MCH Alert: Focus on Infant Mortality

Maternal and Child Health Library

MCH Alert: Focus on Infant Mortality is developed by the Maternal and Child Health Library in collaboration with the National Sudden and Unexpected Infant/Child and Pregnancy Loss Resource Center at Georgetown University. This and past issues are available online at and

October 29, 2010

1. Bright Futures Initiative Releases New Spanish Tools on Emotional Health in Women
2. Review Explores Interrelationships Among Sleep, Culture, and Medical Conditions in Children
3. Authors Highlight Opportunities to Improve Paternal Involvement in Pregnancy and Family Health
4. Article Tests Whether Parents' Alcohol Consumption is a Risk Factor for SIDS



The Bright Futures for Women's Health and Wellness series includes new Spanish-language tools to address the connection between women's mental and physical well-being and encourage better health across the lifespan. The tools, produced by the Health Resources and Services Administration's Office of Women's Health, focus on three main concepts: appreciating oneself, finding balance and purpose in life, and connecting with others. The tools are as follows:

* Futuros Brillantes: Guia de la joven adolescente para el bienestar emocional (Bright Futures: A young woman's guide to emotional wellness)
Available at

* Futuros Brillantes: La guia de la muier sobre el bienestar emocional (Bright Futures: A woman's guide to emotional wellness)
Available at



"Healthcare providers need to be cognizant of cultural factors and health literacy levels when eliciting information about sleep problems in children," state the authors of an article published in the October 2010 issue of the Journal of Pediatric Psychology. Understanding how culture can affect sleep patterns and behaviors is a topic of clinical importance. Sleep problems have negative consequences for all children. However, sleep has unique importance for children with health conditions, given its potential impact on disease course and severity. Culture provides a context to understand influences on children's sleep behaviors. It also offers health professionals an opportunity to connect with families about how best to intervene to enhance children's sleep quality. This review examines the role of culture and cultural factors in the sleep of children with medical conditions. The authors identify how cultural processes (belief systems, values, and experiences) may be meaningful to children with chronic diseases and may affect sleep-related behaviors. They also examine potential factors relevant to diverse groups (ethnic minority status, racial background, socioeconomic status) that are more commonly studied and provide suggestions on how to incorporate specific cultural considerations into future research.

The review comprised searches using the PubMed, Medline, and PsychINFO databases and bibliographies of relevant articles and the keywords sleep; child or pediatric; culture, ethnicity, race, or minority; and illness, disease, or one of the following illness-specific terms: asthma, atopic dermatitis, cancer, cystic fibrosis, diabetes, eczema, epilepsy, headache, inflammatory bowel disease, juvenile rheumatoid arthritis, migraine, obesity, pain, recurrent abdominal pain, sickle cell disease, and sudden infant death syndrome. The articles included in the review were those published in English in a peer-reviewed publication from 1989 through February 2009. Among 238 abstracts screened, the review identified eight studies that examined interrelationships among sleep, culture, and children's health. The researchers also identified representative articles that focused on relationships between sleep and culture (n=16) and sleep and children's health (n=15) in order to support relevant themes or inform clinical implications and research directions.

The authors found that
The authors conclude that
Boergers J, Koinis-Mitchell D. 2010. Sleep and culture in children with medical conditions. Journal of Pediatric Psychology 35(9):915-926. Abstract available at

Readers: More information is available from the following MCH Library resources:

- Children and Adolescents with Special Health Care Needs: Knowledge Path at

- Culturally Competent Services at



"Obstetricians-gynecologists can play a greater role in promoting more 'father-friendly' practices in preconception, prenatal, intrapartum, and postpartum/interconception care," state the authors of an article published in Current Opinion in Obstetrics and Gynecology online (ahead of print) on October 7, 2010. A body of research exists on a father's influence on child health and development, but little is known about the role of the expectant father in pregnancy outcomes. The Commission on Paternal Involvement in Pregnancy Outcomes was assembled in 2009, with funding from the U.S. Department of Health and Human Services' Office of Minority Health. The commission comprises a transdisciplinary working group of scholars from the social sciences and public health, with a goal of raising public awareness for paternal involvement in pregnancy and family health. The article examines the commission's proposed recommendations to advance paternal involvement and opportunities for obstetricians and gynecologists to impact the health and well-being of families. Topics include addressing policy barriers to paternal involvement; promoting best and promising practice in paternal involvement; and expanding research on paternal involvement and pregnancy outcomes.

The authors conclude that
Bond MJ, Heidelbaugh JJ, Robertson A, et al. 2010. Improving research, policy and practice to promote paternal involvement in pregnancy outcomes: The roles of obstetricians-gynecologists. Current Opinion in Obstetrics and Gynecology [published online ahead of print on October 7, 2010]. Abstract available at,_policy_and_practice_to_promote.99857.aspx

Readers: More information is available from the following MCH Library resources:

- Preconception and Pregnancy: Knowledge Path at

- Fatherhood: Resource Brief at



"Our study is the first to provide large-scale US evidence identifying alcohol consumption as a possible risk factor [for SIDS]," write the authors of an article published in Addiction online (ahead of print) on September 15, 2010. In the United States, SIDS is the leading cause of postneonatal infant death. The study described in this article hypothesizes that alcohol-impaired caregivers are less able to protect vulnerable infants; they term this the "Alcohol-SIDS (AS) hypothesis." The authors use three national datasets to test whether SIDS increases when caregivers are alcohol impaired.

The authors analyzed (1) all U.S. computerized death certificates (which provide day of week of death for 1973-2006 and exact date of death for 1973-2004), (2) the linked birth and infant death dataset (which links information from birth and death certificates for decedents under age 1 during 1995-2005 and records information about the infant and the infant's mother, such as whether she consumed alcohol), and (3) the Fatality Analysis Reporting System (FARS), which is available for 1994 through 2008 and provides information on all U.S. motor vehicle accidents involving at least one fatality. For the first two datasets, the authors focused on postneonatal SIDS (i.e., the infant died between ages 28 and 364 days). The authors used FARS for two purposes: (1) to discover occasions when alcohol consumption spiked most dramatically during evening and early morning (8:00 pm to 3:59 am, referred to as the "high-risk period") and (2) to test whether children are less likely to be properly seatbelted in the presence of alcohol-impaired adults (to help test the AS hypothesis that alcohol-impaired parents are less able to protect vulnerable children.)

The authors found that
These findings imply, the authors conclude, that "two areas of research (on SIDS and on alcohol), previously considered largely distinct, may actually be linked. This and other implications are potentially significant and warrant further investigation."

Phillips DP, Brewere KM, Wadensweiler P. 2010. Alcohol as a risk factor for SIDS. Addiction [published online ahead of print on September 15, 2010]. Abstract available at


 To subscribe to MCH Alert, send an e-mail message to with SUBSCRIBE in the subject line. You do not need to enter any text in the body of the message.

To unsubscribe from MCH Alert, send an e-mail message to with UNSUBSCRIBE in the subject line. You do not need to enter any text in the body of the message.


MCH Library shares notices of new issues of MCH Alert on Twitter at


MCH Alert © 1998-2010 by National Center for Education in Maternal and Child Health and Georgetown University. MCH Alert: Focus on Infant Mortality is produced by Maternal and Child Health Library at the National Center for Education in Maternal and Child Health at Georgetown University under its cooperative agreements (U02MC00001 and U48MC08717) with the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. The Maternal and Child Health Bureau reserves a royalty-free, nonexclusive, and irrevocable right to use the work for federal purposes and to authorize others to use the work for federal purposes.
Permission is given to forward MCH Alert, in its entirety, to others. For all other uses, requests for permission to duplicate and use all or part of the information contained in this publication should be sent to

The editors welcome your submissions, suggestions, and questions. Please contact us at the address below.

CO-EDITOR: Tracy Lopez, M.S.L.S.
WRITER: Beth DeFrancis, M.L.S.

MCH Alert
Maternal and Child Health Library
National Center for Education in Maternal and Child Health
Georgetown University
Box 571272
Washington, DC 20057-1272
Phone: (202) 784-9770
Fax: (202) 784-9777
Web site: