EAS Nelson

Department of Health data shows that from 1980 -1992 there were on average 210 postneonatal deaths per annum in Hong Kong. 8 of these deaths were classified as sudden infant death syndrome (SIDS) or aspiration, but a prospective study by Lee et al suggested that the actually number of cot deaths are twice this number. Over 8 countries worldwide have started national campaigns to "Reduce the Risks" of cot death and have subsequently seen cot death rates fall by 50% or more. These campaigns have varied in exact content but in general contain advice on "modifiable" SIDS risk factors identified in case-control studies. The most consistent and important risk factor identified is prone or stomach sleep position. Hong Kong mothers are reluctant to use the prone sleep position and this undoubtedly contributes to the low rate of SIDS seen in the Territory. Other modifiable risk factors include: mothers who smoke, mothers who don't breast feed, mothers who share a bed with the baby, overwrapping or overheating the baby, and using soft underbedding. Lack of breast feeding and bedsharing are unlikely to be important risk factors within the Hong Kong context. However increasing trends to the use of Western style cots and bedding may be undesirable e.g. a change from traditional firm rattan undermats to softer cot mattresses surrounded by soft padded cot boarders. In addition certain cot designs have been demonstrated to be unsafe. It is therefore proposed that information be provided to all mothers on the known risk factors for cot death. This would be achieved through the media and by distributing an information leaflet to postnatal mothers. The proposed leaflet will be shown and discussion on the appropriateness of such a campaign and on the information given will be sought from Hong Kong's paediatric community.