Increase in unexpected infant deaths from fenua, pediatricians warn • TNTV Tahiti Nui Télévision

The baby should be placed on his back, on a firm mattress and in a suitable crib, with nothing around to prevent suffocation. (Photo credit: Tahiti Nui Television)

In 2023, the Hospital Center of French Polynesia (CHPF) recorded 6 unexpected infant deaths (IMN) out of just over 3000 births in Tahiti and Moorea. A significant figure that continues to increase over the course of three years in Fenua. Most of these deaths occur during the first six months of a child’s life. “We need to act before this becomes more important.” warns Charlene Lake, CHPF pediatrician.

Unexpected infant death is defined by Santé Publique France as “the sudden death of a child between 1 month and 1 year of age, previously in good health, when none of its known antecedents or historical facts could have done so. it can be predicted. (…) Unexpected death of an infant remains the leading cause of death in infants under one year of age.” Deaths that most often occur while the child is sleeping. “Among the leading causes of unexpected deaths are: sleeping with children who suffocate in their sleep; viruses or bacteria; and smoking. And when we can’t find a cause, despite all the research we’ve done, we talk about sudden infant death syndrome.” – says Charlene Lake, pediatrician at CHPF.

Today, sleep remains a leading cause of unexpected infant mortality, as does smoking: “The New Zealanders have shown that during pregnancy, nicotine and tobacco particles attach to receptor centers in the brain that are supposed to wake up when we have sleep apnea and tell us that we need to breathe, and so they retrain the breathing movements. When you smoke during pregnancy, these nicotine particles will enter the baby’s brain and lower the apnea threshold, meaning babies may experience more severe apneas and respiratory arrests. This risk also exists after pregnancy when you smoke around your baby.”.

There is no unexpected center of child mortality in Polynesia

In France, every child who dies from an IND is transferred to the Unexpected Death Center, where post-mortem diagnostic tests are carried out and where support is provided to the parents. In addition, the National Observatory of Unexpected Child Deaths studies and evaluates INDs in France.

Among the Fenui, centers of this type do not exist. When a child dies, an investigation begins to determine whether an autopsy should be performed or not. “So we don’t have all the data on all infant deaths, especially on the islands.” the pediatrician regrets.

To safely put a child to sleep, pediatricians remind, during the first year of life: place the newborn on his back, on a firm and not too soft mattress, there should be nothing around him: no pillows, no knees, no wicker, no blankets, soft toys or blankets… which may prevent proper air circulation: ” The baby does not have the opportunity, like an adult, to remove what is on his face at night, or to push an adult who will prevent him from breathing normally.. As soon as the baby learns to turn independently in both directions, he can be left on his stomach.

Bad sleep habits

“In the 80s, children were put to sleep on their stomachs. Simply by changing this position and putting them back on their back, you reduced the number of unexpected sleep-related infant deaths by 75%. remembers Charlene Lake.

“Most mothers tend to cover their children with blankets too much, even up to their faces. We tell them once, but they don’t correct it right away. You will have to remind them several times. I think it’s a little bit in the Polynesian culture. And when grandparents are nearby, it’s even more difficult to convince them! The child doesn’t really need to be covered, a sleeping bag is enough.” points out Florence Tevearai, nurse assistant at CHPF. Indeed, if you are afraid that your baby will get cold, you can put him in two pajamas or even in a sleeping bag.

New Zealand example

Also be careful when placing a baby between parents in the same bed. Is it dangerous: “When we ask families in maternity hospitals how their baby will sleep, they often co-sleep, meaning in the bed with both parents. We would like to find solutions to make it a safe place to sleep, even if breastfeeding is sometimes easier to avoid adding a bassinet to the room at home. But you don’t need a pillow or blanket between mom and dad, because dads usually sleep harder than moms at night and are at greater risk of crushing the baby… There should be room in the crib for the baby to be well laid down. » – the pediatrician explains again.

To solve this sleep problem, CHPF is working with the Order of Malta to weave paore cradles for babies who can go to bed between two parents. The cradles, which will be donated to families in need, “We are also working with prisoners from Papeari to make small mattresses that can be placed in cribs.”. Braiding workshops at CHPF should subsequently be offered to mothers during pregnancy.