TORONTO - Very young babies may be at a slightly higher risk of sudden infant death syndrome when sitting in a car seat or other seating device, a new study suggests.
The work, an analysis of 10 years of data on SIDS deaths in Quebec, suggests premature infants are not at greater risk of sudden and unexplained death from being placed in a car seat, as has been postulated in the past. But the analysis points to an increased risk in all babies, premature and full term, in the first month of life when they are sitting up in a car seat or another type of baby seat.
"I think that really the bottom line of that paper is that let's not concentrate on babies that were born premature," said lead author Dr. Aurore Cote, of the division of respiratory medicine at McGill University Health Centre in Montreal.
"There is a risk, probably, of something happening in a car seat when you're in the first month of life. And I should not say car seat, I should say sitting device. ... So the message to parents will be: Don't have a baby less than one month of age spend a long time in a car seat or in a sitting device."
The study is being published in the British journal Archives of the Diseases of Childhood.
The chief of the neonatology division of Toronto's Hospital for Sick Children termed the findings interesting and said he thinks Cote and her co-authors may be on to something.
But Dr. Keith Tanswell urged parents not to panic - and not to forgo strapping babies into car seats when they are going to be travelling in vehicle.
Tanswell said infants that aren't secured in a proper car seat are at much greater risk of being injured in a journey than of they are of succumbing to SIDS while in a car seat.
"I think you have to take the study as a very interesting study that is suggestive that it may not be ideal to have a baby in a car seat without the head in a neutral position," Tanswell said.
" But the numbers are small and how solid a conclusion and major changes can we suggest on a small study? ... I think there are some messages there that these things are worth looking at. But I wouldn't panic at this stage."
Cote also stressed that babies ought to be secured in a car seat while in a moving vehicle, though she advised parents to try not to take infants out for prolonged drives.
She admitted that science can't currently say how long a young baby can safely sit in a car seat or other sitting device. But she advised that if parents have to have a baby in a car seat for longer than 30 minutes they should consider stopping at half-hour intervals to adjust the baby's position to ensure that the head hadn't flopped over, obstructing the infant's airway.
The study is based on coroners' records for all sudden and unexplained deaths of infants under the age of one in Quebec from January 1991 to December 2000. (SIDS isn't a disease or a diagnosis, it is actually the lack of one. It is the term applied when seemingly healthy babies older than one week but younger than one year die and even an autopsy cannot ascertain a cause of death.)
Records on such deaths are highly detailed and include where and in what position the baby was when it was discovered to have died.
Cote studied the records of 409 deaths in Quebec during that decade-long period, trying to see if she could find evidence that preemies are at greater risk while secured in a car seat, as other studies have suggested.
She didn't find that association. But she did see an increase in cases in all babies under a month old who had been seated. "So I think it's worthwhile warning that there might be risk for babies that are young to spend a long time in a sitting position."
But as Tanswell mentioned, the numbers in the study are very small. There were 64 infants under a month old who died and of that group, six died while in a sitting position. He suggested the jury is still out on whether preemies are at a higher SIDS risk than other babies while in a car seat.
"I don't think they've completely resolved that issue as yet," he said, suggesting larger studies should be done to see if Cote's findings can be confirmed.
