Tag Archives: infant death

Baby Safety: The 2 Leading Causes of Death and How You Can Prevent Them

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Safe to Sleep® campaign, baby safety, SIDS

Image courtesy of the Safe to Sleep® campaign

Recently I was asked to speak at a childbirth education class at my local hospital. I love talking to expecting parents as it brings back my own memories of that time: the excitement, hopes, fears…My topic tonight was baby safety.  I want to share this information with you as well.

1- SIDS (Sudden Infant Death Syndrome) and accidental suffocation is the leading cause of death in infants in the U.S. from 1 month to 1 year old.  Your child’s sleep environment is the most important thing you can control to keep your baby safe.  It is important that your baby always sleeps on her back on a firm surface with no crib bumpers, pillows (or breastfeeding pillows), sleep positioners or soft bedding. The safest place for your baby is in a crib that is in your room for the first 6 months. Breastfeeding is also associated with a lower risk of SIDS. If you choose to have your baby sleep in bed with you it is really important to keep in mind the risks and what makes a sleep surface safe.

Our first child was a really fussy baby and we did end up sleeping with her occasionally during her fussiest months (1-3 months). It is not something I recommend to others, but it was a decision we made out of desperation and with all of the risks in mind. We have a firm mattress (pillowtop removed), we slept with no pillows or blankets, and we placed her in the middle of a king size bed. This would have been especially dangerous if there were any other risk factors for SIDS (secondhand smoke, obesity, alcohol or drug use, or pain medications). We never let her sleep on her stomach and we never slept on a couch or chair with her. Sanity trumped absolute safety in our house, but we did our best.

For more information on SIDS prevention and safe sleeping please go to Safe to Sleep.

2- The leading cause of death in infants 1 month to 1 year worldwide is respiratory infections, including pneumonia and influenza. Thankfully in the U.S. we have free access to vaccinations. Unfortunately our vaccination rates in many areas of the country are below 90% and we can’t protect our infants unless everyone they are surrounded by is fully vaccinated. We also have access to clean water. Good hand washing can be very effective in reducing the spread of disease. Unfortunately not everyone (especially young children) does a great job of washing their hands after coughing, sneezing, wiping their noses, or using the restroom.

So what can you do to keep your baby safe from infection?

  • Remind people to wash their hands or use hand sanitizer before touching your baby.
  • Ask people who are sick to visit another time. The first sign of many illnesses that can be dangerous to your baby is just a clear runny nose (whooping cough, measles, RSV…).
  • Make sure anyone who is around your baby is fully vaccinated. This should include a yearly influenza shot and whooping cough (pertussis) booster.
  • Avoid crowded places for the first few months. If you have to go somewhere crowded try to keep your baby in an infant carrier or stroller with a blanket thrown over the top. Carry hand sanitizer and avoid anyone that looks like a grandma! She will want to touch your baby 🙂

For more information go to the AAP (American Academy of Pediatrics)

So I am curious (and maybe neurotically overprotective based on my career choice): Do you ask your friends and family to stay away if they are sick? Do you ask them if they are vaccinated before they come visit your newborn? How do they react?

 

A Pediatrician’s Survival Story: Remembering the Children

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pediatrician, pediatric residency, child death, infant death
Photo by geishaboy500, Flickr Creative Commons

I have just turned on my computer. It is midnight. I should be trying to sleep right now.

My 5 year old is sick and I am on call for the next few nights. Fortunately, my daughter should get better in a day or two. She needs Tylenol for her fever, mama’s love and time to kick this virus. But as I sat in bed holding her and waiting for her fever to break, the memories of other sick children started to come back. I completed my pediatric training over 10 years ago. I have repressed the memories of that time for so long now. Slowly, painfully they have started to come back. I lived a different life then, and it almost broke me.

I went into pediatrics because it was the only thing I was passionate about. When I entered medical school I was determined to do anything but pediatrics because I was so crazy about kids; I didn’t  think I could handle children hurting and dying every day. As I went through my rotations: emergency medicine, family medicine, obstetrics, surgery; I quickly learned that I was always drawn to the children. As it turns out I am amazingly calm under pressure, and the intensity of taking care of severely ill or injured children was something I was really good at. I ended up matching at my first choice program at the Children’s Hospital of the Kings Daughters in Virginia. Then my life took a detour.

My intern year I married and divorced. I married someone who was broken, but trying to put himself back together. And I was just starting to break. During that time I learned about how resilient a child can be, but I also saw the cruelty of cancer, AIDS, whooping cough, lupus, drownings, child abuse… The lack of sleep, unrelenting hours, and the pain and death around me took huge tolls on my mind and my body. I gained weight, I felt angry, I felt sad, I felt anxious, and I stopped crying my intern year. I finally ended up on antidepressants. On my rare weekend off I drank and danced until the wee hours of the morning. The day after residency ended I hopped on a plane to California. I left my memories and my medication behind, and my new life began. I was 30 years old.

It took a few days to start living and eating healthier. It took almost 2 years for the anxiety to dissipate. It was probably 3 years before I cried again.

My friends here don’t know the “before” me. I have never drank my sadness away here. I have never danced on a table to forget the pain. I am thankfully quite boring now. I run or hike almost every day. I am a loving mother and kind wife. I am a better daughter. I have thought for years about how much I disliked the person I became in training. But the truth was I was a survivor. I always have been and I always will be. I believe I am strong enough to let the memories come back now. I can picture some of the kids faces now. I can hear their words. I remember hugging them. But I still can’t picture the parent’s faces. As a mother there is a limit to how much pain I can process. The pain of a parent losing a child is too personal. Maybe that memory will come back in another decade. I kind of hope it doesn’t.

When I started writing this I thought I would share some of my memories of the tragedies I experienced within the walls of that hospital. It turns out that they are still too personal for me. It is enough for me to know that I remember now. And I am better now. As for the parents of those children lost, please know that everyone who cared for your child was forever changed by the experience. We loved them too. Pediatricians did not choose this field of medicine for money or for glory. We chose this field because we wanted to heal children. There is a part of us that breaks every time that we can not. I may not always remember, but I will ultimately never forget.

Previously published on KevinMD.com, February 22, 2014

I want to thank my strong and compassionate friend Sheila Cason. She first wrote about her experiences on her blog, DrCason.org, years ago. Many of her memories were also my memories. I just wasn’t ready to face them yet.

I would also like to thank Dr. Nadia Wasylyshyn at the Children Hospital of the Kings Daughters. She was a great source of support for so many of us through those tough years. The high rates of depression and burnout are well documented for physicians in training. It is so important to find someone to talk to.