Positional Asphyxiation – the Silent Killer for babies

The word asphyxia comes from Ancient Greek word α- “without” and sphyxis, “heartbeat”. Asphyxiation is a condition of severe deficient of oxygen to the brain and body because of abnormal breathing. There are many causes for asphyxia, for example, choking. Positional asphyxiation is a postural cause (body position) that prevents them from breathing normally.

Positional Asphyxiation in newborns

At early stage (1-4months), a baby’s head is so heavy that the neck isn’t fully strong enough yet to support it. When the head resting with his/her chin on the chest too much, the airway is kinked (in other words, blocked). It doesn’t matter which direction your baby’s head bends, it can still happen. However, it also doesn’t mean that babies above 4 months or babies that are able to lift their head, are not at risk.

Where can Positional Asphyxiation happen?

  • Infant car seats
  • Swings
  • Strollers
  • Incorrectly used or ill-designed baby carriers
  • Baby crib and playpen
  • potentially others…


Let’s learn from Ali and Derek for the tragedy that happened in a baby car seat.

Quoting a news commentator on the story above:-

“whilst parents use baby car seats diligently as a safety device for their babies, WHEN USED INCORRECTLY, are deadly, for very young children”

The same can happen on strollers and swings. Just, never leave your babies unattended. It is just not worth it. Positional Asphyxiation can take a baby’s life in as little as 2-5 minutes. The silent part is that, often baby will not make a sound.

In playpen (baby’s playing ground) and crib, parents will want to be aware of their older babies who can roll over and sleep on their stomach. The safety is not only on fencing the child in an expensive crib.

In fact, there are mounting researches that some babies with lower serotonin levels lack the ability to respond to stressed situation. This can either be a congenital (developed during pregnancy) or genetics condition. It makes even a baby with muscle ability to support his own head, to sleep right through the lack of oxygen and die from it. Parents just have to be aware if babies are sleeping on fiber-filled mattresses.

In fact, there are recommendations to use permeable mattress for babies to sleep on and, even debate on co-sleeping with parents!

Highest risk group for positional asphyxiation

  • Under 4 months old
  • Low birth-weight newborns
  • Hypotonia babies (low muscle tone)
  • Premature babies
  • Babies placed in reclined baby holding devices

There are signs and things to avoid to prevent positional asphyxiation, or sometimes related to SIDS (Sudden Infant Death Syndrome).

“Positional asphyxiation” is a term not often heard and to show just how “unknown” this issue is, the victim parent in the video above, Ali pointed out that the initial report failed to include their son Shepard’s death. Spread the awareness, for it matters.

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