RISK FOR SUDDEN INFANT
Presence of risk factors for an infant under 1 year of age
• Consistent disorientation to
• Delayed prenatal care
• Infant overheating
• Infant over wrapping
• Low birth weight
• Infants placed to sleep in a
• Young maternal age
• Infants placed to sleep in side-
• Lack of prenatal care
• Male gender
• Postnatal infant smoke expo-
• Seasonality of sudden infant
death syndrome (SIDS) (winter
• Prenatal infant smoke
• Soft underlayment (loose arti-
• Infant age of 2–4 months
cles in the sleep environment)
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
The parents will
• Be receptive to teaching and guidance.
• Verbalize understanding of risk factors and provide all precautions
possible to prevent disorder.
• Verbalize feelings of preparedness and ability to handle emergen-
cies utilizing CPR techniques and services.
• Exhibit appropriate coping skills in dealing with high-risk infant.
The infant will
• Sleep alone in a crib on a ﬁrm sleep surface.
• Maintain normal body temperature as indicated by apnea monitor
worn during sleep.
SUGGESTED NOC OUTCOMES
Knowledge Infant Care; Knowledge Parenting; Parent Performance;
Risk Control; Risk Detection
INTERVENTIONS AND RATIONALES
Determine: Assess prenatal history; maternal history; parental experi-
ence; monitor heart rate, blood pressure; respiratory rate, quality,
depth of respirations, breath sounds; reﬂexes, response to touch. The
assessment information will assist in identifying appropriate
Perform: Position infant on back when placed in the crib. Incidence
of SIDS is higher when infant is placed in a prone position.
Elevate infant’s head slightly when placed in the crib to decrease
abdominal pressure on diaphragm and allow better expansion of lungs.
Place infant on a ﬁrm sleep surface to prevent him or her from
sinking into the mattress cover or blanket.
Maintain room at appropriate temperature and avoid wrapping
the infant in heavy blankets. Excessive heat has been identiﬁed as a
possible risk factor.
Inform: Educate parents about risk factors of SIDS because modiﬁca-
tion of current practices can reduce risk and prevent occurrence.
Instruct caregivers on ways to maintain a safe environment in the
home. Provide written information to caregivers on all important
aspects of the infant’s care.
Teach parents to avoid having loose blankets, toys, or other arti-
cles in the crib to decrease risk of accidental suffocation.
Encourage mother to breast-feed because there is a lower
incidence of SIDS in babies who are breast-fed.
Teach parents how to correctly apply leads and set alarms of the
apnea monitor. The beneﬁt of the monitor can be achieved only if it
is used correctly.
Instruct parents in CPR to reduce anxiety and promote conﬁdence
in performing correct technique. Allow time for return
demonstrations to prepare parents to cope with infant when he or
she returns home.
Attend: Encourage parents in their efforts to care for the infant. Pro-
vide suggestions for coping mechanisms to help reduce the anxieties
associated with caring for a high-risk infant. Be aware that parents
may be sensitive to your unspoken feelings about the situation.
Encourage parents to interact with other parents managing high-
risk infants well. Peer support may help to reduce fear in the parents.
Involve parents in planning and decision making for their infant.
Investment in decision making will promote compliance with the plan.
Manage: Refer to case manager/social worker/home health agency to
ensure that parents receive adequate support in caring for the infant.
Refer parents to support group if one is available.
SUGGESTED NIC INTERVENTIONS
Family Support; Infant Care; Risk Control
Thogmartin, J. R., et al. (2001). Sleep position and bed-sharing in sudden
infant deaths and examination of autopsy ﬁndings. Journal of Pediatrics,