Abstract â–¡ 21

Introduction - This study is based on the hypothesis that SIDS may be an unrecognised but significant problem in countries where prone sleeping is still prevalent. A previous study on child care noted a relatively high rate of prone sleeping in Buenos Aires, Argentina, together with a significant incidence of SIDS. This prompted a successful low-cost "Link" programme between New Zealand and Argentina to raise awareness of SIDS and advise "boca arriba" (face up) The initial success of this programme has highlighted the potential for similar cost-effect interventions to be implemented in other countries. Infant sleep position advice given to new mothers in a wide range of countries in Europe and Latin America will be documented.

Methods - The study will utilise the collaborative network of WHO to obtain a sample of maternity units/hospitals with more than 1000 births per annum. A country coordinator will be responsible for liasing with Health Departments and distributing a questionnaire to each participating hospital. The questionnaire will seek information on how babies are placed for sleep in the special care units and normal care units, whether the hospital recommends a best sleep position for babies, and whether there is printed information and a written policy on this. In addition information will be sought on other aspects of child care related to SIDS including: room-sharing and bed-sharing; clothing, bedding and restraint; dummy use; immunisation; and breast feeding. Epilnfo statistical software (CDC Atlanta and WHO) will be used for data-entry and checking.

Timetable - Country coordinators will be recruited in the first part of 1999 and initial results are anticipated late 1999. Any countries identified with apparent high rates of prone sleeping will be examined further to establish whether SIDS is a significant but unrecognised problem. Where indicated consideration will be given to setting up "link" programs between these countries and countries experienced in SIDS risk reduction campaigns. Implementation of the study in other WHO regions will also be considered at this stage.

Conclusion - The study has the potential to identify countries where introduction of a low-cost intervention may have a significant impact on child survival.

Acknowledgement - Dorothy Ford kindly provided copies of questionnaires used in Melbourne, Australia for a "Midwifery and Antenatal Practice Survey".

For further information - Dr Tony Nelson, Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. Fax: +852 26360020, email: tony-nelson@cuhk.edu.hk