Reports of injury risks and reasons for choice of sleep environments for infants and toddlers

OBJECTIVE: Compare mothers\u27 reports of injuries for infants and toddlers sleeping with crib-bumpers/mesh-liners/no-barriers and reasons for these sleep environment choices. METHODS: A cross-sectional survey of mothers subscribing to a parenting magazine and using crib bumpers (n = 224), mesh liners (n = 262), and no barriers (n = 842). Analyses of four possible injuries (face-covered, climb-out/fall, slat-entrapment, hit-head) including multivariate logistic regression adjusted for missing data/demographics and Chi squared analyses of reasons for mothers\u27 choices. RESULTS: Maternal reports of finding infants/toddlers with face covered had 3.5 times higher adjusted odds (aOR) for crib bumper versus mesh liner use. Breathing difficulties and wedgings were reported for infants/toddlers using crib bumpers but not mesh liners. Climb-outs/falls showed no significant difference in aORs for crib bumpers versus no-barriers and mesh liners versus no barriers. Reports of slat-entrapment were less likely for mothers using crib bumpers and mesh liners than using no barrier (aOR = .28 and .32). Reports of hit-heads were less likely for crib bumpers vs no barrier (aOR = .38) with no significant difference between mesh liners versus no barrier use. Mothers using crib bumpers and mesh liners felt their choice prevented slat-entrapment (89%, 91%); 93.5% of crib bumper users felt their choice prevented hit-heads. Significantly more mesh liner than crib bumper users chose them because There is no suffocation risk (64.1% vs. 40.6%), while 83.6% of no-barrier users chose them because I was concerned about suffocation risk. CONCLUSIONS FOR PRACTICE: Mothers appeared to be more concerned about preventing minor risks than suffocation. Understanding reasons for mothers\u27 use of barriers/no-barriers is important in tailoring counseling for mothers with infants/toddlers

Pulmonary arteriolar muscle thickening in sudden infant death syndrome

Pulmonary arteriolar thickening in sudden infant death syndrome has been repeatedly reported but this finding has been challenged. We report a case of a previously healthy 23-day-old infant girl who was witnessed by her parents to die suddenly and unexpectedly. During a routine bottle-feeding, she suddenly began to cry loudly and her face became deep-red and then pale. She became limp and began to gasp. Resuscitation efforts were to no avail. The post-mortem examination, including toxicological studies, screening for inborn errors of metabolism and genetic studies for prolonged Qt syndrome, failed to reveal the cause of death. A more focused study of the lungs showed extensive pulmonary arteriolar thickening. The events in the sudden death of this infant are remarkably similar to deaths in infants with various disorders associated with pulmonary arteriolar thickening. We suggest that this vascular abnormality and associated pulmonary hypertension played a critical role in this infant’s death