January 28, 2023

Co-sleeping, rooming-in, tiredness: what are the possible causes of the child’s death

What are the protocols and the differences between the various types of «neonatal deaths». It is important to know them to avoid tragedies, even at home

The cases

«When a newborn dies unexpectedly, technically we talk about “postnatal collapse” (Supc, Sudden unespected postnatal collapse), an event that concerns 5 newborns for every 100,000. About 400,000 children are born in Italy and the Supc concerns about 20 newborns, of which 25-30% with a fatal outcome. It is therefore a very rare event, usually occurring within two hours after delivery or in the first days of life. In some cases, postnatal collapse occurs due to undiagnosed underlying conditions, such as metabolic disease or heart disease. In other cases it can happen in healthy children, for which it is difficult to find explanations», explains Fabio Mosca Director of the Italian Neonatology and Neonatal Intensive Care Units of the IRCCS Ca’ Granda Foundation Ospedale Maggiore Policlinico of Milan, Clinica Mangiagalli.

Is it possible to prevent this dramatic event?
“To prevent this from happening, the Italian Society of Neonatology – explains Mosca – has implemented a series of alerts that invite the mother to look after the child in the first days of the puerperium, both in the hospital and at home, paying attention to the main risk factors that can be associated with this event: tiredness, smoking, distraction and co-sleepingi.e. keeping the baby in his own bed. This does not mean not being able to breastfeed or cuddle him while lying down, but be careful not to fall asleep with the baby in your arms or next to him, because he could fall, be crushed or risk suffocating. The first rule of prevention to be given to new mothers is to always make sure that your baby’s nose is free (because newborns breathe through the nose), especially during feeding and during sleep».

What help should hospitals provide to a new mother who has to bring together tiredness and the feeding needs of her newborn baby?
«It happens very often that a woman is tired, after a long labor or after a cesarean section – explains Luigi Orfeo, President of the Italian Society of Neonatology -. If we were to meet the new mothers’ desire, however sacrosanct, for rest, it would not be possible to support breastfeeding which (let’s remember) is not a simple nutritional act but is the best investment for the life of the unborn child. To start the milky flow well, it is necessary to attach the baby to the breast frequently, in the right position. For this reason, neonatology departments have the practice of encouraging the rooming-in, or the 24-hour presence of the baby in the room with the mother. Which doesn’t mean sleeping with the baby (co-sleeping), but hold him only to breastfeed him and then put him back in the crib next to the bed of the mother just finished feeding. This is a rule that must be adopted even at home, as well as prevention of SIDS (la Sudden infant death syndromecot death syndrome). The first months of a baby’s life are very tiring for a mother, but if her health is good, giving priority to breastfeeding is essential for the well-being and health of the newborn (but also of the woman) », concludes Orfeo.

January 23, 2023 (change January 23, 2023 | 15:53)

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