August E-zine
The Georgia SIDS
Project E-Zine is an on-line educational update offered monthly by the Georgia
Sudden Infant Death Information, Referral and Support Project, an affiliate of
First Candle/SIDS Alliance. To comment on this issue, request additional
information, refer families in need of support, make a donation or be added or
removed from the list please contact us at
This
publication is made available through the generous donation of friends and
supporters of our program.
Through
the State Charitable Campaign Program state employees can select and donate to
the Georgia SIDS Project. Help us support bereaved families, increase risk
reduction education, make safe cribs available to low-income high-risk infants
through your donations. Select Georgia SIDS Project - # 160000
Volume 2 - Issue Number 8, August 2006
1.
Georgia SIDS Project funding for risk
reduction services no longer underwritten by Georgia DHR- Division of Public
Health
2.
Abstracts from June 2006 International Stillbirth Conference Available
3.
Estimates of the cost and length of stay
changes that can be attributed to one week increases in gestational age for
premature infants
4.
Review of literature: Smoking in
relationship to SIDS deaths
5.
Female resistance to hypoxia: does
it explain the sex difference in mortality rates – new area of research?
6.
New research looks at understanding more
about complicated grief and how it differs diagnostically from the normal grief
process
7.
Legislation looks at initiatives to
prevent premature births
8.
New compendium includes links to electronic versions of publications such
as fact sheets, brochures, booklets, posters, order forms, and electronic
materials in CD/DVD/video format (including foreign-language materials).
9.
New
web-site wins national award for curriculums and educational materials to
prevent teen pregnancy and STDs
10.
New
Self-Assessment Checklist for Personnel Providing Behavioral Health Services
and Supports to Children, Youth and Their Families from
11.
New document outlines Promoting Child Development from
Birth in State Early Care and Education Initiatives in the
12.
Article
reviews Environmental "Riskscape" and
Social Inequality with Implications for Explaining Maternal and Child Health
Disparities
13.
Barriers
to following the supine sleep recommendation among mothers at four centers for
the WIC Program
14.
Stillbirth
and bereavement: Guidelines for Stillbirth Investigation.
15.
Perinatal Loss: A Family
Perspective
1.
The Georgia SIDS Project
will no longer be receiving state funding to support our risk reduction
training services for professionals from Georgia Division of Public Health for fiscal
year 2007 (beginning 7/1/06). These services will continue, but organizations
will be charged a fee for training or fees will need to be underwritten by
private donations or other sources. Last year, as part of our contract Georgia
SIDS was able to contact and provide training for 76 professional groups
reaching 3115 individuals. We hope to continue our training for professionals
in the most cost effective manner available. To learn more about our training
in SIDS risk reduction and bereavement support, for information on available
DECAL CEU training and nursing contact hours see our website or contact us
directly. Also if you are a state employee, please consider supporting our
continued efforts by selecting the Georgia SIDS Project as part of your
charitable campaign donation. Donations
to support this work are more important than ever… We appreciate any support
you may be able to offer.
2.
There are approximately 4.5 million stillbirth deaths worldwide each
year and, until recently, there has been no nternational
forum for research, data collection and/or prevention strategies dedicated to
solving these tragic infant deaths. While there have been advances in
health care and improved health outcomes in many areas, the rates of stillbirth
have not decreased and, in fact, in some regions the rates may be increasing. The 2006
International Stillbirth Conference was successfully held in collaboration with
The 9th SIDS International Conference on
June 1-4 in
3. Estimates
of the cost and length of stay changes that can be attributed to one week
increases in gestational age for premature infants by CS Phibbs and SK Schmitt, Early
Human Dev 2006 Feb. cphibbs@stanford.edu
The goal of this study was to estimate the potential
savings, both in terms of costs and lengths of stay, of one-week increases in
gestational age for premature infants. The purpose is to provide
population-based data that can be used to assess the potential savings of
interventions that delay premature delivery. Cohort data for all births in
4. Smoking and the sudden infant death syndrome. Mitchell EA, Milerad
J. Rev Environ Health. 2006 Apr-Jun; The aims of this review are (a) to
critically examine the epidemiologic evidence for a possible association
between smoking and the sudden infant death syndrome (SIDS), (b) to review the
pathology and postulated physiological mechanism(s) by which smoking might be
causally related to SIDS, and (c) to provide recommendations for SIDS
prevention in relation to tobacco smoking. Over 60 studies have examined the
relation between maternal smoking during pregnancy and risk of SIDS. With
regard to prone-sleep-position intervention programs, the pooled relative risk
associated with maternal smoking was RR = 2.86 (95% CI = 2.77, 2.95) before and
RR = 3.93 (95% CI = 3.78, 4.08) after. Epidemiologically, to distinguish the
effect of active maternal smoking during pregnancy from involuntary tobacco
smoking by the infants of smoking mothers is difficult. Clear evidence for
environmental tobacco smoke exposure can be obtained by examining the risk of
SIDS from paternal smoking when the mother is a non-smoker. Seven such studies
have been carried out. The pooled unadjusted RR was 1.49 (95% CI = 1.25, 1.77).
Consideration of the pathological and physiological effects of tobacco suggests
that the predominant effect from maternal smoking comes from the in utero exposure of the fetus to tobacco smoke. Assuming a causal association between
smoking and SIDS, about one-third of SIDS deaths might have been prevented if
all fetuses had not been exposed to maternal smoking in utero.
5.
Female resistance to hypoxia: does it explain the sex difference in
mortality rates? J Womens Health. 2006 Jul-Aug; Mage DT,
Donner M. There is currently no accepted
explanation in the medical literature for the lower female total mortality rate
in infancy, childhood and adulthood. We review the pediatric mortality data
provided by CDC and the World Health Organization (WHO) and show that for
causes of respiratory infant death that are apparently independent of gender
(e.g., suffocation from inhalation of food or other object), there is a
consistently one-third lower rate of mortality in the female than in the male.
This one-third lower mortality for causes of death with a respiratory terminal
event is hypothesized to be due to an X-linked dominant allele that occurs with
frequency 1/3. It appears as if a second X chromosome provides the one-third
extra probability of protection afforded for an XX female compared with an XY
male. It is suggested that the allele's function is unmasked during transient
periods of cerebral anoxia, requiring a mechanism for anaerobic oxidation to prevent
the death of respiratory control neurons in the brain stem. Examples of the
female one-third extra chance of resistance to hypoxia are given for causes of
death in infancy, such as infant respiratory distress syndrome (IRDS) and
sudden infant death syndrome (SIDS), and for causes of suffocation in childhood
and asphyxiation in adulthood. DNA testing of the X chromosome of probands from causes of respiratory death, such as SIDS and
IRDS, where there is a one-third lower female than male death rate, is a future
direction that can verify the existence of the proposed allele. For full-text: http://www.liebertonline.com/doi/abs/10.1089/jwh.2006.15.786
6. The August issue of Clinical
Psychology: Science and Practice includes presentation
of a model of complicated grief, in the hope of facilitating
research on the subject. Dr. Paul A. Boelen, a
psychologist and psychotherapist from
7.
Last week the
8.
The
National SIDS/Infant Death Resource Center (NSIDRC) is announcing the launch of
the Electronic Resource Compendium
on the NSIDRC Web site. Visit www.sidscenter.org
<http://www.sidscenter.org/> and click on
'Topics A-Z.' The Resource Compendium consists of a searchable database of
information collected from national, state, and local SIDS/Infant Death
programs, as well as perinatal, stillbirth, maternal and child health, and
bereavement organizations. The compendium includes links to electronic versions
of publications such as fact sheets, brochures, booklets, posters, order forms,
and electronic materials in CD/DVD/video format (including foreign-language
materials). If your organization would like to participate in this project,
please go to www.sidscenter.org/biblio
<http://www.sidscenter.org/biblio/> to send links to
electronic copies of publications for consideration.
9.
A
sexual education and information web site developed by the Society Of Ob-Gyns of Canada has been
recognized as one of top five projects in the world. The wed site www.sexualityandu.ca/ was honored by the World
Summit Awards presented as a part of the United Nations Summit on the
Information Society. The new web site was launched in 2001 in response to high
rates of unplanned pregnancy and increased number of STDs in
10.
NEW!
From the
11.
Starting
Off Right: Promoting Child Development
from Birth in State Early Care and Education Initiatives describes a menu
of strategies some states are using to improve early care and education for
infants and toddlers, and supports to their families. In the period from birth
to age 3, early experiences shape the architecture of the brain-including
cognitive, linguistic, social, and emotional capacities-at a phenomenal rate. Early
care and education is a key strategy states can use to promote positive
development for very young children, including those in low-income families.
And since a growing proportion of very young children spend extensive time in
the care of someone other than a parent, state policies to promote the quality
and continuity of those settings and relationships should be part of a strategy
to assure children are ready for school. Despite compelling evidence of the
importance of child development from birth, a clear state early care and
education policy agenda that addresses infants and toddlers is still emerging.
This paper provides illustrative state examples of specific policies to promote
child development birth to 3, as well as ideas for state funding and governance
structures that provide attention and resources for all children birth to age
5. To read this document, go to http://www.clasp.org/publications/startingoffright.htm
12.
The Environmental "Riskscape" and Social Inequality: Implications for
Explaining Maternal and Child Health Disparities by Frosh & Shenassa.
Environmental Health Perspectives
Aug. 2006 The editors report that research indicates that the double jeopardy
of exposure to environmental hazards combined with place-based stressors is
associated with maternal and child health (MCH) disparities. They present
evidence that individual-level and place-based psychosocial stressors may
compromise host resistance such that environmental pollutants would have
adverse health effects at relatively lower doses, thus partially explaining MCH
disparities, particularly poor birth outcomes. The editors propose a conceptual
framework for holistic approaches to future MCH research that elucidates the
interplay of psychosocial stressors and environmental hazards in order to
better explain drivers of MCH disparities. Given the complexity of the link between
environmental factors and MCH disparities, the editors strongly suggest that a
holistic approach to future MCH research that seeks to untangle the double
jeopardy of chronic stressors and environmental hazard exposures could help
elucidate how the interplay of these factors shapes persistent racial and
economic disparities in MCH. View article at http://www.ehponline.org/members/2006/8930/8930.html
13. Barriers to following the supine sleep recommendation among mothers at
four centers for the Women, Infants, and Children Program. Colson ER, et al Pediatrics.
2006 Aug; The risk for sudden infant death syndrome in
black infants is twice that of white infants, and their parents are less likely
to place them in the supine position for sleep. We previously identified
barriers for parents to follow recommendations for sleep position. Our
objective with this study was to quantify these barriers, particularly among
low-income, primarily black mothers. We conducted face-to-face interviews with
671 mothers, 64% of whom were black, who attended WIC Program Centers in
Boston, Dallas, LA, , and New Haven. They looked at factors associated with
choice of sleeping position "ever" (meaning usually, sometimes,
or last night) put infant in the prone (tummy) position for sleep and
"usually" put infant in the supine (back) position to sleep. Results:
59% of mothers reported back, 25% side, 15% tummy, and 1% other as the usual
position. 34% reported that they ever placed infants in the tummy position.
Seventy-two percent said that a nurse, 53% a doctor, and 38% a female friend or
relative provided source of advice. Only 42% reported that a nurse, 36% a
doctor, and 15% a female friend or relative recommended the back position for
sleep. When a female friend or relative recommended the prone position, mothers
were more likely ever to place their infants in the prone position and less
likely usually to choose supine compared with those who received no advice from
friends or relatives. When a doctor or a nurse recommended a non-supine
position, the mothers were less likely to choose supine compared with those who
received no advice from a doctor or a nurse. Mothers who trusted the opinion of
a doctor or a nurse about infant sleeping position were more likely to place
their infants in the back position. Half of the mothers believed that infants
were more likely to choke when supine, and they were less likely to place their
infants supine. Mothers who believed that infants are more comfortable in the
prone position (36%) were more likely to place their infants prone. 29%
believed that having their infants sleep with an adult helps prevent SIDS and
only 43% believed that SIDS is related to sleeping position. Conclusions: Researchers
identified specific barriers to placing infants in the supine position for
sleep (lack of or wrong advice, lack of trust in providers, knowledge and
concerns about safety and comfort) in low-income, primarily black mothers that
should be considered when designing interventions to get more infants onto
their back for sleep.
14. Stillbirth and bereavement: Guidelines for Stillbirth Investigation. J Obstet Gynaecol
Can. 2006 Jun; Leduc L,
et al. Objectives: To provide an investigation protocol to help health care
providers determine the cause of a fetal death. Consideration has been given to
protocols for the investigation of fetal death that are currently available in
15. Perinatal Loss: A Family
Perspective. J Perinat Neonatal Nurs. 2006
July/September; Callister LC. Perinatal
loss is a profound experience for childbearing families. Examples of perinatal
loss include miscarriage, ectopic pregnancy, stillbirth, neonatal death, and
other losses. Perinatal loss engenders a unique kind of mourning since the
child is so much a part of the parental identity. Societal expectations for
mourning associated with perinatal loss are noticeably absent. Gender
differences in response to such loss, as well as sibling and grandparent grief
have been identified in the literature. Descriptive studies provide information
on cultural responses to perinatal loss. Nursing interventions have been
refined over the past two decades as research studies have been performed, in
order to more fully promote health and healing in the face of perinatal loss.
These include helping to create meaning through the sharing of the story of
parental loss, the facilitation of sociocultural rituals associated with loss,
the provision of tangible mementos, sensitive presence, and the validation of
the loss. Outcome evaluations of such interventions are recommended.
www.sidsga.org
678-342-3360 or Powerline 1-800-822-2539 FAX 770-451-2466
-mail: gasids@mindspring.com