Accidental Infant Asphyxial Deaths

Last Thursday and Friday I was at the 12th Annual IL Symposium for Child Death Review Teams. In addition to a couple of “business” meetings there were lectures on issues of child death.

The first lecture was about a constellation of deaths that, in the past, were often confused with SIDS. But these deaths are preventable, so it is important to look for us to look for them in investigations and based on the growing body of related information, it is incumbent on those of us involved in the investigation of these deaths to get warnings out to parents about them.

I have written some about it in the past. These tragic, accidental deaths occur while these children are in bed, most often in an “adult” bed. Broadly, they are suffocation or asphyxia deaths. They can occur with:

“Overlaying”, bed-sharing adult or child unintentionally lays upon the child either totally or partially, it only takes about 4 pounds of pressure on the neck for asphyxia to occur,

Asphyxia related a child’s face becoming trapped in soft bedding (infants are unable to move their heads out of position),

Asphyxia related to getting wedged into a space in which the chest and lungs cannot expand (often seen with trapping between mattress and wall or, as we have seen, between 2 couch cushions)

Suffocation when bedding or similar materials cover the child’s head and mouth

These deaths are way too common and are preventable. The “Back to Sleep” program to prevent SIDS has been very successful. Next we must push the information that bed-sharing is incredibly dangerous. [One point that the speaker brought up is that one of the major reasons for bed-sharing is the inability to afford a crib. A child dies because of poverty. That should not happen.] The other point that must be stressed (in part already out there, but it needs to be emphasized) is that children should only sleep on appropriate sleep surfaces, not soft surfaces, not buried in bedding, not with stuffed toys, and on a surface without the possibility that the infant might become entrapped.

We must work to prevent death and this is a great potential target for prevention.