Positional Asphyxia - I Never Knew

[Cat Herder]

Yes, this is new to me too. I have allowed my own children to sleep in their car seats and swings without giving it much thought. Thanks for educating us on this topic.

I was wondering how often deaths occur while riding in a carseat in the car because of positional asphyxia? Or is this a non issue?

I have transported only one to the ER while on duty, but have heard of others. (neglect was also suspected in my particular patient)

Typically it was extended drives, like when on vacation, rear facing out of mothers view. Again, this is more of a slow process; their underdeveloped brains never see it coming to put up a struggle . Google "Re-breathing Asphyxia" for more information.

[sharlan]

My daughter was also told NOT to use the strollers that the carseat snaps into.

[Unregistered]

When an infant is in a "reclined" position it places their chin to their chest. Due to the proportional difference of their head size to the body, this crimps their trachea leading to slow asphyxiation. Think of parking a car on a running garden hose.

This is not a new thing, it is just something they no longer label as SIDS because we KNOW it can be prevented. It sometimes falls under the category of SUID, but I hope that stops as it really has nothing to do with it.

It is explained and preventable, YKWIM? The number one airway obstruction, and cause of death in infants, is their own tongue (I am a Pediatric Advanced Life Support Instructor and that is a test question .)

check out www.firstcandle.org/

www.heart.org for infant cpr

Thank you for not being judgmental. I guess I still don't see how the baby's head is going to touch his chest, at least in this seat I have. Think man in his recliner with the seat "pushed" as far into recline as it goes. I know what you're talking about though, because one of my other carseats was always bad for the head bobbing forward and I've seen newer bucket style seats that cause it to happen quite a bit. That's why I was thinking perhaps there's a difference in the angle of how they're made now vs back almost 12 years ago when I bought the seat.

The only reason I question it is that I've had babies here and there who will stand in the pack n play and cry and cry so using the seat makes them sit and relax. The one I have now will sit on his legs and fall asleep sitting up, always waking himself when he bobbles a little. I tried for weeks to get him to lay down, but he doesn't because he sleeps with mom at home. The only way he sleeps is if I buckle him in this seat so he can't sit up. He don't cry more than a minute and he's out. I check on him constantly. His head is never bent over due to the amount of recline. I'm not sure what else to do with him because at 9mo he needs 2 naps a day and he doesn't get any if I try to lay him down. In the past, I've used this as a temporary thing until they forget about the bad little habit they got into and then I switch back to regular napping in the pack n play. If you have any better suggestions for how I can get him out of this habit, I'd love to hear ideas.

Thanks for the links too. I will check them out.

[JenNJ]

Thank you for not being judgmental. I guess I still don't see how the baby's head is going to touch his chest, at least in this seat I have. Think man in his recliner with the seat "pushed" as far into recline as it goes. I know what you're talking about though, because one of my other carseats was always bad for the head bobbing forward and I've seen newer bucket style seats that cause it to happen quite a bit. That's why I was thinking perhaps there's a difference in the angle of how they're made now vs back almost 12 years ago when I bought the seat.

The only reason I question it is that I've had babies here and there who will stand in the pack n play and cry and cry so using the seat makes them sit and relax. The one I have now will sit on his legs and fall asleep sitting up, always waking himself when he bobbles a little. I tried for weeks to get him to lay down, but he doesn't because he sleeps with mom at home. The only way he sleeps is if I buckle him in this seat so he can't sit up. He don't cry more than a minute and he's out. I check on him constantly. His head is never bent over due to the amount of recline. I'm not sure what else to do with him because at 9mo he needs 2 naps a day and he doesn't get any if I try to lay him down. In the past, I've used this as a temporary thing until they forget about the bad little habit they got into and then I switch back to regular napping in the pack n play. If you have any better suggestions for how I can get him out of this habit, I'd love to hear ideas.

Thanks for the links too. I will check them out.

BUT REMEMBER, A CRYING BABY IS AN ALIVE BABY. I rather have a crier at naptime than buckle a child into an unnatural position to induce sleep.

[Unregistered]

BUT REMEMBER, A CRYING BABY IS AN ALIVE BABY. I rather have a crier at naptime than buckle a child into an unnatural position to induce sleep.

Have you ever cared for a baby that cries through most of two naptimes every single day because he never sleeps alone at home?

[Unregistered]

BUT REMEMBER, A CRYING BABY IS AN ALIVE BABY. I rather have a crier at naptime than buckle a child into an unnatural position to induce sleep.

Also, I asked for suggestions and all you have here is criticism. I already know it's not good. I've tried for weeks to break him of it. I let him sit and cry it out and it has gotten worse so I let him have some much needed rest in a car seat. He fell asleep within minutes. He's not back until Monday so I have until then to hear some better ideas.

[MarinaVanessa]

Have you ever cared for a baby that cries through most of two naptimes every single day because he never sleeps alone at home?

I have. Eventually the infant learns to sleep on their own in my home. It takes some time but it can be done. I've done it plenty of times and it's much the same as teaching a child to to certain things at your home differently than their own home.

Most infants that I get have already learned to fall asleep in their parents arms by being rocked to sleep. Here at daycare I have to teach the infant to fall asleep after laying the infant down while awake. It takes a while (up to 2 weeks sometimes) but it can be done. In most cases the parents continue to put the baby to sleep by rocking him/her or by holding and feeding the infant a bottle but they continue to fall asleep on their own when at daycare.

[Unregistered]

I have. Eventually the infant learns to sleep on their own in my home. It takes some time but it can be done. I've done it plenty of times and it's much the same as teaching a child to to certain things at your home differently than their own home.

Most infants that I get have already learned to fall asleep in their parents arms by being rocked to sleep. Here at daycare I have to teach the infant to fall asleep after laying the infant down while awake. It takes a while (up to 2 weeks sometimes) but it can be done. In most cases the parents continue to put the baby to sleep by rocking him/her or by holding and feeding the infant a bottle but they continue to fall asleep on their own when at daycare.

This has usually been the case here too, apart from one who would attempt to sleep standing up...a week in the car seat made him forget about that and he went back to laying down to sleep. I've never had a sit & scream baby before. He used to nap perfectly fine until he figured out how to sit up and now that's all he does. I left him be that way for a couple weeks with no improvement. Then put him in the seat for a week to break the habit. Then I went back to laying him down and he'd sit right back up. I let it go for another 3 weeks and just couldn't do the crying yesterday so I let him sleep in the seat again. It's not like I'm not trying the usual cry it out plan. I need somebody's secret trick for special babies who are apparently more stubborn than most.

[Cat Herder]

Have you ever cared for a baby that cries through most of two naptimes every single day because he never sleeps alone at home?

Yes, I have and I do understand how it makes you feel.

The walls "cave in" on you, you can't keep your heart from racing and the it makes it very difficult to see the light at the end of the tunnel.

I clip a sleep sheep on the crib alot and set it to ocean sounds. It seems to help alot. I also use a box fan for background white noise.

It does take time for them to adapt to sleeping alone. The parents SHOULD be helping with this since they chose to put him in daycare. It isn't fair to their child, the other children OR you. Unfortunately that seems to be an unpopular opinion these days.

Just a few short years ago it was generally viewed to be a PARENTAL RESPONSIBILITY to prepare children for daycare. Now, I don't see that in any of the parenting literature. Sadly, I think that is going to be followed with a rise in infants dying in daycare, again, like happened in the early 90's.

[JenNJ]

Have you ever cared for a baby that cries through most of two naptimes every single day because he never sleeps alone at home?

Yes, I have. I have cared for multiple babies and children who fit that description. Even my own son was that way.

It is an adjustment for the child and as with most things, adjustments take time. There is no quick fix. Strapping a child into a swing or bouncy chair to calm them is something I have done. It works like a charm. But once they fall asleep, I move them to the playpen. Most of the time they wake up and get angry again. And it is ok for babies to cry. I have never heard of a baby dying from crying. I have heard of babies who have died from positional asphyxia, being shaken by their caregiver, or from being unattended when they sleep (in a crib or elsewhere).

So yes, babies cry for a lot of reasons. We as professional caregivers need to teach ourselves that crying is ok. Crying means the child is breathing. Crying means life. A child who is strapped into a carseat, swing, or boucy chair is easily forgotten (look at how many PARENTS forget their own children in the car on a hot summer day) because they are quiet and put into a small space. It is so easy to assume that a quiet baby is sleeping. It is too easy to be comfortable with that silence. We as caregivers must never be comfortable with silence. We must be diligent in checking on sleeping babies, toddlers, and children.

So yes, I mean it when I say that a crying baby is ok with me. A crying baby means while the baby may be sad or angry, that baby is alive and kicking. And that is what I want.

[Country Kids]

Yes, crying does mean an alive baby! How long though do you let a baby cry before it isn't good? Someone yesterday said there own child cried for like 6 hours straight! That sounds like that wouldn't be good for the baby. It seems like their little heart would beat to hard, blood pressure up, and just over all not good.

What is the longest time a baby should cry-anyone know?

[laundrymom]

The key is SUPERVISED sleep. I think you have that covered. You are pretty awesome...

There is always going to be some risk involved in caring for infants. It really is up to the individual how much risk their bathroom mirror is willing to take. YKWIM? Mine is pretty demanding so I take NONE.

Please rethink the sling for naps. I found out at this years safe sleep that a new mother took her infant to the fair, in a sling to keep them close. After an hour or so she went to change her,.... She had passed in that time. From positional asphyxia. I'm thinking it was in Muncie In.

**not sure why this quoted cat. I tried to respond to meyou

[JenNJ]

I'm NOT saying to leave babies cry for hours. If that is the case, the parent needs to be called. As always, work with the parent to help the child adjust to crib/playpen sleeping. And you don't need to leave the child alone to cry. You can be with the child while they cry. You can rub their back, talk to them, sing, pat them, etc. Sometimes they cry because they simply aren't ready to sleep. I only let a baby yell for about 10 minutes before picking them up. I will calm them and try again for a nap a short while later.

I am saying that in a case where a child will only sleep in a carseat/swing/bouncy seat without crying vs. a playpen where a child cries, we need to choose the playpen. 99% of the time, a child will learn within days that the playpen/crib is the rest area and will learn to go to sleep without movement (rocking, swinging, vibrating, etc.).

Yes, there are extreme cases of kids who do not adjust to crib sleeping, but I believe that has a lot to do with what goes on at home. I believe that in those type of cases, most of the time the parents aren't making the necessary changes at home to make the baby's days easier in daycare.

[Solandia]

Yes, crying does mean an alive baby! How long though do you let a baby cry before it isn't good? Someone yesterday said there own child cried for like 6 hours straight! That sounds like that wouldn't be good for the baby. It seems like their little heart would beat to hard, blood pressure up, and just over all not good.

What is the longest time a baby should cry-anyone know?

It isn't good to have the high heart rate, tense muscles, etc. for long periods of time. It is very stressful on the baby & caregiver at the very least. I have never heard of a max amount of time...but if there is something wrong or hurting with the baby, I would have the parents take him/her in to the doc.

However... for true colicky babies, their blood pressure remains normal, heart rate normal. Even their muscles are relaxed. All very similar to a sleepy or calm baby, only crying for hours on end. But not stressful to the baby, just us.

My pedi & I talked about this once for quite some time at an appt (so sorry to whoever might have had the appt after us!), he had some research that he was all excited about it. I didn't even have a colicky baby at the time...but I have since messed around with inconsolable babies (daycare and my last 2 of my own), and I was still surprised and how relaxed a crying colic baby can be. Compared to the reflux crying babies that were all stiff, hard to hold, and getting quite upset rather than 'just' crying. Interesting stuff.

[Unregistered]

Yes, I have and I do understand how it makes you feel.

The walls "cave in" on you, you can't keep your heart from racing and the it makes it very difficult to see the light at the end of the tunnel.

I clip a sleep sheep on the crib alot and set it to ocean sounds. It seems to help alot. I also use a box fan for background white noise.

It does take time for them to adapt to sleeping alone. The parents SHOULD be helping with this since they chose to put him in daycare. It isn't fair to their child, the other children OR you. Unfortunately that seems to be an unpopular opinion these days.

Just a few short years ago it was generally viewed to be a PARENTAL RESPONSIBILITY to prepare children for daycare. Now, I don't see that in any of the parenting literature. Sadly, I think that is going to be followed with a rise in infants dying in daycare, again, like happened in the early 90's.

Thank you. I do have the bathroom fan on that's closest to the bedroom where he sleeps and I play piano music loud enough so he can hear it, but like you say, the parents should be helping with this and are not. The mother firmly believes in attachment parenting, which she never mentioned until he was 7months old...grrrrr, and couldn't bear to let him cry it out at all. She knows he cries here, but that hasn't seemed to motivate her to change her ways.

I'm not going to terminate. I have a pretty high tolerance for crying so that's really not the issue here. I'm not looking for a quick way to make a baby sleep so I can have free time. I'm more concerned that this baby doesn't get enough quality sleep in a day. Sooner or later that's going to hinder his development.