New Campaign Highlights Greater Cot Death Risk For Premature Babies

Main Category: Pediatrics / Children's Health
Article Date: 01 Aug 2008 - 4:00 PST

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The cot death charity, the Foundation for the Study of Infant Deaths (FSID), and the special care baby charity Bliss today launch a new campaign to raise awareness of the heightened risk of cot death amongst premature babies. The 'Time to Get Back to Sleep' campaign highlights the need for premature babies, who sleep on their tummies while in hospital (1), to be switched to sleeping on their backs at home.

Premature or low birth weight babies (2) are more likely to die as cot deaths than those born at term of normal birth weight. The risk increases even more if premature babies are not slept on their backs at home. A premature baby is 48 times more likely to die as a cot death if they have been placed to sleep on their tummy instead of their back.

The campaign follows the publication of research (3) that found that only 38 per cent of neonatal units actively discouraged parents from sleeping their prematurely-born babies on the front after discharge from the unit. All neonatal units in the country will this week be receiving new guidelines explaining the advice, and a colourful flyer for parents reinforcing the back sleeping advice is also available.

Joyce Epstein, FSID Director, said: "Cot death is still the leading cause of death in babies over one month old in the UK today. To reduce the especially high risk of cot death among babies who were born prematurely, they must be slept on their backs at home. Hospitals need to start placing babies to sleep on their backs several weeks before they are ready to go home, so parents see medical staff doing this and understand why. Studies (4) have shown that parents are strongly influenced by what they see doctors and nurses doing."

Professor George Haycock, FSID's scientific adviser, said: "Many parents worry that if their baby sleeps on their back, they are more likely to choke on their vomit, but research (5) shows this isn't true. Another concern parents have is that reflux will get worse if their baby sleeps on their back, but, again, research (6) shows that this doesn't happen. Parents also worry that their premature baby won't sleep well if they are lying on their back and research does show that they do wake less if they are sleeping on their tummies. However, parents must not be tempted to let their babies sleep on their fronts as babies who wake up less are more vulnerable to cot death."

Bliss Chief Executive Andy Cole said: "This is an extremely important campaign, considering that 80,000 babies are born premature or sick in the UK every year and that these babies are at a very high risk of cot death. The best quality care should always be delivered to these most vulnerable babies. Turning babies on their backs to sleep both in the latter stages of their stay on a special care baby unit, and then at home, is a simple step that can make a crucial difference."

Research papers:

(1) Prematurely born infants with respiratory distress and those in the recovery stage of respiratory disease are nursed on their tummies because they have higher blood oxygen levels, better respiratory mechanics and higher lung volumes when nursed this way compared with being nursed on their backs. In hospital, these infants are under continuous intensive monitoring and many are on mechanical ventilators, conditions that do not apply once they are discharged home.

(2) Premature babies are those born before 37 weeks and low birth weight babies are those weighing less than 2.5kg or 5 ½ lbs at birth.

(3) Rao H, May C, Hannam S, Rafferty GF, Greenough A. Survey of sleeping position recommendations for prematurely born infants on neonatal intensive care unit discharge. Eur J Pediatr 2007;166:809-811.

(4) Colson ER, Bergman DM, Shapiro E, Leventhal JH. Position for newborn sleep: associations with parents' perceptions of their nursery experience. Birth 2001;28:249-253. Vernacchio L, Corwin MJ, Lesko SM, Vezina RM, Hunt CE, Hoffman JH, Willinger M, Mitchell AA. Sleep position of very low birthweight infants. Pediatrics 2003;111:633-640.

(5) Malloy MH. Trends in postneonatal aspiration deaths and reclassification of sudden infant death syndrome: impact of the 'Back to Sleep' program. Pediatrics 2002;109:661-665.

(6) Bhat RY, Rafferty G, Hannam S, Greenough A. Acid gastro-esophageal reflux in convalescent preterm infants - effect of posture and relationship to apneas. Pediatr Res 2007;62:620-623.

About FSID

The Foundation for the Study of Infant Deaths is the UK's leading baby charity working to prevent sudden deaths and promote infant health. FSID funds research, supports bereaved families, promotes baby care advice, and works to improve investigations when a baby dies. FSID runs a Helpline (020 7233 2090) for parents and professionals seeking advice on safe baby care. Advice for parents and professionals can also be found at http://www.fsid.org.uk

About Bliss

Bliss, the special care baby charity was founded in 1979 and is dedicated to making sure that more babies born prematurely or sick in the UK survive and that each one has the best quality of life. It seeks to achieve this through supporting new developments and innovations in care; supporting parents and carers of premature and sick newborn babies; and campaigning for improvements in neonatal care.

Bliss