Siblings Of Infants Research Articles

Apnea of infancy and sudden infant death syndrome.

The sudden infant death syndrome (SIDS) is the leading cause of death of infants between the end of the first month and the first year of life. The risk of SIDS is increased in subsequent siblings of infants with SIDS, infants with apnea of infancy (AI), and prematurely born infants. The cause of SIDS is unknown, but much clinical and investigative attention has been directed toward AI as a possible premortem expression of the abnormality that can potentially cause SIDS. Both AI and SIDS probably have multiple different mechanisms. Some infants with AI have been shown to have abnormal control of respiration. This article is intended to summarize the relationship between AI and SIDS and to review the published physiologic studies about AI. I present and discuss a system for evaluation and "treatment" of patients with AI.

Developmental comparison of sleep EEG power spectral patterns in infants at low and high risk for sudden death

Power spectral density measured from central cortical EEG recordings during sleep was compared in two groups of 20 infants each at intervals between 1 week and 6 months of age. One group consisted of siblings of infants who had previously died of the sudden infant death syndrome, as determined by history and autopsy report (sibling group). The second group was made up of age, sex, and socioeconomically matched infants with no familial history of sudden infant death (control group).

99 VISITING BY SIBLINGS IN A NEONATAL INTENSIVE CARE UNIT (NICU)

Negative changes in sibling behavior have been documented following the birth of a newborn. They may be exaggerated by the prolonged hospitalization which occurs when sick neonates are admitted to NICUs. We randomly assigned 15 siblings (ages 3.8–7.25 years) of infants admitted to our NICU to a visiting group (n=8 permitted inside NICU, touch, hold neonate) or a control group (n=7 came to hospital for interview only). A structured interview was administered to sibs directly after the visit. Parents responded to questionnaires comparing the child's behavior before and after the neonate's birth, one week after admission to NICU and one week after experimental (or control) intervention. 80% of all children showed some behavioral changes after birth of the infant and both groups showed improved behavioral trends following the intervention. No differences were found between groups. 3/5 siblings in the control group and 0/5 in the visiting group gave negative or fearful descriptions of the hospital (p=0.08). None of the visits were disruptive of patient care and none of the children asked to leave the unit. Parents' comments were uniformly favorable. No nosocomial infections were documented following visits. In this study no detrimental effects and some favorable effects were found when siblings of this age were permitted to visit sick neonates in the hospital.

Sudden Infant Death Syndrome: Sleep Apnea and Respiration in Subsequent Siblings

Subsequent siblings of infants who died of the Sudden Infant Death Syndrome are at a four- to six-times increased risk to die of this syndrome. This study compares the respiratory development during sleep state of this epidemiologic high risk group with that of normal infants during the first six months of life. Subsequent siblings exhibited higher respiratory rates in all states at 3 months of age. Quiet sleep and indeterminate respiratory rates were elevated at 1 week of age compared to control infants. Indeterminate respiratory rates remained higher at 6 months of age. These differences were accompanied by a reduced incidence of total breathing pauses of two to five seconds and six to nine seconds duration in siblings. Study groups could not be differentiated on the basis of either breathing pauses of more than ten seconds of central apnea of six seconds or more. Obstructive and mixed apnea (6 seconds or more) were infrequently observed in these study groups. A high degree of intersubject variability characterized all data on breathing pauses.

Impact of the Apnea Monitor on Family Life

The use of an apnea monitor in the home to limit the duration of prolonged apneic spells and thus, possibly, to prevent sudden infant death syndrome (SIDS) has raised a number of questions about the effect of such devices on the infant, family, and parent-child interaction. Through interviews and questionnaires, descriptive data were obtained from 31 families who recently or currently had an infant on a monitor. The infants treated were either those who had one or more severe cyanotic episodes, siblings of infants with SIDS or severely cyanotic infants, or normal newborn infants in a research study. On the basis of laboratory sleep studies, all were believed to be prone to prolonged apneic spells. Most families believed that using the apnea monitor had a significant but temporary impact on their personal and social lives. Many patterns of daily living and child-care routines were altered to accommodate monitor use. Technical limitations of the machine severely aggravated parents' problems. Despite these observations, most parents believed the monitor was an anxiety reducer and, in retrospect, well worth the trouble. Generally it was not seen as a deterrent to normal parent-child relations. These generalizations are explored in detail and are presented as a stimulus to further investigation and improved management.