Citation

Randall B, Wilson AL. S. Dak. J. Med. 2008; 61(8): 287-9, 291, 293.

Copyright

(Copyright © 2008, South Dakota Medical Association)

DOI

unavailable

PMID

18819316

Abstract

The mission of the Regional Infant and Child Mortality Review Committee (RICMRC) is to review infant and child deaths so that information can be transformed into action to protect young lives. The 2007 review area includes South Dakota's Minnehaha, Turner, Lincoln, Moody, Lake, McCook, Union, Hansen, Miner and Brookings counties. Although there were no deaths in 2007 that met the criteria of the Sudden Infant Death Syndrome (SIDS) in our region, there were three infant deaths associated with unsafe sleeping environments (including adult co-sleeping) that either caused or potentially may have caused these infants' deaths. We need to continue to promote the"Back to Sleep"campaign message of not only placing infants to sleep on their backs, but also making sure infants are put down to sleep on safe, firm sleeping surfaces and that they are appropriately dressed for the ambient temperature. Parents need to be aware of the potential hazards of co-sleeping with their infants. Compared to nine such deaths in 2006, only four deaths in 2007 involved motor-vehicle crashes, none of which were alcohol related. Two drowning deaths illustrated the rapidity in which even momentary caregiver distractions can lead to deaths in children in and around water. Since 1997 the Regional Infant and Child Mortality Review Committee (RICMRC) has sought to achieve its mission to"review infant and child deaths so that information can be transformed into action to protect young lives."For 2007, the committee reviewed 25 deaths from Minnehaha, Turner, Lincoln, Moody, Lake, McCook, Union, Hansen, Miner and Brookings counties that met the following criteria: Children under the age of 18 dying subsequent to hospital discharge following delivery. Children who either died in these counties from causes sustained in them, or residents who died elsewhere from causes sustained in the 10-county region. The report that follows reviews the committee's activities for 2007. No deaths meeting the criteria for Sudden Infant Death Syndrome (SIDS) occurred in the review region. The committee has observed a stable decline in the number of deaths due to the SIDS as compared to the eight SIDS or possible SIDS deaths occurring in 1999. Unfortunately, however, there were three infant deaths in SIDS-like settings where asphyxia could not be excluded. Although the committee strives to be consistent year to year in its investigation protocols, we have noticed that the number of deaths classified as"undetermined"has been increasing over the last few years (starting in 1997: 1, 2, 1, 0, 2, 1, 2, 0, 5, 4, 5). Although it is possible that deaths certified as SIDS in earlier years may now be classified as undetermined due to asphyxial risks, we may also be seeing an increase in infants sleeping in unsafe environments. Our data may be mirroring a national trend amongst death investigators to increasingly recognize asphyxial risks in infant death scenes. Infants co-sleeping with adults (two deaths in 2007) may represent a risk factor not as frequently seen as in prior years. We will watch this trend closely in the future. The Committee strenuously advocates that the Back to Sleep message include placing infants on their back to sleep, avoiding soft bedding for infants, making parents aware of the potential hazards of co-sleeping with young infants, and eliminating both pre- and post-delivery fetal/infant cigarette smoke exposure. a decrease in youth motor-vehicle crash deaths to four versus the nine seen in 2006.2 Three of those dying in motor-vehicle crashes in 2007 were not wearing seat belts. The committee continues to feel that some of these deaths could have been prevented had these children been wearing a seat belt. Compared to four alcohol-related motor-vehicle crash fatalities in 2006, no deaths in 2007 were alcohol related. The committee, however, is painfully aware that even one crash involving multiple occupants can rapidly skew the apparent improvements in 2007 in the wrong direction. In 2007, two youths, both with disabilities, drown. One drown in a bath tub and the other in an outdoor pool. It is unfortunate that these deaths bring home the message that even the smallest, momentary lapses in supervision of these children can have fatal consequences. Fortunately, the child and infant homicide rate in our region is very low. Unfortunately, however, one infant did die as a result of being assaulted and shaken by one of its parents. There remains a need for the community at large, and the medical community specifically, to address issues of parental anger management, particularly when caregiver frustration is directed at children.

Language: en