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Sleeping Pattern Important in Reducing SIDS
most appropriate approach to reducing the risk of using dietary supplement products containing ephedrine alkaloids. The National Advisory Council for the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health (NIH), was scheduled to meet on March 17 to assess the evidence on ephedra’s safety and effectiveness in order to develop a research agenda on ephedra. FDA will give that committee an opportunity to comment on the notice, should the committee find it appropriate to do so. Health care practitioners are being urged to submit written comments to the FDA or report any known adverse events related to ephedra use to www.fda.gov/medwatch.
Sleeping Pattern Important in Reducing SIDS
I
nfants accustomed to sleeping on their backs who are then placed to
106
AWHONN Lifelines
sleep on their stomachs or sides are at an increased risk for SIDS—greater than the increased SIDS risk of infants always placed on their stomachs or sides, according to a newly released study. The study, conducted by Kaiser Permanente in Northern and Southern California and supported by the National Institute of Child Health and Human Development (NICHD) and the National Institute on Deafness and Other Communications Disorders, appears in American Journal of Epidemiology. The study also shows that infants sleeping on their sides are at an increased risk of SIDS. The researchers think that a large part of the risk may be due to the instability of the side sleeping position and the tendency for infants sleeping in this position to turn onto their stomachs. The study, which was conducted in 11 counties in Northern and Southern California, is the first to examine the relationship between infant sleeping position and SIDS in a racially diverse U.S. population. The incidence of SIDS has declined over 50 percent since 1992, when the American Academy of Pediatrics recommended that infants be placed on their backs to sleep. Before the current study, evidence of the link between stomach sleeping and SIDS risk was based largely on overseas studies, where populations and cultural practices are different from those in the U.S. The researchers also collected information about bedding materials, type of mattress, room- or bed-sharing, room temperature, exposure to passive smoking and infant sickness. The researchers found that infants last placed on their sides for sleep were twice more likely to die of SIDS than infants last placed on their backs. In addition, the risk of SIDS was significantly increased if infants turned from their sides to their stomachs during
sleep. While the reason isn’t clear, the researchers think that the instability of the side position makes it more likely for babies who are placed to sleep in this position to roll over onto their stomachs. A pattern also emerged when the researchers looked specifically at the position in which an infant was last placed to sleep, compared to their usual sleeping position. If an infant who was usually placed to sleep in the low-risk position—on the back—was then placed to sleep in a high-risk position (the stomach or side), his or her SIDS risk was seven to eight times greater than that of an infant who was always placed to sleep on his or her back. “The message here is ‘every night and nap time count,’” said study coauthor Dr. Marian Willinger of NICHD. “Parents and caregivers should place their babies on their backs every time they go to sleep. Consistency is the key.” One of the strengths of this study is that the researchers interviewed a racially—and culturally diverse group of mothers—White, African American, Hispanic, and Asian/Pacific Islander, although the small sample size limited the researchers’ ability to examine risk within each racial group. This study provides results from the first study of infant sleeping position in relation to SIDS risk to be collected entirely after the NICHD’s “Back to Sleep” campaign is launched to inform the public about the importance of sleep position in preventing SIDS.
Low-Dose Warfarin Prevents Clot Recurrence
A
study of long-term, low-dose warfarin to prevent the recurrence of the blood clotting disorders deep vein thrombosis (DVT) and pulmonary embolism (PE) resulted in such a high degree of benefit to the patients—without significant adverse
Volume 7
Issue 2
Sleeping Pattern Important in Reducing SIDS
I
nfants accustomed to sleeping on their backs who are then placed to
106
AWHONN Lifelines
sleep on their stomachs or sides are at an increased risk for SIDS—greater than the increased SIDS risk of infants always placed on their stomachs or sides, according to a newly released study. The study, conducted by Kaiser Permanente in Northern and Southern California and supported by the National Institute of Child Health and Human Development (NICHD) and the National Institute on Deafness and Other Communications Disorders, appears in American Journal of Epidemiology. The study also shows that infants sleeping on their sides are at an increased risk of SIDS. The researchers think that a large part of the risk may be due to the instability of the side sleeping position and the tendency for infants sleeping in this position to turn onto their stomachs. The study, which was conducted in 11 counties in Northern and Southern California, is the first to examine the relationship between infant sleeping position and SIDS in a racially diverse U.S. population. The incidence of SIDS has declined over 50 percent since 1992, when the American Academy of Pediatrics recommended that infants be placed on their backs to sleep. Before the current study, evidence of the link between stomach sleeping and SIDS risk was based largely on overseas studies, where populations and cultural practices are different from those in the U.S. The researchers also collected information about bedding materials, type of mattress, room- or bed-sharing, room temperature, exposure to passive smoking and infant sickness. The researchers found that infants last placed on their sides for sleep were twice more likely to die of SIDS than infants last placed on their backs. In addition, the risk of SIDS was significantly increased if infants turned from their sides to their stomachs during
sleep. While the reason isn’t clear, the researchers think that the instability of the side position makes it more likely for babies who are placed to sleep in this position to roll over onto their stomachs. A pattern also emerged when the researchers looked specifically at the position in which an infant was last placed to sleep, compared to their usual sleeping position. If an infant who was usually placed to sleep in the low-risk position—on the back—was then placed to sleep in a high-risk position (the stomach or side), his or her SIDS risk was seven to eight times greater than that of an infant who was always placed to sleep on his or her back. “The message here is ‘every night and nap time count,’” said study coauthor Dr. Marian Willinger of NICHD. “Parents and caregivers should place their babies on their backs every time they go to sleep. Consistency is the key.” One of the strengths of this study is that the researchers interviewed a racially—and culturally diverse group of mothers—White, African American, Hispanic, and Asian/Pacific Islander, although the small sample size limited the researchers’ ability to examine risk within each racial group. This study provides results from the first study of infant sleeping position in relation to SIDS risk to be collected entirely after the NICHD’s “Back to Sleep” campaign is launched to inform the public about the importance of sleep position in preventing SIDS.
Low-Dose Warfarin Prevents Clot Recurrence
A
study of long-term, low-dose warfarin to prevent the recurrence of the blood clotting disorders deep vein thrombosis (DVT) and pulmonary embolism (PE) resulted in such a high degree of benefit to the patients—without significant adverse
Volume 7
Issue 2