Another reason babies should sleep on their backs: better oxygenation
Last Updated: 2011-03-01 11:19:23 -0400 (Reuters Health)
By Will Boggs, MD
NEW YORK (Reuters Health) - In healthy term infants, cerebral oxygenation is lower when they sleep prone than when they sleep on their backs, according to research from Australia.
"Previously we have shown that blood pressure is lower and arousal responses depressed in this position," Dr. Rosemary S. C. Horne from Monash University, Clayton, Victoria, told Reuters Health by email.
"We hope that clinicians will use the scientific evidence of reduced arousal, lower blood pressure and cerebral oxygenation, and impaired cardiovascular control when infants sleep prone to promote the safe sleeping message to parents -- always sleep infants on their backs."
She and her colleagues studied 17 healthy term infants at ages 2 to 4 weeks, 2 to 3 months, and 5 to 6 months, using continuous blood pressure measurement in combination with near-infrared spectroscopy to measure the cerebral tissue oxygenation index.
Cerebral tissue oxygenation was lower when infants slept prone - as opposed to supine -- during active sleep and quiet sleep at all ages. The difference was significant for active and quiet sleep at ages 2 to 4 weeks and for quiet sleep at ages 2 to 3 months, the authors report in Pediatrics online February 28th.
The researchers also found that cerebral tissue oxygenation was significantly lower in active sleep than in quiet sleep at 2 to 4 weeks but significantly higher in active sleep than in quiet sleep at 5 to 6 months.
Heart rate and mean arterial pressure were usually higher in the prone position than in the supine position, but there was no significant relationship between tissue oxygenation index and mean arterial pressure.
"Clinicians and health professionals will be able to use this evidence to support promotion of sleeping infants in the supine position when explaining the risks of prone sleeping to parents," Dr. Horne said.
"This is important as babies often 'sleep better' on their tummies because they arouse less often, and a failure to arouse from sleep is probably the underlying mechanism for SIDS (sudden infant death syndrome)," she added.
"An important consideration is that impairment in cerebral oxygenation may be further exacerbated in infants at increased risk for SIDS, such as preterm infants and infants whose mothers smoked during pregnancy, both factors that may adversely affect the regulation of cerebral blood flow and oxygen delivery," Dr. Horne and her colleagues say in their paper.
SOURCE:http://bit.ly/guSw03
Pediatrics 2011.
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