4th Austrian SIDS-Consensus Meeting and Vienna SIDS Prevention Campaign "safe sleep"

Despite numerous investigations the pathophysiologic mechanisms of SIDS hav e not been fully elucidated. In large epidemiologic studies highly variable SIDS mortality rates were noted between different countries and cultures. This presumably is due not only to differences in diagnostics and classific ation of SIDS but also in lifestyle and newborn care. The common denominato r is the identification and prevention of the main risk factors: smoking, s leeping in the prone position, overheating, wrong "bedding". SIDS preventio n campaigns that have focussed upon these risk factors have led to a dramat ic reduction in the incidence of SIDS. In preparation for the SIDS prevention campaign of Vienna ("Safe Sleep") th e content, strategy and procedure of the Austrian prevention campaigns were analysed. The current focus is to convey a clear and uniform message in pe rsonal conversations before and after birth of the child. These conversatio ns with parents are the most important tool to detect SIDS related anxiety and a possibly increased risk of SIDS. In the last 30 years various polysom nographic parameters were published that were associated with an increased risk of SIDS. Today there is international consent that polysomnography is not an efficient screening method to demonstrate increased risk of SIDS. Th erefore the use of polysomnography, besides research purposes, has been lim ited to investigating clinical symptoms of infants and children. Concerning monitoring it is important to note that - in contrast to the und isputed importance of monitoring breathing disorders - the effectiveness in SIDS prevention is unproven. State of the art are instruments that monitor heart and breathing rate and have adequate storage functions. The duration of monitoring should encompass the symptomatic period as well as a safety period of three months. The monitor should not be routinely prescribed for a year. The guiding principle is "As short as possible, with stringent: ind ication". Prerequisite for the monitoring is good instruction of the parent s and a continuous consultation by competent outpatient clinics.