Maternal and Child Health Library

MCH Alert: Focus on Infant Mortality is developed by the Maternal and Child Health Library in collaboration with the National Sudden and Unexpected Infant/Child and Pregnancy Loss Resource Center at Georgetown University. This and past issues are available online at http://www.mchlibrary.info/alert/archives.html and http://www.sidscenter.org/alert/archives.html.

March 27, 2009

Special Notice: Sudden Unexpected Infant Death: National Developments, Initiatives, Studies, and Opportunities (a Maternal and Child Health Bureau-sponsored Webcast) will be held on Monday, March 30, 2009, from 2:00 p.m. to 3:30 p.m., ET. Registration is open to the maternal and child health community. More information is available at http://www.mchcom.com/liveWebcastDetail.asp?leid=381. Video and audio archives will be available shortly after the event at http://webcast.hrsa.gov/Postevents/recentEvents.asp.

1. RESOURCE CENTER UPDATES PARENT BROCHURE ON INFANT SLEEP

Helping Baby "Back to Sleep" encourages parents to place infants (under age 1) on their backs for sleep and explains why back sleeping helps lower an infant's risk for sudden infant death syndrome. The new brochure, produced by the National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource Center at Georgetown University updates the 2007 version developed by Circle Solutions. Contents include tips for parents on helping infants fall asleep, what to do when they roll over during sleep, and how to return them to sleep if they awaken during the night. Other tips include how to create a safe sleep environment and the importance of "tummy time" when infants are awake during the day. Contact information for the resource center and partner organizations is provided. The brochure is available at
http://www.sidscenter.org/documents/SIDRC/BackToSleep.pdf.

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• Study 1 before and after siblings had an average of 2.0 FAS criteria, whereas study 2 before and after siblings had an average of 1.2 FAS criteria.
• Compared with control siblings, the 39 study 1 before and after siblings had more facial features characteristic of FAS (23.1 percent and 16.7 percent, respectively), growth delay (38.5 percent and 10.0 percent), CNS impairment (48.7 percent and 33.3 percent), maternal alcohol history (82.1 percent and 76.7 percent), and prenatal alcohol exposure (45 percent and 40.9 percent) and were diagnosed more often with FAS by physicians (25 percent and 13.6 percent).
• Compared with control siblings, study 1 before and after siblings had significantly lower mean birthweight, length, and head circumference, as well as postnatal growth delay in height, weight, and head circumference. Study 1 after siblings had significantly lower mean gestational age at birth than controls and study 2 after siblings. Study 1 after siblings had significantly lower birthweight, smaller birth head circumference, and smaller postnatal head circumference than study 2 after siblings.
• Dysmorphic facial features were reported more often for both the study 1 before and after siblings, compared with controls.
• Compared with controls, before siblings had numerous CNS impairments, including behavior problems, developmental delays, speech and language delays, microcephaly, seizures, and ptosis.

• Oral health professionals should recognize the impact of sleep impairment and the need for diagnostic testing to confirm suspicions when evaluating a child's breathing management.
• Oral health professionals should collaborate with a physician who is a sleep specialist and with the child's primary physician when evaluating and treating children with DS and OSA.