INFANTS WHO ROLL OVER THAT ARE NOT ACCUSTOMED TO SLEEPING PRONE HAVE A 50% GREATER CHANCE OF SIDS/SUID

-- The AAP Recommends Parents to Stand Vigil All Night to Flip Rolling Babies Back To their Backs to Avoid SIDS – A Detroit Company has a Better Idea --

 

Detroit, Mich. – December 5, 2014 -  Studies show that unaccustomed prone sleepers, including infants who are placed supine and roll prone have an increased risk of SIDS (O’Hoir 1998 and Mitchell EA 1999).  These studies and others have shown that nearly half of SIDS victims’ unaccustomed to prone sleep, were discovered in the face-straight-down position. 

 

According to a recent study published in the Journal of Pediatrics authored by Dr. R. Moon (the Academy of Pediatrics lead author on the 2011 safe sleep policy), swaddled infants who roll have an even higher risk of SIDS/SUID.  Moon’s retrospective analysis of 13 infant deaths reported to the Consumer Product Safety Commission (CPSC) reveals two of the infant were placed prone and the other 11 (87%) had rolled prone. The medium age of the infants who were swaddled and rolled was four months with the youngest being five weeks. The cause of death was asphyxia (McDonnell – Moon 2014). 

 

Moon states in her book 14 Ways to Keep Your Baby Safe from SIDS, most babies begin to roll when they are between four and six months old.  If your baby can roll from stomach to back and back to stomach very easily, you can leave her as is.  If she rolls on to her stomach and you’re not sure if she can roll back, then it’s best to flip her onto her back (Moon –Hauk 2011). 

 

BUT WHAT DOES A PARENT DO IF THEIR BABY ROLLS IN THE MIDDLE OF THE NIGHT AND IS UNATTENDED?   Secure Beginnings, a Detroit based manufacturer, has the answer.  They have revolutionized safe sleep for infants by designing a line of crib mattresses that allow a baby who is lying face down to breathe normally right through her mattress.  Their crib mattresses replace the fiber fill with circulating air.  The Secure Beginnings’ mattress consists of a crib-mattress sized box with 4 wooden sides, a plastic bottom and a top surface made of breathable spacer fabric (same as that used in some tennis shoes) that is stretched taught over the top of the wooden sides.  The infant lies on the breathable surface and no sheet or mattress pad is used.  The wooden sides have decorative cut-outs which allows the center of the sleep surface to be filled with nothing but air that has passive movement.  The unit fits in the crib like any crib mattress.  The entire sleep surface is easily to remove and is machine washable.  So in a sense it is like the baby is sleeping on a tight fitting hammock with nothing but air under them—no plastic surface of mattress, no sheet, no mattress pad, no fiber filling.

 

The intent of the design is to reduce suffocation and asphyxia (rebreathing of carbon dioxide) deaths.  According to Julie Andreae, one of the mattresses’ creators, “We support the Back-to-Sleep campaign as a successful initiative in reducing the incidence of SIDS/SUID.  However, death of infants placed supine and found face down on a firm crib mattress continue to occur because we have no way to prevent these infants from rolling.”

 

I think most agree that a mattress of this type will prevent a lot of suffocation and asphyxiation deaths should a baby roll prone since the infant’s nose and mouth are not obstructed from air exchange and carbon dioxide is not trapped.  Peer reviewed published data and testing also support an air permeable crib mattress as a safer option than the firm fiber-filled crib mattress.

 

Dr James Kemp and colleagues were some of the first to study the potential for various sleep surfaces to prevent infant rebreathing and suffocation. They found that the firm mattress and four of the five surfaces designed to prevent rebreathing consistently allowed lethal rebreathing of CO2.  Only one product—an air permeable crib mattress—was able to maintain CO2 levels below this threshold.  The authors go on to say that “even firm mattresses could pose a rebreathing threat when vulnerable infants sleep prone.”  Dr Kemp’s data supports that if vulnerable infants were placed on an air permeable surface, they would experience less risk of rebreathing and suffocation should they inadvertently roll prone.

 

In 2011, Dr Ephraim Bar-Yishay and colleagues provided the second study on CO2 accumulation and rebreathing on six infant sleep surfaces—an air permeable mattress, two conventional firm crib mattresses and three mattresses with an additional layer or topper designed to improve air flow (Bar-Yishay 2011).  The air permeable mattress had a significantly faster rate of CO2 elimination and only the air permeable mattress was able to prevent CO2 accumulation with maximal CO2 levels significantly lower than that of the other mattresses. They concluded that the air permeable mattress exhibited significantly better aeration properties compared to the other five mattresses including the firm mattresses with tight sheet currently recommended by the AAP.

 

A representative of Secure Beginnings contacted the CPSC for recommendations on an accredited independent lab to conduct similar tests on aeration properties on their air permeable/breathable crib mattress.  Intertek was recommended because they use a similar mechanical model and methods as designed by Dr. Kemp.  The lab compared CO2 elimination on four different surfaces—the air permeable crib mattress, a firm crib mattress with tight fitting sheet, sheepskin, and a bean bag chair.   The latter two are known high risk hazards for rebreathing (Kemp 1991, Kemp 1993) and have been implicated in a significant number of SIDS fatalities.  Just as in the studies by Kemp and Bar-Yishay, the air permeable mattress showed significantly less CO2 retention than the firm mattress and the high hazard comparators.   Intertek concluded that the air permeable mattress represents a significantly lower risk hazard for asphyxia and suffocation than the firm mattress. 

 

The Company recently had their product tested for “firmness.”  Firmness testing was designed by Ron Somers, PhD Director of Epidemiology for the South Australian Department of Health.  According to Somers, “I can confirm that the Secure Beginnings Crib Mattress passes the test specified in AS/NZS 8811.1:2013(Methods of testing infant products, Method 1: Sleep surfaces---Test for firmness).”  Australia will be the first Country to mandate compliance for crib mattress firmness.  This proposed new regulation is still being considered by Australia’s federal government.  According to Andreae, “Parents are confused when it comes to mattress firmness.  Most believe the AAP recommends a firm surface because it is better for a baby developmentally.  This is not the case.  A firm surface is recommended because a firm surface makes it less likely to accumulate carbon dioxide.  The problem is, there are no measures or standards in the US for “firmness.”  Also, parents are using mattress pads and even sheets that can trap carbon dioxide.  Deaths are also occurring where a baby has their arm or hand up around their face on a firm flat surface that causes carbon dioxide to trap.  It just makes a lot more sense to make crib mattresses air permeable, that do not harmful carbon dioxide and increase air circulation.”

 

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            For more information, contact Julie Andreae,

            executive vice president of Secure Beginnings LLC

            at This email address is being protected from spambots. You need JavaScript enabled to view it. ,

            or by phone at (586) 219-7112.

            Or visit us at www.securebeginnings.com.

 
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