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Prone Sleeping and SIDS
Circumstances Leading to a Change to Prone Sleeping in sudden Infant Death Syndrome Victims. Cote A, Gerez T, Brouillette RT et al. Pediatrics 2000; 106:1476.
Of the 157 SIDS cases that occurred in Quebec between 1991 and 1997, 139 were found in the prone position, although only 93 usually slept prone. Of the 64 non-prone sleepers, 34 had been changed to prone by the parents or another caretaker, and 18 had apparently been turned prone for the first time. In 56% of cases changed from a non-prone to prone sleeping position, a caretaker other than the parents had precipitated the change.
Comment. The association between SIDS and prone positioning keeps getting stronger. Since SIDS is much more common in premature babies, we should be sure that the parents of our premies are all instructed in the importance of placing their babies on their back to sleep. After their pulmonary insufficiency has resolved, growing premies should be positioned supine in the NICU, and they should be required to demonstrate that they tolerate supine positioning (without increased apnea or desaturations) prior to discharge home. For further discussion of supine positioning in growing premies, see the article by Keene et al in J Perinatol 2000: 1:17-20 (reviewed in Vol 1, Issue 3 of this publication).
Andrew B. Kairalla MD