"Car Seats Can Kill Sleeping Babies, Coronor Warns
Advice follows investigation into death by asphyxiation of two-month-old Quebec boy
LES PERREAUX
From Thursday's Globe and Mail
February 5, 2009 at 4:45 AM EST
MONTREAL - For many parents, the baby's car seat has long been a magical spot where even the fussiest infant would finally drift off to a peaceful slumber.
But a Quebec coroner who examined the sudden death of a two-month-old boy has issued a stark warning: Parents who leave their newborns semi-reclined in car seats for hours on end are putting them at higher risk of sudden death by asphyxiation.
Coroner Jacques Robinson published the warning yesterday in his report on a baby's death in a car seat one year ago at a family home in the Montreal suburb of Pointe-Claire.
The colicky baby's mother found the car seat was an effective way to get the boy to drift off, so she left him in it overnight, with the seat and baby placed in his bassinette. The mother rose at 3 a.m. to feed the baby and again at 6 a.m. when he started to cry.
When the boy did not wake at his usual 7 a.m. time, the mother discovered he wasn't breathing and had white, waxy skin. The boy's parents and emergency responders tried to resuscitate him without success.
"Car seats are named that for a reason. They're not for the house, they're not meant to replace a crib, and they're not meant to be left in a bassinette," Dr. Robinson said in an interview.
Properly installed infant car seats are set at a precise angle, usually 45 degrees, to balance head support against safety in a collision.
But more than a couple of hours sitting at any angle is too much for a newborn, Dr. Robinson said.
"A baby sitting, or semi-sitting, even at an angle of 30 degrees, does not have the strength to keep his head straight, and it's easy for his airway to be blocked."
Dr. Robinson emphasized that a car seat is still vital for transporting babies in vehicles but he said long trips should be broken up every couple of hours. Even babies need a break to stretch and change positions, he said.
"A couple hours is fine. Overnight is not fine," Dr. Robinson said.
Researchers at the coroner's office went back 15 years analyzing babies who died from sudden infant death syndrome and found 15 to 20 deaths might have been triggered by sleeping sitting or semi-reclined.
Separate studies by Quebec and New Zealand researchers in 2006 analyzed deaths among babies under 12 months and found an increased likelihood of death in car seats.
The Quebec study examined unexplained deaths from 1991 to 2000. Ten of 409 unexplained deaths among children under 12 months occurred while the tots were in "sitting positions." But the rate rose dramatically to five out of 49 among babies under one month old. Dr. Robinson acknowledged the numbers are small but he argued the deaths are easily preventable.
The warning about car seats adds to a growing list of warnings about potential causes of sudden infant death syndrome. Parents are now advised to avoid letting infants sleep on their stomachs, or in cribs crowded with soft objects. Sleeping in the same bed as adults or other children is another no-no.
"It's always best for babies to sleep in a crib that meets Canadian safety standards," said Lisa Lipkin, a spokeswoman with Safe Kids Canada.
Dr. Robinson offered more detailed instructions: "A baby sleeps on his back, on a firm mattress, in his own bed, with no objects in the bed with him, not even covers, if it's possible."
The frequency of sudden infant deaths has fallen by 50 per cent as parents have increasingly heeded the updated advice, Dr. Robinson said.
But common practice and expert opinion are not completely in sync. Unfortunately several online baby-advice sites refer to the car seat as a great tool to put babies to sleep for extended naps."
