Sudden infant death syndrome – Punch Newspapers

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Dr. Sylvester Ikhisemojie
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The prevalence of this condition among Nigerians is unknown like many other things are unknown about our country especially when such things refer to figures. With virtually anything under the Nigerian sun, we are not certain. We are not sure of our population. We do not know how many Nigerians are men, and how many are women, nor for that matter do we know how many children are born every day in the country. Everything is based on estimates and so, once again, we must have to cope with the estimate of how many babies are affected every year by the terrible fate that the sudden infant death syndrome can impose on a family.
It is a truly scary event and one in which parents go to bed one night and wake up the next day, sad that their baby has somehow died suddenly during the night even in the absence of any evident illness. It is speculated that every year, many thousands of children under the age of one year die suddenly and unexpectedly mainly from unknown causes. The associations of this bad event are now known and many are still factors that are related to a number of associations that are also preventable. Therefore, it is important that those mothers who want to limit the risk their babies are exposed to should pay attention to what we shall discuss in the following paragraphs.
 One of the most commonly associated factors related to this problem is late or absent antenatal care. The mothers falling into these categories are either too poor to afford antenatal care or live too far away from any proper healthcare facility to benefit from this vital service. As a result, they are uniformly ignorant about basic things to do with the care of a newborn and rely instead on the care and advice of village women. As the bulk of our population still lives in rural communities, it is likely that this is a problem confronting millions of women who must be considered deprived women in the modern age. On the whole, deprived women most likely will give birth to deprived babies and that is where the risk of suffering from this problem remains high. The second related factor is the delivery of newborns to underage girls or young women less than 20 years. In this population subgroup, most have little knowledge of basic childcare practices. Many are uneducated or poorly educated and so are likely to take undue risks in the course of caring for their babies. Often, the young expectant mother is the same one least expected to seek antenatal care either out of ignorance or as a result of a desire to conceal their pregnancy or because of shame that they are pregnant.
Among women who do have some knowledge of basic childcare practices, it is considered dangerous to put a baby to sleep on its stomach. In the past, this was a common practice in many countries for many generations, but the guidelines changed in the 1990s in favour of putting babies to sleep on their backs rather than their stomachs or even on their sides. Those changes cut the risk of babies suffering from these problems by as much as 50 per cent. In the country’s hinterland, there is usually no one to monitor these practices or educate rural women about the changes that have been formulated to increase safety. Among their urban and semi-urban counterparts, it is important for mothers to allow babies to sleep close to them, preferably in a crib that is just an arm’s length away rather than have babies share beds with their parents. When your baby sleeps with both parents in the same bed, the chances of experiencing this heartrending event are quite high. The risk remains even when the baby sleeps with the mother alone, rather than both parents. The reasons for these associations are not clear but these have been discovered to be real problems by researchers, hence the kinds of advice that have emerged from them. Once more, these are problems that are often likely to arise in cramped housing where sometimes, an entire family of six or more is forced to live in a single room.

Even among those women who do not share sleeping spaces with their babies, there are some practices increasingly associated with a social class where mothers surround their babies with teddy bears, loose blankets, and bumper pads. These items have been associated with sudden infant death syndrome because of the restless way in which a baby sleeps and the fact that clothing items like these ones can cause suffocation. It is really in the interests of any family to seek their paediatrician’s advice regarding these facts. It is common sense, therefore, that whatever it is that they do not recommend should go to bed with your baby should be kept out of their crib. For good measure, it is considered safer to use a wearable blanket on babies than to swaddle them in loose blankets because of the potential risk posed by the mobility of loose blankets. This is a matter of particular importance to the urban rich women who tend to emulate western nursing practices that are often overdone in our environment. Increasingly, we are also seeing smoking mothers. Expectant mothers who smoke cigarettes are more likely to give birth to babies more prone to suffering from SIDS than babies of mothers who do not. The same is true of mothers who smoke after delivery even if they do not do so in bed. Once babies share the same bed with their smoking mother, their risk of dying suddenly without a clear cause increases.
In the same way, babies who find it soothing to suck on pacifiers at bedtime can be indulged as the use of this item during such times has been found to significantly reduce the risk of SIDS. In doing so, it is important to not attach a leash to the pacifier as doing so probably restricts the movement so that it becomes less adaptable to the baby’s changing positions. Lastly, if a baby is breastfed, even if it is for only a couple of months, it is found to be fundamentally beneficial to such babies to such a huge extent that SIDS is prevented. The reasons are not clear, but this catastrophe is found to be more common among babies who have not been breastfed. There is a lot to worry about in the health of a newborn, but it is a difficult task to prevent a situation of such deadly dimensions whose definite causes are not known. These are the reasons why knowledge of the associated factors is so important because that will help with its prevention. In the future, therefore, mothers who have read this essay and even their husbands would be able to caution themselves when they see that they have stepped out of line and are engaging in practices that could harm their offspring.

Questions and answers

Dear doctor, I am a 58-year-old man diagnosed with diabetes in 2008. I have regularly taken my medications since then and observed a pattern of watching what I eat according to the doctors. Despite all that, I was unable to have sex with my wife since the beginning of this year. I tried the local Viagra of bitter cola and coconut at a stage when no medicine seemed to be working and there was still no improvement. Then all of a sudden, last weekend, I had an erection, and I was even able to have sex with my wife. Will it stay like this, or will it go again? Please help me with a good answer. Thank you.                  0806xxxxxxx

Thank you for that interesting question. The truth here is that nobody can assure you that the erection you suddenly regained last weekend is here to stay or that it might go away again. The more likely thing is that you will have erections like this one now and again, but they will certainly not be as often or as strong as they used to be. Damage to the nerves and blood vessels that play key roles in the mechanism of erections and their sustenance are progressively damaged in diabetes and that results in the experience you just had.
Dear doctor, can I know what is wrong? When I have an erection, my penis used to bend downwards, and I used to have pain. I contacted my doctor, and one said it is old age while the other one gave me a paper to do an X-ray. I am 72 years old. As I have said, I don’t have a straight erection. What is wrong with me? 0802xxxxxxx
Well, you did not tell us what kind of X-ray you were asked to do. It is certainly an important and interesting question that you have complaints like this at your age. It is not every penis that is straight and the fact that you can get an erection at 72 years of age is a bonus. It probably does not matter in which direction the penis points during an erection. Most men will simply use their hands to direct the penis where they want it to go. However, the pain associated with the erection is something odd, but you did not say if this is a recent development, or if it has been like that for a long time. All in all, the good thing remains the fact that you can gain an erection.
Dear doctor, my baby, now 11 years old, has a constantly runny nose during the day and blockage at night which is so bad that she now breathes through her mouth and snores. There is temperature too. When she was three months old, I took her to a private hospital where she was given an injection. When she was six months old, I noticed that she had pain in her leg (both the right leg and right hand). Later, I noticed that she can’t hear or talk so I took her to a general hospital for a tongue and ear test. The outer ear was okay, but the inner ear was not discovered. Can my baby still hear? 0806xxxxxxx

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 Thank you very much for the multiple questions. As for the runny nose that gets blocked at night, the expert to see your child is called an ear, nose, and throat surgeon, or ENT surgeon for short. They would also have been the ones that discovered that the inner ear was not there. If you are quoting them correctly, what this represents is a birth defect in which the small bones of the inner ear without which we cannot hear did not form. This is, therefore, a congenital deafness that has no chance of reversal or improvement. The pain or weakness in the right leg and hand can be improved with the relevant type of physiotherapy depending on how severe the problem is. That will be where to begin the therapy but see an orthopaedic surgeon first for a proper examination and recommendation.
Dear doctor, is it a normal thing for somebody to always have dry skin? My skin is dry most of the time and it itches me also. Why? 0704xxxxxxx
 You can have dry skin depending on a number of factors. Sometimes, there are certain things around you that may be responsible for that because you have an adverse reaction to such substances. At other times, it is because there is a disease condition present that predisposes your skin towards dryness and itchiness. In disease conditions such as diabetes, the skin can become dry and thickened. In others like jaundice due to liver disease, such skin can be itchy. So, if you are not now undergoing treatment for any other ailment it is possible that you are either reacting to something around you or you naturally have unduly dry skin. If it is the latter, you can seek to apply any good moisturising lotion to help deal with the dryness. Most of the time, when such dryness abates, the itching also will stop.

Dear doctor, my son is six years old and was recently treated for malaria. At about the time the fever broke out, he developed some rashes around his mouth that are now peeling. He has recovered from the fever now, but when the rashes began to peel I started to apply Vaseline to the areas affected. It has been three weeks now but there has been no change. Yoruba call it “isinu.” What can we do to clear this up, please? 0803xxxxxxx
Actually, there is usually no need to treat these rashes separately. They often erupt in association with a fever and tend to do so more commonly in children. However, multivitamin supplementation and vitamin C especially help a lot to help them heal. In a short while, normal skin colour will return to those affected areas.
Dear doctor, greetings to you and thank you for all the work you are doing for ordinary people. I saw a doctor last week for a vaginal infection and after he examined me, he took a sample for the lab to test. Then I went back to see him after two days and he said there is an infection and that I had to take treatment. That is fine but he also said that he has to treat my boyfriend. But how does it concern my boyfriend when he does not have any problem? I don’t understand that part. How did the doctor know that he got the infection from me? 0803xxxxxxx
Thank you for your kind words. The reason for that approach to treatment is this; the penis is the one that goes into a vagina and so even when there is no symptom in the man, it is assumed that there may be spores of the relevant organism on the skin of the penis or inside the urethra. If the conditions that will make the microorganisms reproduce, and cause disease are met in a particular vagina, then infection will result. Now, this doctor has found such a disease and is seeking to treat you properly by also treating your boyfriend. This is called contact tracing and is a standard procedure. It does not mean that he got the infection from you or vice versa; that can usually not be proved.
Dear doctor, thank you very much for the advice you always give people on this page. I am always suffering from malaria. Let’s say twice a month. This makes me miserable. What can I do about it? Thank you.   0806xxxxxxx
The answer lies in prevention. You have to take serious measures to prevent malaria attacks by using insecticides regularly inside your apartment, sleeping under an insecticide-treated mosquito net, clearing out any pools of stagnant water around your house, and ensuring that your diagnosis of malaria fever is confirmed with proper laboratory testing. Sometimes, what you may have is incompletely treated malaria or a resistant type of illness that then appears as if it is recurrent. The assurance of a successful treatment is to repeat the test when the treatment is over so that you can confirm if it is gone or not.

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