Cot death warning
Bupa investigative news - 4 November 2003
written by Rachel Newcombe, reporter for Bupa's Health Information Team
Each week in the UK, seven babies die as a result of cot death. Despite much research and better understanding of the condition, it's still the leading cause of death in babies over one month old, accounting for more deaths than meningitis, leukaemia, cancer, household and traffic accidents combined. One of the factors known to be linked to an increased risk is overheating in babies, yet a recent survey found a worrying lack of knowledge about baby heat issues.
KEY POINTS
Cot death is the leading cause of death in babies over one month old. But it is rare, affecting only one baby in 1,500 in the first year of life.
Although the exact cause is still unknown, one of the factors is thought to be overheating.
The Foundation for the Study of Infant Deaths (FSID) surveyed parents and discovered that many are unaware of the correct room temperature for where their baby sleeps.
FSID say that the correct room temperature for sleeping babies is 16 to 20°C.
56 per cent of parents didn't know the correct room temperature and only 32 per cent were using a room thermometer.
FSID are keen to promote the precautions parents can take to reduce the risk of cot death. Keeping a thermometer in the room is just one way that may help.
Other ways to reduce cot death risk include: putting your baby to sleep on his back, putting your baby's feet to the foot of the bed, keeping your baby's head uncovered when sleeping, avoiding sharing a bed with your baby and seeking medical advice promptly if you think your baby could be ill.
What were the headlines?
The results of the survey were featured in range of UK newspapers and websites, gaining headlines such as "Overheating puts babies at risk", "Hot bedrooms increase cot death risk", "Parents 'ignorant of best temperature for baby'", "Too hot bedrooms put babies at risk of cot death", "Hot rooms 'heighten risk of cot death'", "Heat can kill kids", "The danger of baby being too hot in bed" and "Cot death heat risk".
What is the bigger picture?
A survey of 187 parents with babies aged 0 - 1 year old was commissioned by the Foundation for the Study of Infant Deaths (FSID) with support from baby food manufacturer Cow and Gate, in September 2003.
The survey covered temperature issues - a key factor in cot death - and parents were asked questions such as whether they knew what the correct room temperature should be for their baby, whether they had a room thermometer and if they were able to correctly judge the temperature in their own homes.
They discovered that over half of the parents surveyed (56 per cent) didn't know the correct temperature at which to keep the room where their baby sleeps. One in five parents thought the room should be kept hotter than the recommended temperature band of 16 to 20°C, something that could potentially put their babies at risk of overheating.
When it came to estimating the heat in their own home, only 22 per cent of parents were able to correctly guess within two degrees Celsius and four out of ten people mistakenly thought their home was cooler than it actually was. Most worryingly, with heat being such a crucial factor, only 32 per cent of parents had a room thermometer in their baby's room.
Commenting on the findings, Joyce Epstein, director of FSID, said, "The clocks have gone back and winter is setting in - it's a time to wrap up warm outdoors, but not indoors. Babies who get too hot are at an increased risk of cot death. Our message to parents is: look at and touch your baby to see if they are too warm, and keep an eye on the room temperature. Getting a simple room thermometer will help you create a safer sleep environment for your baby."
"The risk of cot death is a worry to parents of young babies, but thankfully it is quite rare affecting only one in 1500 babies in the first year of life.
"Why cot death affects some babies but not others is unknown, and in most cases no cause is found and it is not due to anything the parents have or have not done.
"There are several things parents can do to reduce the risk including not letting their baby get too hot when they are sleeping. Parents can keep a check on the room temperature where a baby sleeps by using a room thermometer and FSID recommend that the temperature should be 16-20°C.
"Protecting babies from overheating is just as important as protecting them from getting cold."
Dr. Annabel Bentley,
assistant medical director,
Bupa Group
What does this mean?
Alice Hamilton-Bowman, from Cow and Gate, said, "Now that winter's on the way we want to make sure parents know that protecting baby from too much heat is every bit as important as protecting them from the cold."
A spokesperson for the Department of Health welcomed the continuing promotion of the cot death message and the need to prevent babies from becoming too hot.
The Department of Health, Social Services and Public Safety in Northern Ireland has recently launched a similar campaign to encourage people to be aware of cot death and heat issues. Dr. Henrietta Campbell, chief medical officer, said, "Cot death is one of the most tragic events any family can suffer."
She added, "We have seen a welcome decrease in such deaths since the early 1990s, but there continues to be about 10 deaths each year in Northern Ireland, and I believe there's a need to reinforce the advice on how to reduce the risks of such tragedies."
What does this mean to me?
Although no single cause of cot death has yet been identified, overheating is one of a number of factors likely to be involved.
According to FSID, "To avoid overheating, babies need to lose excess heat, and up to 85 per cent of this excess is lost through their head. Covers rising up over the head could prevent this normal heat loss, resulting in acute thermal imbalance."
So the best advice is to keep the head uncovered when the baby is in the cot and to check that the baby is not too hot. FSID say that a simple way to check if a baby is too hot is to look for sweat or feel the baby. If they do seem too hot, remove one or more layers of blankets. But, if you find that their hands or feet are cold, don't worry as this is usually normal. It's also important to note that babies who are unwell need fewer, rather than more, bedclothes.
Other important ways of reducing the risk of cot death include:
- putting your baby to sleep on his or her back.
- not smoking - both during pregnancy, and in the same room as your baby.
- keeping your baby's head uncovered when sleeping and place his feet at the foot of the cot to prevent any wriggling down under the covers.
- not letting your baby sleep with a hot water bottle, next to a radiator, in direct sunlight or near a heater or fire.
- avoiding the use of duvets, quilts, cot bumpers or sheepskins that may cause your baby to get too hot.
- avoiding falling asleep with your baby on a sofa.
- avoiding bed sharing with your baby, especially if you or your partner has been drinking or taken anything that could cause extreme tiredness.
- avoiding crowding the cot with soft toys.
- putting your baby to sleep in a cot in your room for the first six months.
- seeking medical advice promptly if your baby seems unwell.
ACTION POINTS
Check to ensure your baby isn't too hot - look for sweating or feel the baby, but don't worry if hands or feet are cold, as this is usually normal.
If the baby is too hot, remove one or more layers of blankets.
Babies who are unwell need fewer, not more bedclothes.
Use a room thermometer in your baby's room to ensure the correct temperature - 16 to 20°C - is maintained.
Summary
Cot death continues to be an issue parents should be aware of and, among the many practical measures they can take, avoiding overheating is one crucial aspect. Room thermometers offer an easy way of maintaining a correct room temperature and may offer extra peace of mind.
Links for more information
- Bupa cot death factsheet
- Foundation for the Study of Infant Deaths (FSID)
- FSID helpline number - 0870 787 0554
- Department of Health cot death leaflet
