In plain words
Positional asphyxia happens when a baby's position makes it hard to breathe. The baby may slump forward in a seat, so the chin rests on the chest. Or the baby may be on a soft or sloped surface, where the face can be pressed into bedding or the body. The baby may not be able to lift the head or move away. This is why infant safety guidance says to keep babies on a firm, flat surface for sleep, and to check that car seats are used correctly. Safety guidance focuses on keeping the airway clear at all times, and a can check the setup.
The deeper version
Positional asphyxia occurs when body position impairs ventilation in infants, most often through airway obstruction or restricted chest expansion in a semi-upright or prone posture on soft surfaces. The AAP recommendations (Moon, 2022) address sleep surfaces, position, and the risk of soft bedding, which are the main modifiable factors in sleep-related infant deaths. Durbin and Hoffman (2018) describe the risk of slumping and the need for appropriate recline and harness fit, with the AAP recommending use of car seats in the correct position and checking the airway. The mechanism is supported by case series and by the known vulnerability of infants with poor head control, and risk is highest in the first months.
Where it comes up
- BabywearingBaby Basics
- Car seat: choosing, installing, getting it checkedGetting Ready for Birth
- Going home: the car ride and the first eveningBirth and the First Days
- Car seat safety day to dayBaby Basics
- Newborn sleep and safe sleepBaby Basics
What mothers here say about positional asphyxia
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Sources
- Moon RY — AAP Task Force on Sudden Infant Death Syndrome: SIDS and other sleep-related infant deaths, updated 2022 recommendations for a safe infant sleeping environment. Pediatrics, 2022
- Durbin DR, Hoffman BD — Child passenger safety policy statement. Pediatrics, 2018