Respiratory conditions and unsafe sleep practices suspected in recent deaths
By the Erie County Department of Health
Following six recent cases involving deaths of infants and young children, Erie County Commissioner of Health Dr. Gale Burstein and UBMD physicians Dr. Geovanny F. Perez and Dr. Fred Archer presented the warning signs and symptoms of infant respiratory distress and safe sleep recommendations on Tuesday.
In the past month, the Erie County Medical Examiner’s Office investigated six deaths among children ages 3 years and younger, with suspected causes of death either related to respiratory illness or unsafe sleeping practices. Three of those infants were under 1 year of age.
“The Medical Examiner’s Office alerted our department to these recent deaths,” Burstein said. “Though some of the ME’s Office investigations are pending, these cases involved very young children who had severe respiratory infections or died as a result of an unsafe sleep practice.”
She added, “If you have an infant or young child in your life, every single person who watches them needs to know the warning signs of infant respiratory distress and how to make a safe sleep environment. These cases are tragic and heart-breaking, and as communities and families we can prevent these deaths from happening. Parents, grandparents, babysitters and occasional caregivers like older siblings or neighbors must have this information and be ready to act.”
Perez is chief of the division of pediatric pulmonology and sleep medicine for UBMD Pediatrics and the department of pediatrics at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. He is also the medical director for the Oishei Children’s Hospital Lung Center. Archer is interim chief of general pediatrics and medical director of Oishei Children’s Hospital Primary Care clinics.
“Infants and young children are very vulnerable to respiratory pathogens like RSV, influenza, COVID-19, and they cannot tell you that they are having trouble breathing,” Perez explained. “Many childhood respiratory illnesses are easily managed at home, but children’s health conditions can worsen quickly, without warning.”
Archer said, “Medical treatment can prevent respiratory failure and death. Parents and anyone caring for a child should not hesitate to call their pediatrician or get their child to a hospital if they notice any signs of respiratory distress.”
Respiratory distress symptoms include:
√ Nose flaring where the openings of the nose spread open while breathing
√ Ribs are pulling in with each breath (called retractions)
√ Muscles of the neck appear to be moving or your child's head is bobbing up and down when breathing in
√ Breathing has become noisy (such as wheezes or stridor)
√ Breathing and heart rate is much faster than normal
√ Struggling for each breath or shortness of breath
√ Tight breathing so that your child can barely speak or cry
√ A grunting sound heard each time the child exhales
√ Lips or face turn a blue color
√ Changes in alertness
Adults and children who spend time with very young infants – especially if they have not yet been immunized – need to be up to date with recommended vaccines. Washing hands frequently is another very important infection control strategy; so is staying away from infants if you have any signs of respiratory illness. If you are a primary caregiver for an infant and are ill, consider wearing a mask consistently and correctly.
Vaccines as Prevention
Most people ages 6 months and older are eligible for the seasonal influenza vaccine and the updated COVID-19 vaccine.
RSV (respiratory syncytial virus) can cause difficulty breathing, cough and congestion, particularly in infants and older adults. RSV is the leading cause of hospitalization for U.S. infants. This fall, an RSV vaccine was approved and is now recommended for adults over 60 years, some infants under 19 months of age, and people in weeks 32 to 36 of pregnancy. The RSV vaccine for infants and pregnant people reduces the risk of both RSV-related hospitalizations and health care visits by about 80% for the infant. Families should check with their doctor with questions and for availability.
Safe Sleep Practices
October is Safe Sleep Month, and every parent or expectant parent should follow these recommendations. Infants depend on their caregivers to provide a safe environment to play, grow and sleep. Follow the ABCs of safe sleep for children:
•Babies sleep ALONE: Infants should be alone in a crib to sleep – no pillows, blankets or toys. Use a wearable blanket or other type sleeper instead of blankets to keep your baby warm and safe.
•BACK to Sleep: Always place infants on their backs to sleep. The child will breathe easier and this may help prevent sudden unexpected infant death. Caregivers or grandparents may not be familiar with this “back to sleep” practice. They may prefer to place infants on their side or stomach. If you are a parent, this is your child: That means your rules are the only rules. Insist that anyone caring for your baby puts them on their back to sleep. Some babies can fall asleep anywhere – a car seat, stroller, infant carrier, or swing. When this happens, move the baby to a firm sleep surface – on his or her back – as soon as it is practical.
•Sleep in a Safe CRIB: Use a crib that meets current safety standards. The mattress should be firm and fit in the crib with no gaps. Cover the mattress with only a tight-fitting crib sheet. Portable cribs and play-yard-style cribs are also good choices. Never place your baby to sleep on top of any soft surface. This includes adult beds, sofas, chairs, waterbeds, pillows, cushions, comforters and sheepskins.
•Keep Your Home Smoke-Free: Quit smoking to reduce your baby’s risk of sudden unexpected infant death. No one should smoke in your home or around your baby.