Baby Sleeping Bag and Conventional Bedding Conditions – Comparative Investigations by Infrared Thermography

Abstract

Background: Thermal stress is a risk factor for sudden infant death syndrome (SIDS). Recently, baby sleeping bags have been recommended as a preventive measure against SIDS. The aim of this study was to describe in which way the use of baby sleeping bags might influence thermoregulation of sleeping infants and maybe the incidence of SIDS.

Methods: Body surface temperature was recorded by use of infrared thermography in 15 infants (median age 49 days). Recordings were done twice: after sleeping for 60 min under a blanket and after sleeping for 60 min in a baby sleeping bag. Temperature was recorded and compared for defined sites of body surface.

Results: Infants’ mean body surface temperature as well as core temperature after sleeping in a baby sleeping bag did not show significant differences when compared to infants sleeping under a conventional blanket.

Conclusion: Under controlled conditions, core temperature and mean body surface temperature are comparable, equally if using a baby sleeping bag or conventional bedding. However, under the more uncontrolled conditions of baby care at home, sleeping bags might provide a more constant temperature profile, while other bedding conditions may lead to significant variations of temperature pattern.

Zusammenfassung

Hintergrund: Überwärmung ist ein Risikofaktor für den Plötzlichen Säuglingstod (SIDS). Neuerdings wird die Verwendung von Baby-Schlafsäcken als Präventionsmaßnahme empfohlen. Das Ziel dieser Studie war es herauszufinden, ob und inwieweit Baby-Schlafsäcke die Thermoregulation von schlafenden Säuglingen beeinflussen.

Methoden: Das Temperaturprofil von 15 schlafenden Säuglingen (medianes Alter: 49 Tage) wurde mittels Infrarot-Thermografie nach jeweils 60 Minuten Schlaf unter einer Decke bzw. einem Baby-Schlafsack vergleichend untersucht.

Ergebnisse: Sowohl die Oberflächentemperatur als auch die Körperkerntemperatur von Säuglingen zeigten bei Verwendung einer Decke bzw. eines Schlafsacks mit vergleichbarem Wärmekoeffizienten keine signifikanten Unterschiede.

Schlussfolgerungen: Unter kontrollierten Bedingungen sind Oberflächentemperatur und Körperkerntemperatur nach Schlaf im Baby-Schlafsack und unter einer Decke vergleichbar. Unter den weniger kontrollierten Bedingungen der häuslichen Pflege können Baby-Schlafsäcke jedoch vermutlich ein konstanteres Temperaturprofil und eine geringere Streuung der Werte bewirken als konventionelle Säuglingsdecken.

Key words

bedding - baby sleeping bag - body surface temperature - infrared thermography - SIDS

Schlüsselwörter

Baby-Schlafsack - Oberflächentemperatur - Infrarot-Thermografie - SIDS

References

• 1 Arkell S, Blair P, Henderson J. et al . Is the mattress important in helping babies keep warm? – Paradoxical effects of a sleeping surface with negligible thermal resistance.  Acta Paediatr. 2007;  96 199-205
• 2 Blair PS, Sidebotham P, Berry PJ. et al . Major epidemiological changes in sudden infant death syndrome: a 20-year population-based study in the UK.  Lancet. 2006;  367 314-319
• 3 Christidis I, Zotter H, Rosegger H. et al . Infrared thermography in newborns: The first hour after birth.  Gynakol Geburtshilfliche Rundsch. 2003;  43 31-35
• 4 Einspieler C, Löscher WN, Kurz R. et al . The Graz SIDS Risk Questionnaire: prospective study of 6 000 infants.  Klin Padiatr. 1992;  204 88-91
• 5 Fleming PJ, Azaz Y, Wigfield R. Development of thermoregulation in infancy: possible implications for SIDS.  J Clin Pathol. 1992;  45 17-19
• 6 Fleming PJ, Gilbert R, Azaz Y. et al . Interaction between bedding and sleeping position in the sudden infant death syndrome: a population based case-control study.  BMJ. 1990;  301 85-89
• 7 Fleming PJ, Levine MR, Azaz Y. et al . Interactions between thermoregulation and control of respiration in infants: possible relationship to sudden infant death.  Acta Paediatr Suppl. 1993;  389 57-59
• 8 Frankenberger RT, Bussmann O, Nahm W. et al . Measuring lateral skin temperature profile of preterm infants in incubators with thermography.  Biomed Tech (Berl). 1998;  43 174-178
• 9 Grover G, Berkowitz CD, Lewis RJ. et al . The effects of bundling on infant temperature.  Pediatrics. 1994;  94 669-673
• 10 Gunteroth WG, Spiers PS. Thermal stress in sudden infant death: Is there an ambiguity with the rebreathing hypothesis?.  Pediatrics. 2001;  107 693-698
• 11 Hauck FR, Tanabe KO. International trends in sudden infant death syndrome: stabilization of rates requires further action.  Pediatrics. 2008;  122 660-666
• 12 Hunt CE, Hauck FR. Sudden infant death syndrome.  CMAJ. 2006;  174 1861-1869
• 13 James C, Klenka H, Manning D. Sudden infant death syndrome: bed sharing with mothers who smoke.  Arch Dis Child. 2003;  88 112-113
• 14 Kahraman L, Thach BT. Inhibitory effects of hyperthermia on mechanisms involved in autoresuscitation from hypoxic apnea in mice: a model for thermal stress causing SIDS.  J Appl Physiol. 2004;  97 669-674
• 15 Kerbl R, Schwinger W, Lackner H. et al . Peripheral harlequin-like thermal imbalance after Wilms’ tumor.  J Pediatr. 2000;  204 355-358
• 16 Kerbl R, Zotter H, Einspieler C. et al . Classification of sudden infant death (SID) cases in a multidisciplinary setting. Ten years experience in Styria (Austria).  Wien Klin Wochenschr. 2003;  115 887-893
• 17 Kinney HC, Thach BT. The sudden infant death syndrome.  N Engl J Med. 2009;  361 795-805
• 18 L’Hoir MP, Engelberts AC, van Well GT. et al . Risk and preventive factors for cot death in The Netherlands, a low-incidence country.  Eur J Pediatr. 1998;  157 681-688
• 19 Mitchell EA. SIDS: past, present and future.  Acta Paediatr. 2009;  98 1712-1719
• 20 Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome.  Lancet. 2007;  370 1578-1587
• 21 Nelson EA, Taylor BJ, Weatherall IL. Sleeping position and infant bedding may predispose to hyperthermia and the sudden infant death syndrome.  Lancet. 1989;  28 199-201
• 22 Nelson EA, Wong Y, Yu LM. et al . Effects of hyperthermia and muramyl dipeptide on IL-1beta, IL-6, and mortality in a neonatal rat model.  Pediatr Res. 2002;  52 886-891
• 23 Nennstiel-Ratzel U, Hölscher G, Ehrensperger-Reeh P. et al . Prevention of Sudden Infant Death Syndrome (SIDS) in Bavaria – evaluation of a prevention campaign.  Klin Padiatr. 2010;  222 45-50
• 24 Oriot D, Berthier M, Saulnier JP. et al . Prone position may increase temperature around the head of the infant.  Acta Paediatr. 1998;  87 1005-1007
• 25 Ponsonby AL, Dwyer T, Gibbons LE. et al . Factors potentiating the risk of sudden infant death syndrome associated with the prone position.  NEJM. 1993;  329 377-382
• 26 Sauseng W, Zotter H, Thaller S. et al . A new method to evaluate nicotine exposure in infants.  Eur J Pediatr. 2005;  164 188-189
• 27 Scheers-Masters JR, Schootman M, Thach BT. Heat stress and sudden infant death syndrome incidence: A United States population epidemiologic study.  Pediatrics. 2004;  113 586-592
• 28 Scragg R, Mitchell EA, Taylor BJ. et al . Bed sharing, smoking, and alcohol in the sudden infant death syndrome. New Zealand Cot Death Study Group.  BMJ. 1993;  307 1312-1318
• 29 Tuffnell CS, Petersen SA, Wailoo MP. Higher rectal temperatures in co-sleeping infants.  Arch Dis Child. 1996;  75 249-250
• 30 Tuffnell CS, Petersen SA, Wailoo MP. Prone sleeping infants have a reduced ability to lose heat.  Early Hum Dev. 1995;  43 109-116
• 31 Vennemann MM, Bajanowski T, Brinkmann B. et al.GeSID Study Group . Sleep environment risk factors for sudden infant death syndrome: the German Sudden Infant Death Syndrome Study.  Pediatrics. 2009;  123 1162-1170
• 32 Wilson CA, Chu MS. Thermal insulation and SIDS – an investigation of selected “Eastern” and “Western” infant bedding combinations.  Early Hum Dev. 2005;  81 695-709
• 33 Zotter H, Kerbl R, Gallistl S. et al . Rewarming index of the lower leg assessed by infrared thermography in adolescents with type 1 Diabetes mellitus.  J Pediatr Endocrinol Metab. 2003;  16 1257-1262
• 34 Zotter H, Kerbl R, Schwantzer G. et al . Sudden infant death syndrome risk questionnaire: a mirror of parental awareness rather than a prospective diagnostic tool.  Acta Paediatr. 2004;  93 255-257

Correspondence