Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Research studies continue to demonstrate a greater risk for SIDS among male
infants. SIDS is observed more frequently during winter months than summer
months, although this distribution is not as pronounced in recent years as it
had been in the past. In the United States, both African American and Native
American infants have a higher rate of SIDS than do Caucasian, Hispanic, and
Asian infants.
Certain infant-care practices have an effect on the risk for SIDS. Most
notable is the increased risk associated with the placement of infants on their
stomach (prone sleep position) for sleep. The "Back to Sleep" campaign was
launched in the United States in 1994 and embodies a public-health effort
encouraging families to place infants on their backs (supine sleep position) to
sleep. Since the start of this campaign, SIDS rates have dropped 50% in the
United States. Similar drops have been observed worldwide, highlighting the
importance of the supine sleep position for infants.
Other factors increasing the risk for SIDS include exposure to cigarette
smoke, bed-sharing or co-sleeping, over-bundling or the covering of the infant's
head by bed covers, loose bedding, or blankets. Recent research studies suggest
that breastfeeding and pacifier use may reduce the risk of SIDS.
How is SIDS diagnosed?
Sudden infant death remains an unpredictable, unpreventable, and largely
inexplicable tragedy. The baby is seemingly healthy without any sign of distress
or significant illness prior to the incident.
Death occurs rapidly while the infant is sleeping.
Typically, it is a
silent event. The baby does not cry.
The infant usually appears to be well
developed, well nourished, and is generally felt to be in good health prior to
death. Minor upper respiratory or gastrointestinal symptoms due to viruses like
respiratory syncytial virus (RSV) are not uncommon in the last two weeks
preceding SIDS.
Sudden, unexpected infant death (SUID) is a general term used for the
circumstance of an infant death which occurs suddenly and in an unexpected
manner. SIDS is a diagnosis of exclusion, meaning that other causes of death
must be ruled out. The cause of an infant's death can be determined only through
a process of collecting information and conducting, at times, complex forensic
tests and procedures. All other recognizable causes of death are investigated
prior to making the diagnosis of SIDS.
Four major avenues of investigation aid in the determination of a SIDS death:
postmortem lab tests, autopsy, death-scene investigation, and the review of
victim and family case history.
Postmortem laboratory tests are done to rule out other causes of death (for
example, electrolytes are checked to rule out dehydration and electrolyte
imbalance; bacterial and viral cultures are obtained to evaluate whether an
infection was present). In SIDS, these laboratory tests are generally
not revealing.
An autopsy provides clues as to the cause of death. In 15%-25% of
sudden, unexpected infant deaths specific abnormalities of the brain or central
nervous system, the heart or lungs, or infection may be identified as the cause
of death. The autopsy findings in SIDS victims are typically subtle and yield
only supportive, rather than conclusive, findings to explain SIDS.
A thorough
investigation of the death scene consists of interviewing the parents, other
caregivers, and family members, collecting items from the death scene, and
evaluating that information. A detailed scene investigation may reveal a
recognizable and possibly preventable cause of death.
A parent or caregiver
may be asked these questions:
Where was the baby discovered?
What position
was the baby in?
When was the baby last checked? Last fed?
How was the baby
sleeping?
Where there any recent signs of illness?
Was the infant taking any
medication, either prescription or over-the-counter?
You should let your
doctor know about any family or infant medical history. Family history to note
would include any previous history of unexplained infant death, sudden cardiac
death, and metabolic or genetic disorders, for example.
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. Not getting enough sleep can hurt memory performance, health, and your mood.
Respiratory syncytial virus (RSV) is a highly contagious viral infection. Symptoms include fever and nasal congestion and discharge. Treatment focuses on supportive care.
Good parenting helps foster empathy, honesty, self-reliance, self-control, kindness, cooperation, and cheerfulness, says Steinberg, a distinguished professor of psychology at Temple University in Philadelphia. It also promotes intellectual curiosity, motivation, and desire to achieve. It helps protect children from developing anxiety, depression, eating disorders, antisocial behavior, and alcohol and drug abuse.
Hyperthermia is the overheating of the body. Heat-related illnesses like heat stroke, heat exhaustion, heat cramps, heat rash, and sunburn are all hyperthermia conditions. Treatment of these conditions depends upon the condition, environment, and circumstances. Heat stroke is a medical emergency, and may result in death if not treated promptly. Heat exhaustion may lead to heat stroke if not treated properly.
Secondhand smoke can cause illness and disease in nonsmokers. Some of these conditions include lung cancer, heart disease, respiratory illnesses such as asthma, SIDS, bronchitis, and pneumonia. Learn how you can protect yourself and your family from secondhand smoke exposure in the home environment and workplace.
Smoking during pregnancy increases the risk of miscarriage or stillbirth, low birth weight or premature birth, and more. Secondhand smoke also increases your baby's risk of developing lung cancer, heart diseases, emphysema, asthma, allergies, and SIDS.
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