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Editor,—The term ‘apparent life threatening event’ (ALTE) replaces the older term ‘near miss cot death’ and is used to describe an event perceived by the child’s caregiver to be life threatening. The features showed usually involve a combination of a change in colour, tone, and respiratory pattern and may be difficult to differentiate from physiological events during sleep.1
Of the 15 babies referred to our hospital for investigation of ALTE in the last six months, only one parent was perceived to have performed resuscitation correctly and appropriately after such an event. One method of stimulation included a mother sticking her tongue into the infant’s mouth and another where the family, who were driving at the time of the apparent event, repeatedly braked and accelerated the car in an unsuccessful attempt to rouse the child. Two parents in the group gave mouth to mouth resuscitation but did not know if the baby had actually stopped breathing first. A further two parents did not have any knowledge of resuscitation; one of these was able to follow guidelines given down the telephone by the emergency services and the other parent was too distressed and had to wait for the arrival of the ambulance crew. Another father, not knowing what to do took his baby outside into the cold and shook him. He was not the only parent in the group unaware that shaking an infant can be dangerous.
Before discharge from our unit, all parents and caregivers are taught full resuscitation and it is during these sessions that a lack of knowledge has become evident. Many neonatal units have introduced programmes for teaching their parents resuscitation skills but very few studies evaluating these are available. Those which do exist have highlighted the fact that training in resuscitation techniques provides parents with an important skill and increases their confidence which in turn leads to reduced anxiety levels.2 However, none of the infants in our group had been premature and no parent had been taught resuscitation since they had been at school. Health professionals involved in the area of midwifery and paediatrics must continue to promote the Department of Health campaigns against cot death and this should include adequate training in resuscitation.
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