Quantifying the effect of biomechanical SUID risk factors on infant respiration

PROJECT SUMMARY The leading cause of mortality for infants from 1–12 months is sudden unexpected infant death (SUID), encompassing both suffocation-related deaths and sudden infant death syndrome. No single condition appears to cause SUID, but many deaths occur within infant products not intended for sleep where suffocation likely played a role. Retrospective fatality data identify contributing risk factors and hazard modes as biomechanical- based factors including body position, infant product interaction, and feeding. However, researchers have yet to quantify a relationship between these factors and infant respiration, leaving clinicians, parents, and manufacturers of infant products with little evidence-based guidance on the best biomechanical practices to avoid SUID. The proposed study would respond to this problem. It would also substantively advance the biomechanics domain as the first to use biomechanics as the foundational science through which to study SUID. We will bring a multidisciplinary team (infant biomechanics, juvenile product design and assessment, computational modeling, pediatric pulmonology, and infant development) to this effort to untangle the complex relationships between biomechanics and SUID. The goal of this research project is to significantly reduce infant mortality by quantifying the respiratory effects from biomechanical SUID risk factors. The objective of our study is to integrate in vivo human subjects biomechanics experiments and computational modeling to define the relationships between respiration and biomechanical factors (body position, product interaction, and feeding) which influence breathing. The central hypothesis is that biomechanical-related risk factors of SUID affect younger and preterm infants more adversely than older or full-term infants. We will quantify relationships between biomechanical factors and respiration via three specific aims: (1) Quantify relationship between infant body position and breathing biomechanics, (2) Determine how product design features effect head/neck flexion and trunk expansion using computational modeling, and (3) Evaluate effect of feeding on breathing biomechanics in vivo. This project will provide a foundational understanding of how body position, product features, and feeding affect infant breathing biomechanics, and will likely help flag the very real danger of some infant products currently on the market. Deliverables include: (1) the first analysis of common body positions on infant breathing biomechanics, (2) computational models to inform product designers and reduce SUID risk, (3) characterization of breathing biomechanics changes after feeding to guide caregiving practices, and (4) industry dissemination workshops. Collectively, these data would provide needed insight to advance understanding of SUID-related deaths in relation to body position and daily life, and provide industry, parents, and clinicians with the research upon which to inform biomechanics-based safe-sleep and infant care guidelines.