A new national health system: the opportunity to address data quality issues in maternal immunisation coverage.

Aim: Maternal immunisation coverage is suboptimal in Aotearoa New Zealand. Our objective was to highlight discrepancies resulting from how maternal immunisation coverage for pertussis and influenza is measured in Aotearoa New Zealand.

Method: A retrospective cohort study of pregnant people was undertaken using administrative datasets.

The Evolving Understanding of Sudden Unexpected Infant Death.

Sudden unexpected infant death (SUID) is the leading cause for post-neonatal mortality in industrialized nations. Case-control studies have identified risk factors for SUID that have shaped research into studies of causation. Most current hypotheses for the mechanisms for SUID contribute to the "SUID sequence"-hypoxia and/or hypercarbia in sleep to which a vulnerable infant fails to respond adequately and that results in death.

Randomized controlled trial of a car safety seat insert to reduce hypoxia in term infants.

Objective: To test the hypothesis that a foam plastic insert that allows the infant head to rest in a neutral position in sleep may prevent obstruction of the upper airway and thus reduce episodes of reduced oxygenation in term infants in car seats.

Methods: Healthy full-term babies were randomized to be studied during sleep while restrained in an infant car safety seat either with or without the insert, with continuous polysomnographic recordings with sleep video.

Results: Seventy-eight infants (39 in each group) had polysomnogram recordings at a mean of 8 days of age.

What is the mechanism of sudden infant deaths associated with co-sleeping?

The risk of Sudden Infant Death Syndrome (SIDS) has fallen dramatically in the "Back to Sleep" era; however, half the cases now occur when the infant has been sleeping in bed with another person. Despite the association of SIDS with co-sleeping, parents are receiving mixed messages. It is often presumed that co-sleeping deaths are due to 'overlaying', when the adult rolls on top of the baby, stopping baby from breathing.

Can we reduce episodes of haemoglobin desaturation in full-term babies restrained in car seats?

Objectives: To determine whether episodes of haemoglobin oxygen (SpO2) desaturation in full-term infants restrained in car seats can be reduced by a simple foam plastic infant car seat insert designed to push the body forward, with space for the protuberant occiput to lie behind the spine, and so reduce flexion of the infant's head on the trunk.

Methods: Eighteen healthy full-term babies were evaluated while restrained in an infant car safety seat with, and without, the foam insert. Infants were monitored in each position for 30 min with continuous polygraphic recording of respiratory and heart rate, nasal airflow and SpO2.

Effect of pacifier use on mandibular position in preterm infants.

Aim: It has been hypothesized that the association of pacifier use with reduced risk of sudden infant death is mediated by forward movement of the mandible and tongue that helps open the upper airway. Our aim was to examine whether the mandible is moved forward when an infant is sucking on a pacifier, and if so, whether the mandible remains advanced after the pacifier is removed.

Methods: In sixty clinically stable premature infants (corrected gestation age 36.

Simple car seat insert to prevent upper airway narrowing in preterm infants: a pilot study.

Objectives: To test prospectively the hypothesis that an infant car seat modification to allow the infant's head to rest in a neutral position on the trunk would prevent narrowing of the upper airway and thus reduce oxygen desaturation in preterm infants who are restrained in car seats.

Methods: Seventeen preterm infants who were approved for discharge were evaluated in a car seat for newborns, with and without a foam insert that provided a slot for the back of the infants' head. Respiration timed inspiratory radiographs for assessment of upper airway dimensions were taken during quiet sleep in each position.