Çocuk Polikliniğinde İzlenen Bebeklerin Uyuma Pozisyonlarının Değerlendirilmesi

Öz

Amaç: Pek çok ülkede Ani Bebek Ölümü Sendromu sıklığını azaltmak için bebeklerin sırtüstü yatırılmaları yönünde kampanyalar düzenlenmektedir. Ülkemizde ise bebeklerin hangi pozisyonda yatırıldıklarına dair yeterli veri bulunmamaktadır. Bu çalışmada çocuk polikliniğinde izlenen bebeklerin uyuma pozisyonlarının incelenmesi amaçlanmıştır. Yöntemler: Ocak 2005 ile Mayıs 2005 tarihleri arasında 6 aylıktan küçük bebeklerin annelerine anket uygulanarak elde edilen veriler incelendi. Bulgular: Toplam 102 bebek çalışmaya alındı. Ortalama yaş 92± 52.7 gündü. Bebeklerin % 45.1’i yan pozisyonda yatırılırken, % 24.5’i sırtüstü, % 23.5’i bazen yan bazen sırtüstü, % 6.9’u ise yüzüstü yatırılmaktaydı. Bebeklerin uyuma pozisyonları belirlenirken % 53.9 oranında sağlık çalışanları, % 11.8 medya, % 6.9 ise aile büyüklerinin etkili olduğu saptandı. Sonuç: Bu çalışmada bebeklerin büyük oranda ani bebek ölümü sendromu riski yüksek olan pozisyonlarda yatırıldıkları saptanmıştır. Sağlık çalışanlarının ve ailelerin bebeklerin uyuma pozisyonunun önemi hakkında bilgilendirilmelerinin gerekli olduğu görülmektedir.

Anahtar Kelimeler

• Bebek,uyuma pozisyonu,Ani Bebek

Assessment of Sleeping Positions of Infants Followed-up in a Pediatric Outpatient Clinic

Öz

Objective: In many countries campaigns were launched in favour of supine positioning of the infants to decrease the prevelance of the sudden infant death syndrome. There are few data about the sleeping positions of the babies in our country. We aimed to determine the sleeping positions of the infants in our pediatric outpatient clinics. Methods: Our cases comprised 102 infants followed-up in our pediatric outpatient clinics. Data was collected through questionnaires completed by their mothers. Results: Lateral 45.1 % supine 24.5 % , alternatively supine or lateral 23.5 % and prone 6.9 % sleeping positions were reported by the mothers. The factors that affect the sleeping positions of the infants included the recommendations of the doctors and nurses 53.9 % , media 11.8 % and grandparents 6.9 % . Conclusion: It was found that the sleeping positions of the babies in this study were highly risky for sudden infant death syndrome. Health care providers and parents should be instructed about the importance of sleeping positions of the babies.

Anahtar Kelimeler

• Infant,sleeping position,sudden infant death syndrome

Kaynakça

1. 1. Gökçe S, Baysal SU. Ani bebek ölümü sendromu, İst Tıp Fak Mecmuası 2004; 67:56-61.
2. 2. Shields LB, Hunsaker DM, Muldoon S, et al. Risk factors associated with sudden unexplained infant death: a prospective study of infant care practices in Kentucky, Pediatrics 2005; 116:13-20. http://dx.doi.org/10.1542/peds.2004-2333 PMid:15995014
3. 3. Horne RS, Witcombe NB, Yiallourou SR, et al. Cardiovascular control during sleep in infants: implications for sudden infant death syndrome, Sleep Med 2010;11:615– 21. http://dx.doi.org/10.1016/j.sleep.2009.10.008 PMid:20609624
4. 4. Sahni R, Fifer WP, Myers MM. Identifying infants at risk for sudden infant death syndrome, Curr Opin Pediatr 2007;19:145-9. http://dx.doi.org/10.1097/MOP.0b013e32808373b6 PMid:17496756
5. 5. Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome, Lancet 2007;370:1578-87. http://dx.doi.org/10.1016/S0140-6736(07)61662-6
6. 6. Haycock G. Recent research in sudden infant death syndrome, J Fam Health Care 2007;17:149-51. PMid:17990653
7. 7. Hunt CE. Sudden infant death syndrome, In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 17th ed. Philadelphia: Saunders, 2004:1380-5.
8. 8. Gibson E, Dembofsky CA, Rubin S, Greenspan JS. Infant sleep position practices 2 years into the “back to sleep” cam- paign, Clin Pediatr 2000;39(5):285-9. http://dx.doi.org/10.1177/000992280003900505 PMid:10826076

9. 9. Kattwinkel J, Brooks JG, Keenan ME, Malloy M. Changing concepts of sudden infant death syndrome: Implications for infant sleeping environment and sleep position, Pediatrics 2000;105:650-6. http://dx.doi.org/10.1542/peds.105.3.650
10. 10. Moon RY, Oden RP, Grandy KC. Back to sleep: an educational intervention with women, infants, and children program clients, Pediatrics 2004;113:542-7. http://dx.doi.org/10.1542/peds.113.3.542 PMid:14993547
11. 11. Lindgren C, Thompson JM, Haggblom L, et al. Sleeping position, brestfeeding, bedsharing and passive smoking in 3-month-old Swedish infants, Acta Paediatr 1998;87:1028- 32. http://dx.doi.org/10.1080/080352598750031329 PMid:9825967
12. 12. Carpenter RG, Irgens LM, Blair PS, et al. Sudden unexplained infant death in 20 regions ın europe: case control study, Lancet 2004;363:185-91. http://dx.doi.org/10.1016/S0140-6736(03)15323-8
13. 13. Bradford D, Gessner GC, Ives A, et al. Association between sudden infant death syndrome and prone sleep position, bedsharing and sleeping outside an infant crip in alaska, Pediatrics 2001;108:923-7. http://dx.doi.org/10.1542/peds.108.4.923 PMid:11581445
14. 14. Moon RY, Oden RP, Grandy KC. Back to sleep: an educational intervention with women, infants, and children program clients, Pediatrics 2004;113:542-7. http://dx.doi.org/10.1542/peds.113.3.542 PMid:14993547
15. 15. Willinger M, Ko CW, Hoffman HJ, et al. Factors associated with caregivers choice of infant sleep position, 1994-1998: the national infant sleep position study, JAMA 2000;283:2135- 42. PMid:12671114
16. 16. Moon RY, Weese DE, Silvestri JM, et al. Nighttime child care: inadeguate sudden infant death syndrome risk factor knowledge, practice, and policies, Pediatrics 2003;111:795-9. http://dx.doi.org/10.1542/peds.111.4.795 PMid:10400554
17. 17. Schlaud M, Eberhard C, Trumann B, et al. Prevalence and determinants of prone sleeping position in infants: result two cross-sectional studies on risk factors for SIDS in Germany, Am J Epidemiol 1999;150:51-7.
18. 18. Koturoğlu G, Akşit S, Kurugöl Z. Ege Üniversitesi Tıp Fakültesi Çocuk Polikliniği’nde izlenen bebeklerin yatış pozisyonunun değerlendirilmesi, Tur Ped Ars 2004;39:78-82. PMid:16027691
19. 19. Tappin D, Ecop R, Brooke H. Bedsharing, roomsharing and sudden infant death syndrome in Scotland: a case-control study, J Pediatrcs 2005;147:32-7. http://dx.doi.org/10.1016/j.jpeds.2005.01.035
20. 20. Scragg RK, Mitchell EA, Ford RP, et al. Infant roomsharing and prone sleep position in sudden infant death syndrome, Lancet 1996;347:7-12. http://dx.doi.org/10.1016/S0140-6736(96)91554-8 PMid:16027684
21. 21. Thach BT. Where sould baby be put back to sleep, J Pediatr 2005;147:32-7. http://dx.doi.org/10.1016/j.jpeds.2005.03.049 PMid:11230595
22. 22. Hein HA, Pettit SF. Back to sleep: good advice for parents but not for hospitals, Pediatrics 2001;107:537-9. http://dx.doi.org/10.1542/peds.107.3.537 PMid:11927712
23. 23. Malloy MH. Trends in postneonatal aspiration deaths and reclassification of sudden infant death syndrome: impact of the “back to sleep” program, Pediatrics 2002;109:661-5. http://dx.doi.org/10.1542/peds.109.4.661 PMid:10791506
24. 24. Dattani N, Bhat R, Rafferty GF, Hannam S, Greenough A. Survey of sleeping position recommendations for prematurely born infants (Accessed Sep18, 2010, at http://www.springerlink.com/content/wu534q4702571014/fulltext.pdf).