Introduction
Healthcare is an essential requirement for adults and infants. Due to the various factors that children are exposed to in the process of their development, it is critical for parents and caregivers to ensure that children are provided with all the necessities that will enhance their overall health status.
Despite the measures that have been put in place to realize this goal, children are still susceptible to various diseases, some of which might be fatal. Pneumonia, malaria, cholera, typhoid, and HIV are examples of fatal diseases that can have profound effects on the health of children.
Sudden infant death syndrome (SIDS) is a condition that causes sudden death to a child. Despite the fact that this condition can affect children of all ages, its effect is mainly felt on children who are under the age of one year. However, unlike other diseases, SIDS is a condition that cannot be detected on the medical history of the victim (Dick, 2009).
Consequently, the cause of death cannot be ascertained even after conducting a thorough forensic autopsy on the body of the victim or investigating the crime scene. In most cases, SIDS causes death when a child is sleeping. It is due to this fact that the condition is referred to as the crib death disease.
Despite the fact that it has been virtually impossible to tie a given factor as the cause of SIDS, information gathered from recent studies has revealed that the sleeping position of children might be a relevant risk factor (Dick, 2009).
For instance, the study that was conducted by the American Academy of Pediatrics revealed that putting a baby to sleep on the supine position greatly reduced the occurrence of SIDS (Dick, 2009). The results of this study led to the development of the Back to Sleep campaign that was launched in the USA, the UK, New Zealand, and Australia.
This movement was an educational campaign that aimed at increasing the awareness of SIDS and empowering individuals to take precautionary measures that resulted in the reduction of the occurrence of SIDS. The campaign was successful since it led to a decline of death as a result of SIDS to around 66% in New Zealand alone (Dick, 2009).
Despite the success of this program, the incidences of SIDS are still high in some nations across the globe. Particularly, the incidence of SIDS in developing nations is very high.
These nations are characterized by high levels of poverty, poor healthcare services, and the lack of post-natal education that would empower parents to provide the best conditions for the growth of their children. These factors are responsible for the high rates of infant mortality in developing nations.
This paper will therefore focus on the impact of SIDS in developing nations, its trends, and the actions that have been taken to put this condition under control. Finally, the paper will come up with recommendations that should be applied in order to reduce the incidences of death from SIDS in developing states.
The Global Trends of SIDS
The trends of SIDS in the world vary from nation to nation. However, developing nations exhibit high death as compared to developed states. From the surveys that have been conducted, Japan is the nation that has the lowest rates of deaths in developed states by recording an astonishing rate of 0.09/1000 deaths.
On the other hand, New Zealand is the developed state that has the highest death rate as a result of SIDS (0.08/1000). The United States of America has been placed at the intermediate level after having a death rate of 0.57/1000.
In the nations where SIDS studies have been carried out, it has been identified that the rates of death from this condition highly depend on various factors. For instance, the rate of SIDS varies greatly across racial and ethnic lines. In the United States for instance, the rate of SIDS in African Americans and Hispanics is almost two times that of Native Americans.
Consequently, the rate of SIDS is higher among the members of the mixed race in Cape Town, South Africa. In New Zealand and Australia, the Maoris and Aboriginals exhibit the highest rates of SIDS respectively in these nations (Dick, 2009).
From these trends therefore, it is evident that the way of life plays a significant role in determining the occurrence of SIDS. Thus, poor living conditions have a direct relationship with SIDS.
Prior to the 1990s, not a lot of research on SIDS had been conducted in the world. This fact therefore played a significant role in the high rates of infant mortality that was being experienced in the world. In Africa, the infant mortality rate during the early 1990s was around 112/1000 children (Vanderford, 2009).
Despite the fact this rate was relatively low in developed nations, SIDS was one of the leading causes of infant mortality. These trends played a significant role in the increased number of studies that focused on factors that caused infant mortality.
Particularly, several studies were conducted on SIDS. Most of these studies focused on the incidences of SIDS, factors that are responsible for the condition, and the possible measures that could be put in place to reduce the incidence of the condition.
The information gathered from these studies led to the development of campaigns and education initiatives that led to an increase in the awareness of the condition. Most of these campaigns and initiatives were successful since they led to an overall decline in the number of deaths as a result of SIDS.
According to the study conducted by Vanderford (2009), the period between 1999 and 2005 saw a drastic decline in SIDS related cases in nations such as the United States of America, England, South Africa, Nigeria, Australia, and New Zealand.
For instance, Argentina recorded a decline of 40% in SIDS during this period while Ireland recorded a decline of 83%. However, Mage (2004) came up with the diagnostic shift argument that he used to explain the drastic decline in SIDS related cases.
According to this argument, the drastic decline in SIDS since 1999 can be attributed to the shift in diagnosis from SIDS to other related cases such as accidental suffocation or indeterminate causes. The diagnostic shift argument can thus be used to explain the static trend in SIDS that has been experienced since the year 2000.
However, it is evident that individuals all around the world have become more aware about the condition. Thus, these individuals take necessary measures to that have greatly reduced the incidence of SIDS. Despite this fact however, the incidences of SIDS in developing nations are fairly high.
In Nigeria for instance, only a limited number of studies have been conducted. This factor therefore explains why the level of awareness in these nations is very low hence resulting in high deaths.
Risk Factors
Several risk factors have been involved with SIDS. Most of these factors however, have been linked to the standards of living. Many of these factors have been linked to the socioeconomic status of individuals, families, and states.
In the United States for instance, it is assumed that White Americans have a higher income as compared to African Americans and Hispanics.
White Americans therefore tend to have a better quality of life which in turn reduces the risk associated with SIDS as compared to African Americans and Hispanics. The same trend is exhibited all across the globe with the risk being even higher in developing nations.
Social class is thus a critical factor that determines the incidence of SIDS in a given nation. Developing nations are characterized with low incomes and low levels of GDP. These factors have a direct correlation with SIDS. According to a study that was conducted by Dick (2009), the level of SIDS was higher by 62% in families where the father had no income.
In such a situation, there are high chances that a child will be exposed to situations that will greatly increase the incidence of SIDS. This trend was also experienced across ethnic lines. In South Africa for instance, the rate of SIDS was slightly higher in families that had a mixed ancestry as compared to Dutch families.
Socioeconomic factors play a significant role in determining a number of factors that increase the prevalence levels of SIDS. Due to low income levels, there are high chances that a mother will not take considerable measures during pregnancy to enhance her health and the health of her baby.
The lack of proper prenatal care, poor eating habits, and exposure of extreme environmental condition usually have detrimental effects on the unborn baby. For instance, such a baby might be underweight during birth.
In Nigeria, the rate of SIDS in children who are born weighing between 1.0-1.5 kg is 15.89/1000 as compared to the rate of 2.91/1000 on children who are born weighing between 3.5-4.0 kg (Dick, 2009). A low weight during birth is an indicator of poor health of a baby. Thus, such a child will be prone to a lot of diseases including SIDS.
Consequently, the children who are exposed to extreme environmental conditions exhibit higher rates of SIDS as compared to those children who are exposed to conducive environmental condition. Air pollution and tobacco smoke are examples of factors that can result into SIDS.
Thus, a child who is exposed to tobacco smoke either from his parents or the people who are immediately around him/her will stand a high chance of becoming susceptible to SIDS. On the other hand, there are minimal chances of a child who is living in a properly aerated environment that is free from air pollution to become susceptible to SIDS.
SIDS usually occurs when a child is sleeping. Therefore, the sleeping environment of a child is a key determinant of this condition. The sleeping position of a child is thus a critical factor. From the studies that have been conducted, it has been identified that most children who succumb to SIDS were sleeping on their stomachs.
These incidences have been particularly high in developing nations due to lack of awareness about the importance of sleeping positions. Consequently, due to economic constraints and social practices, children in less developed nations tend to share beds either with their parents or with other siblings.
Sharing of beds increases the occurrence of SIDS. Despite the fact that the mechanisms behind bed sharing and SIDS are unclear, possible causes of death include accidental suffocation and position accidental asphyxiation (Mage, 2004).
It is thus advised that children sleep in their own cribs but in the same room with adults. Other causes of death include excessive use of beddings and soft materials, stuffed animals such as dolls, and the presence of soft surfaces in the sleeping area.
Other than socioeconomic factors, biological factors also play a significant role in deterring the occurrence of SIDS. Breastfeeding is an important post natal practice that mothers are encouraged to engage in. A mother’s milk contains the essential nutrients that are important in the process of growth and development in a child.
Therefore, the children who do not breastfeed do not get the necessary nutrients that will protect them from infections and diseases. Thus, the level of SIDS in children who are not breastfed is relatively higher as compared to the children who are breastfed.
Children who are born prematurely also stand a high chance of becoming victims of SIDS. The defensive mechanisms of a child who is born prematurely are relatively lower as compared to that of a child who is born maturely. Thus, a premature baby will stand a high chance of succumbing to SIDS due to his/her weak defensive mechanism.
The age of a child also determines the prevalence levels of SIDS. From the studies that have been conducted, it has emerged that children who are between 2-4 months stand a high chance of succumbing to SIDS as compared to newborns and children who are almost 12 months.
Research has also revealed that male children have a 50% chance of becoming SIDS victims as compared to female children. Consequently, anaemia increases the risk of a child succumbing to SIDS. However, it is difficult for doctors to diagnose this condition since anaemia tests need to be conducted on the blood cells of an individual who is alive.
Other conditions that might result to SIDS include pulmonary haemorrhage, virus infections, bacterial infections, and influenza. Infanticide also plays a significant role in SIDS cases.
Numerous cases have been reported where a mother kills a child immediately after birth or after some time. In some societies, female children are always killed after birth due to the preference for male children.
Addressing and Preventing SIDS
In addressing this phenomenon, many governments across the world have come up with several policies that aim at reducing the incidence of SIDS within their nations.
Despite the fact that the policies that have been developed vary from one nation to another, most of the nations across the globe have developed the policies that enhance pre-natal and post-natal care.
SIDS is a condition that mainly affects children who are under one year old. In this age bracket, the level of healthcare offered to such a child before and after birth is essential. With effective pre-natal and post-natal exercises, mothers will be able to enhance their health and diet during pregnancy.
This will increase the chances of giving birth to a healthy baby who is not susceptible to opportunistic diseases. Consequently, through post-natal care, the health of the new born baby will be monitored through frequent clinic visits.
If a child is diagnosed with any health complications, preventive measures will be taken early enough before becoming fatal. Consequently, a child will be immunized against various diseases that are known to affect the health of children hence leading to death.
Through research, several practices have been developed to prevent SIDS. These practices aim at reducing the risk at which children might be involved in during their process of growth and development.
Putting a baby to sleep on his/her back is one of the most effective measures that can be used to reduce the occurrence of SIDS (Mage, 2004). Initially, it was advised that a baby should be put to sleep on the side. However, this position is risky since a baby can roll over and put his/her face in the mattress.
This will in turn lead to chocking hence leading to the death of the baby. This realization led to the development of the Back to Sleep campaign that drastically reduced the rates of SIDS in developing nations by about 66%.
This campaign aimed at creating the awareness regarding to SIDS and the importance of putting a baby to sleep on his/her back. This campaign targeted parents, grandparents, siblings, nannies, and any other individual who might be taking care of a baby.
The message of this campaign was simple; ensure that a baby sleeps on his/her back at all times. This includes during the day, at night, and after meals. However, there were concerns regarding chocking from fluids or saliva when a baby is sleeping in this position.
To overcome this shortcoming, this strategy advocated that a baby’s head should be elevated during sleep. In such a position, a child can easily swallow or drool any fluids that come out of his/her mouth.
Consequently, it is advised that children should sleep on a hardened surface. For instance, the use of a safety approved mattress is highly recommended. Despite the fact that this mattress might be stiff, it is very comfortable for a child.
Parents should also avoid putting additional materials such as extra blankets, stuffed animals, pillows and crib bumpers in the sleeping area of children. These materials might result in the suffocation of a child leading to his/her death.
Another measure that can be taken to reduce the incidence of SIDS is to ensure that a child sleeps close to an adult but not in the same bed. However, a mother can share the bed with a child for feeding and breastfeeding purposes after which, the child should be taken back to his/her own crib.
This practice is essential as it reduces the risk of another individual suffocating a child during sleep. Breastfeeding is also encouraged especially during the first six months after birth. Despite the fact that the effects of breastfeeding with regards to SIDS are not quite known, it is believed that it reduces the risk factors and infections that might result to SIDS.
A child should also be immunized against various diseases and kept away from extreme temperatures. Smoking during pregnancy or around the baby should also be discouraged.
The Role of Community Health Nurses
Community health nurses (CHN) play a significant role in fighting against SIDS. CHNs are the direct care providers within a given community. It is thus their role to ensure that members of a given community are provided with the best healthcare services.
In this respect, CHNs should utilize their knowledge, skills, and expertise to ensure that they provide their clients with the best health services.
Consequently, the actions of CHNs should be guided by the codes of ethics and standards. For instance, CHNs are not supposed to discriminate their patients on the grounds of race, religion, or economic success (Vanderford, 2009).
CHNs also act as the health educators within a given community. It is thus their role to decimate the knowledge and information that they have with regards to SIDS to community members.
To achieve this goal, CHNs usually organize seminars, workshops, and short courses that aim at creating SIDS awareness to the members of the public. This information is essential as it empowers the members of the public to put in place measures that will reduce the occurrence of SIDS.
Finally, CHNs act as the health counselors and advisors within a given community. It is their role to advise the members of the public on the best health practices that they can use to prevent SIDS. Examples of such practices include breastfeeding, proper sleeping strategies, the impacts of smoking, and so on.
CHNs also counsel the parents, friends, and relatives of individuals who have lost a child as a result of SIDS. This will encourage such individuals to have the motivation to move on with their lives and take proper care of their other children.
As it has been stated, different nations put in place different measures to prevent the occurrence of SIDS. As a result, the budgetary considerations vary depending on the nature of the project, its incidence, and the expected outcomes.
Despite this fact, a lot of money has been used in research and project implementation all around the world. These initiatives have however been successful in reducing the levels of SIDS all around the world.
Conclusion, Recommendation, and Evaluation
SIDS is one of the leading factors that cause death of children who are less than one year old. Due to this fact, therefore, several measures have been put in place to put this condition under control.
Therefore, to ensure that this condition is put under control, I would advocate for increased research to ensure that the specific causal factors of SIDS are determined. This will ensure that the condition can be controlled more effectively.
Consequently, I will advocate for increased education as a means of empowering the public on the condition. With relevant knowledge and skills, members of the public will be in a position to implement effectively and efficiently preventive measures that will ultimately reduce the occurrence of SIDS.
To determine the effectiveness of these recommendations, I will monitor the number of studies that have been taken on this topic and the number of SIDS project all around the world. Research in this topic is essential since it will increase the knowledge that professionals have on the topic.
As a result, better measures will be put in place to the condition under control. Furthermore, I will monitor the trends in SIDS statistic to determine whether the numbers of fatalities are increasing or reducing.
An increase in the number of fatalities as a result of SIDS is an indicator that the measures that have been put in place to control the condition are not working.
On the other hand, a decline in the number of deaths as a result of this condition is an indicator of the effectiveness of the measures that have been put in place. Therefore, it will be the objective of the measures that have been put in place to ensure that a decline in death rates is realized.
References
Dick, A. (2009). Incidence of SIDS in Infants. Acta Paediatr, 98(11), 1768–75.
Mage, D. (2004). Trends of SIDS in the 21st Century. JSTOR, 1(2), 1210–5.
Vanderford, J. (2009). Physiological factors that affect Health in Children. Arch Pediatr Adolesc Med, 163(5), 490-1.