Prematurity,sleeping position and sudden infant death syndrome

Preterm birth and prone sleeping position significantly increase the risk of sudden infant death syndrome (SIDS). The reduced incidence of SIDS with supine sleeping has been well publicised, yet some prematurely born infants are slept prone at the high-risk age for SIDS. This may reflect inadequate educational targeting of high-risk groups and/or concerns about possible adverse effects of supine sleeping. In addition, parents may receive mixed messages about sleeping positions, as they witness their prematurely born infants being nursed prone on neonatal units, often for many weeks. In the neonatal period, the prone position improves oxygenation, tidal volume and compliance of preterm infants with respiratory distress. The limited data available suggest prone positioning is also beneficial for convalescent, preterm infants. Thus, it is not clear when the advantages of prone sleeping cease. Studies are required to determine when supine sleeping for prematurely born infants can safely be recommended and hence an unambiguous message given to parents.