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People not keeping to cot death advice

Sunday Star Times November 14, 2010

'People not keeping to cot death advice'

COT DEATH is killing too many babies when Simple safety messages could save them, a leading health researcher says. Auckland University's Dr Shirley Tonkin has spent 30 years researching cot death and is worried that despite a campaign in the 1990s to reduce sudden unexpected deaths in infants (SUDI), 60 to 80 babies still die in their sleep each year.

Although that is down from 250 deaths in the 1980s, it is still the main cause of preventable baby deaths in the first year. "It's dreadful, far too many," said Tonkin, who founded the New Zealand Cot Death Association.

On Friday the former cot death campaign Red Nose Day is being resurrected with a wider focus on children's illnesses, and Tonkin hopes it will lead to renewed focus on the baby-killer.

She is convinced the reason some babies die in their sleep is because the joint of the jaw and skull is not fully formed in young babies, so pressure on the chin pushes the jaw back, with the palate blocking the breathing passage.That is why putting babies in their own beds, on their backs with their faces clear, is important.

"A large proportion of deaths are babies in bed with someone else, so sharing is the one we want to stop," Tonkin said.

But work done by Change for our Children, the group the Ministry of Health contracts to educate the public about cot death, suggests fatality rates are not responding to information campaigns of the past.

Coroners report that although people know the key messages, being away from home, cold houses, poverty 01' an un set~ tied baby competed with safe sleep advice and babies died because of it.

An unsettled baby was placed on its front last year, despite contrary advice. It became •the baby's usual sleep position and it died overnight at 10 weeks.

Change for our Children director Stephanie Cowan said the risks related to how babies slept, not who their parents were. Cot death was a development issue and babies needed protection through the first months. Although behaviours known to reduce risks had become the norm for many parents, where they hadn't there was a disproportionate number of deaths. Some people still slept babies in unsafe positions on the side, front or propped up, despite evidence flat on the back was the only safe position. "Any other position compromises their lives," said Cowan.

"The explanation lies in the anatomy of a baby's airway and systems that support breathing. Lying on the back gives young babies the best chance to breathe easily.

LOWER YOUR BABY'S RISK - (Source New Zealand Cot Death Association)

• Sleep baby on its back
• Don't smoke in pregnancy or around baby
• Breastfeed baby
• Put baby to sleep in its own bed
• Keep baby's face clear of all bedding

It's essential in the first six months."

Cowan said informing people about the rationale behind the "face up + face clear + smoke free" message was key to reaching parents who had yet to trust safe-sleep advice. An online education programme had drawn 3000 people in its first year. "We're encouraging anyone who has a part to play in a baby's life to do the 15-minutc programme and understand how to protect a young baby's life."

Positive parenting advocate and Safe T Sleep managing director Miriam Rutherford has spent 25 years working to give babies the best start. She designed her own Sleepwrap to help protect her infant son after nursing a baby with severe head injuries suffered as a result of a fall from a cot.

She was determined her son would not suffer a similar fate and the Sleepwrap she designed worked so well friends urged her to market it, which she did after extensive product testing involving professionals from 15 fields within the medical arena, and working with more than 300 babies. That research was followed by "independent" hospital clinical testing conducted by a leading craniofacial plastic surgeon.

Rutherford did not design the Safe T Sleep Sleepwrap (pictured above) specifically to prevent sudden infant death but there have been no reported fatalities or injuries with the product since 1992, when it was released.

It has been used by hundreds of thousands of people since then, for use in the risk period for sudden death, and has been used when children are learning to stand and climb, and when parents are travelling, because it is highly portable.

She said the "excellent efforts of researchers and medical professionals had resulted in advice that back sleeping helps reduce risks", but parents frequently ask her how many babies sleeping on their back without any aids still died each year?

"We all genuinely want to help reduce the risks so parenting can be more enjoyable but unfortunately some risk reducing messages have changed so often that it seems to have created confusion and lack of trust.

"The advice most parents seem to appreciate is to listen to new knowledge and old knowledge from people you trust, then put it together with your own common sense and intuitive wisdom, but above all, to enjoy each other and your baby."


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