Proposing an Educational Video: Preventing Airway Occlusion with Infants in Supported Sitting

Sudden Unexpected Infant Death (SUID) includes the full spectrum of all infant death causes, which include “Determined” causes [e.g. Sudden Infant Death Syndrome (SIDS) at 42% and Accidental Suffocation and Strangulation at 24%], as well as “Undetermined” causes at 34% [1]. Literature is replete with studies that address the risk factors associated with SIDS, accounting for at least 42% of infant mortality [1]. Scarce to find, however, is public health education or learning opportunities that address the mechanism of brain injury and death by Positional Asphyxiation (PA). Better yet, in the current day of popular social media platforms and cell phone apps, there should be readily available video education on the topic where the focus is on PA risk factors and prevention. Viewing should be required of new parents and caretakers, as well as to health professionals, including pediatric clinical trainees who specialize in infant care. Other suggested locations for viewing would be hospital postpartum delivery suites and pediatric waiting rooms.The accidental but preventable phenomenon of PA gives rise to the annual occurrence rate of 2.8 – 3.0% (98-105 deaths) in healthy infants who have no pre-existing medical conditions, including prematurity. They die from SUID primarily in car seats, accounting for 69% of deaths in sitting devices [1]. Webster’s Dictionary defines PA as, “A condition of deficient oxygen supply to the brain and body which occurs when a person’s physical position prevents normal breathing.” Each tragic occurrence is first suspected, then largely confirmed by a combination of investigative reports and the absence of gross or observable findings from post-mortem autopsy--like tissue injury from traumatic injury or inflammatory changes. Additionally, there would be no recorded or known history of a pre-existing medical condition. Given these factors, post-autopsy typically confirms the cause of death as “Undetermined or Unknown.” Perhaps the combination of the low incidence rate of PA and “Undetermined” autopsy reports cause this mechanism of infant mortality to be an “unsung” category of SUID, thus remains in obscurity with respect to disseminated public health education.