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October 25, 2015 www.guardian.co.tt Sunday Guardian
WOW MAGAZINE| 7
By Dr Makini McGuire
THIS QUOTE MIRRORS a com-
monly used statement that no par-
ent should have to bury their child.
Unfortunately, life isn't so kind; chil-
dren die. Children die daily at all
ages, from cancer, chest infections,
prematurity, violence, and some-
times from seemingly nothing at all.
Grief over the passing of a child is
insurmountable in any circum-
stance; however some parents cope
better if they understand the cir-
cumstances behind the child's
death. If the child was undergoing
treatment for a terminal illness, par-
ents have an opportunity to prepare
themselves as best they can. For
some, the worst punishment is not
ever receiving an explanation for
their child's death; this is the case in
Sudden Infant Death Syndrome
(SIDS). In these cases, babies die
suddenly and without explanation,
even after autopsy.
SIDS is difficult to define and is con-
stantly under review; however the
current accepted definition is the
sudden death of an infant younger
than 1 year that remains unex-
plained after a thorough case inves-
tigation, including performance of a
complete autopsy, examination of
the death scene, and a review of the
clinical history. These conditions are
important because child abuse is
very real, and there are cases that
at first seem like SIDS but are de-
termined to be suffocation, either
with intent or not, poisoning, or
death due to another medical condi-
tion. The common presentation of
an infant who has seemingly died
from SIDS is that the infant was fed
via breast or bottle and was put
down to sleep on his/her stomach.
Following this, nothing unusual was
found during random interval
checks, until the child is found dead.
Attempts of resuscitation are un-
successful. SIDS occurs in infants
less than 8 months of age, with
most deaths occurring at 2--4
months with approximately 70% of
the cases being male babies.
The question that remains largely
unanswered is why. SIDS continues
to be studied extensively but no
conclusive answer has been
reached. There are two risk factors,
though, that have been clearly and
unmistakably linked as significant
risk factors for SIDS. These are ma-
ternal smoking, and infants placed
on their stomach to sleep.
Smoking is a nasty habit that is
detrimental to the individual and
those in their environment in a mul-
titude of ways. The list of complica-
tions that smoking and
second-hand smoke causes are near
infinite. With regards to SIDS, ma-
ternal smoking during pregnancy
poses the highest risk. The inci-
dence of SIDS is 7 times higher
among infants whose mothers
smoked more than 1 pack of ciga-
rettes per day during pregnancy.
This in no way means that smoking
less than a pack decreases the risk.
Data indicate that if women re-
frained from smoking during preg-
nancy, as many as 30--46.7% of
SIDS deaths might be prevented.
The risk is less, but still significant in
infants exposed to second hand
smoke after birth by parents that
Infant sleeping position is a remark-
ably significant factor. There is a
high risk of SIDS in infants that are
placed on their front to sleep. Statis-
tics estimate that as many as 73%
of SIDS deaths could be avoided in
infants were placed on their back to
The latest recommendations (2005)
from the American Academy of Pe-
diatrics in the "Back to Sleep" cam-
paign offer some advice as to how
to prevent cases of SIDS. "Back to
Sleep" was originally started in 1994
and was a successful attempt to re-
duce the incidence of SIDS by en-
couraging the very significant factor
of sleeping position and raising
awareness that infants should be
placed on their back to sleep. Since
then, recommendations have been
improved and expanded by using re-
search data. Recommendations now
• Infants should be placed exclu-
sively on their back to sleep every
• Use firm mattresses with tight-fit-
ting sheets. Avoid pillows, com-
• Do not smoke during pregnancy.
Avoid exposing the infant to second
• Bed sharing is associated with a
higher risk of SIDS. Room sharing,
however, is helpful.
• After 1 month of age a pacifier can
be offered at sleep time.
• Avoid over-heating and over-
• Avoid commercial devices mar-
keted to reduce the risk for SIDS.
• Do not use home monitors as a
strategy to reduce SIDS.
• Alternate head positions when lay-
ing down to sleep and use tummy-
time once fully awake
• Keep soft objects and loose-bed-
ding out of the crib.
"In some aspects, losing a child is like a wall, but
instead of getting over it, you must carry the
wall with you, wherever you go, for as long as
you live. You can't go anywhere until you learn to
move the wall. Knowing that I must bring this
wall with me, I need to turn my wall into a raft."
A , A
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