Paeds Vivas · preventive-and-community-paediatrics
Safe sleep and SUDI prevention — branching viva
Structured oral on definitions, triple-risk model, counselling and hazardous shared sleep.
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Target exams
Stem
You are in a newborn clinic with first-time parents. [1]
Examiner: What is the difference between SUDI and SIDS? [1]
Strong answer: SUDI is the umbrella for unexpected infant death. SIDS is the unexplained residual category after complete investigation. Some sleep-related deaths are explained (for example accidental suffocation). [1]
Examiner: Explain the triple-risk model in one minute. [3]
Strong answer: A vulnerable infant plus a critical developmental period plus an exogenous stressor. Prevention mainly removes the exogenous stressor — unsafe sleep environment, smoke, thermal stress. [3]
Examiner: They want to bed-share to breastfeed. What do you say? [1]
Strong answer: Support breastfeeding. Recommend room-sharing with a separate safe surface rather than routine bed-sharing. Explicitly ban sofa sharing and remove hazards if any shared surface still occurs (smoke, alcohol, drugs, soft bedding, preterm infant). [1] [9] [10] [6]
Examiner: Why not side sleeping “just in case of vomit”? [1]
Strong answer: Side is unstable and often becomes prone. Supine is the recommended position for every sleep; choking concern is not a reason to abandon back-to-sleep evidence. [1] [2]
Examiner: Parents are exhausted and say guidelines feel impossible. [17]
Strong answer: Acknowledge the tension without abandoning core rules. Problem-solve night routines, bassinet placement, feed plans that avoid sofa sleep, and supports. Shame blocks disclosure. [17]
References
- [1]Moon RY Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment Pediatrics, 2022.PMID 35726558
- [2]Moon RY Evidence Base for 2022 Updated Recommendations for a Safe Infant Sleeping Environment to Reduce the Risk of Sleep-Related Infant Deaths Pediatrics, 2022.PMID 35921639
- [3]Filiano JJ A perspective on neuropathologic findings in victims of the sudden infant death syndrome: the triple-risk model Biology of the neonate, 1994.PMID 8038282
- [6]Hauck FR Breastfeeding and reduced risk of sudden infant death syndrome: a meta-analysis Pediatrics, 2011.PMID 21669892
- [9]Blair PS Bed-sharing in the absence of hazardous circumstances: is there a risk of sudden infant death syndrome? An analysis from two case-control studies conducted in the UK PloS one, 2014.PMID 25238618
- [10]Blair PS Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England BMJ (Clinical research ed.), 2009.PMID 19826174
- [17]Moon RY The Tension Between AAP Safe Sleep Guidelines and Infant Sleep Pediatrics, 2024.PMID 38529562