How can we reduce the risk of cot death?

• 1. How can we reduce the risk of cot death?

2.

• Registered charity since 1971

• Fund research

• Support families

• Improve investigations

• Disseminate information

3. Definition of Cot Death

• Cot death is the sudden and unexpected death of a baby for no obvious reasons.The post-mortem examination may explain some deaths.

• Those that remain unexplained after post-mortem examination may be registered as sudden infant death syndrome (SIDS), sudden infant death, sudden unexpected death in infancy, unascertained or cot death.

4. Rate of Sudden Infant Deaths per 1,000 live births:1989-2007England & Wales, birth to 12 months 5. Childhood mortality in 2007The majority of deaths are in infancy Source: Office of National Statistics.Figures are provisional . 6. Incidence of SIDS by age at death 7. Rate by age of mother, 2007(source ONS) 8. Research

• FSID has funded around 10m of research since 1971

• Pathology, infection, respiration, infant care, genetics, temperature control, immunology, allergy, maternal depression, epidemiology

• Neurology (US)

9. Some current FSID research

• To consider theory that anaphylactic shock(allergy) explains some cases of SIDS, Dr A Walls, Southampton

• Why do Asian families have fewer cot deaths, Dr E Moya, Bradford

• Does exposure to air pollution increase the risk, Professor J Jaakkola, Birmingham

• Looking at genetic variants in SIDS babies to seeif Long QT Syndrome is involved, Dr R Coombs, Sheffield

• Study of bedsharing, room sharing and separate sleeping, Prof P Fleming, Bristol

10. More current FSID research

• Role of infection in SIDS (staph aureus), Dr C Blackwell, Australia

• Role of infection in SIDS (e coli) Dr P Goldwater, Australia

• Whole genome association study in SIDS and control babies, Dr T Bajanowski, Germany

• Is MRI an alternative to autopsy, Dr S Thayyil, Institute of Child Health

• Effect on heart and breathing of babies sitting in a car seat, Dr R Arya, Swindon

11. Newest FSID funded project

• Are babies born to women who suffer high levels of stress in pregnancy more vulnerable to cot death?

• Theory: this would be because the babys own stress levels would be affected

• Sue Conroy, Institute of Psychiatry, London

• Pilot

12. Epidemiological research

• Has yielded valuable information on reducing the risk of cot death

• Looks at 100s of babies who have lived and who have died, carefully matched, and examines what factors - especially aspects of infant care - differ between the two groups

• Forms the basis of FSIDs evidence-based advice on safe infant care

13. 14.

• Place your baby on the back to sleep in a cot in a room with you

• Do not smoke in pregnancy or let anyone smoke in the same room as your baby

• Do not share a bed with your baby if you have been drinking alcohol, if you take drugs or if you are a smoker

• Never sleep with your baby on a sofa or armchair

• Do not let your baby get too hot keep your babys head uncovered place you baby in the feet to foot position

15. Back to Sleep and Feet to Foot 16. Further information inside the leaflet

• Do not share a bed with your baby if the baby was premature or was of low birth weight or if you feel very tired

• The safest place for your baby to sleep is in a cot in a room with you for the first six months

• More detail on how to avoid overheating the baby, eg use blankets not duvet, keep cot away from heaters, out of direct sunlight

• Breastfeed your baby

• It is possible that using a dummy at the start of any sleep period reduces the risk of cot death

17. The safest place for your baby to sleep is in a cot in a room with you

• It is widely accepted that sleeping with a baby in the parental bed is dangerous if either parent is a smoker.

• But at least 6 research studies have found a small but statistically significant increase in riskeven if the parents are non-smokers

• No study has found that sleeping in the same bed with your baby reduces the risk

18. SIDS and bed sharing withnon-smokers Mitchell EA et al (1992)J Paediatr Child Health 28 (Suppl1): S3-S8;RuysJH et al (2007) Acta Paediatr 10:1339-403; Vennemann M et al (2009) Pediatrics 123:1162-70; Tappin D et al (2005)J Pediatr 147 : 32-37;McGarvey C et al (2006)Arch Dis Child 91 : 318-323; Carpenter RG et al (2004)Lancet 363 : 185-191 New Zealand Netherlands Germy Scotld Ireland Europe Cases 393 138 333 146 276 745 Controls 1,592 1628 998 276 831 2,411 OR 2.4 (sig) 9.1 at 4 weeks (sig) 19.86