. Canadian Medical Association Journal. 174(13), 1861-1869. doi: 10.1503/cmaj.051671 Mitchell, E.A., Blair, P.S. & L’Hoir M.P. (2006). Should Pacifiers Be Recommended To Prevent Sudden Infant Death Syndrome? Pediatrics, 117(5), 1755-1758. doi: 10.1542/peds.2005- 1625 Richardson, H.L., Walker, A.M. & Horne, R.S.C. (2008). Sleep position alters arousal processes maximally at the high-risk age for sudden infant death syndrome. Journal of Sleep Research, 17(4), 450-457. doi: 10.1111/j.1365-2869.2008.00683.x Silveira, M.R.I., Cauduro, J.P.M., & Justo, R.E.G. (2009). Infant sleep position: A randomized clinical trial of an educational intervention in the Maternity ward in Porto Alegre, Brazil. Birth: Issues in Perinatal Care, 36(2), 115-121.doi: 10.1111/j.1523-536X.2009.00308.x Sobralske, C.M., & Gruber, E.M. (2009). Risks and benefits of parent/child bed sharing. Journal of the American Academy of Nurse Practitioners, 21(9), 474-479. doi: 10.1111/j.1745-7599.2009.00430.x Read More