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解析嬰兒趴睡 3 大風險，寶寶仰睡才最安全--小兒科醫師葉勝雄專欄

新聞 yang - 新興公托最新消息 | 2020-01-16 | 點閱數： 6013

【 2019 最新】解析嬰兒趴睡 3 大風險，寶寶仰睡才最安全｜小兒科醫師葉勝雄專欄

Apr 29, 2018

資料來源：https://tw.getcubo.com/blogs/newborn/baby-newborn-sleep-on-back

在談論嬰兒睡眠安全時，兒科醫師都會建議仰睡。而媒體在報導寶寶趴睡與嬰兒猝死的新聞時，常會將趴睡睡姿、窒息、和嬰兒猝死三者連成一線。但其實這樣的報導是有問題的，所謂的嬰兒猝死，應該是指經過詳細的檢查之後仍找不到原因的案例。如果確定是由窒息引起，那麼原因就是窒息，而不是嬰兒猝死。這樣的報導方式，會讓社會大眾有一個錯誤的印象，以為趴睡只要不窒息，就不會造成嬰兒猝死（延伸閱讀：遵守 4 大睡眠安全守則，降低猝死危險）。

因此今天我們不談窒息的因素，改談其他因為趴睡所造成的影響：

低血氧和高二氧化碳：趴睡和側睡都會讓寶寶容易再次吸入剛剛才吐出去的空氣。這些空氣含有較高的二氧化碳和較低的氧氣，會升高寶寶血液中的二氧化碳濃度，並降低氧氣的濃度。
升高體溫：身體在趴睡的姿勢下較不容易散熱，因此趴睡比仰睡容易造成體溫過熱。而體溫過熱正是嬰兒猝死的危險因子之一。
影響自律神經：趴睡會影響心血管的自律神經，減少對大腦的氧氣供應。這樣的影響在寶寶兩到三個月大時最為明顯。

以上這三點，都是趴睡的直接影響，並不是說只要注意嬰兒床的擺設就可以避免的。

儘管如此，在推廣仰睡時，還是會遇到一些阻力，例如：

趴睡會睡得比較安穩？

我們要改變一個觀念，經常從睡眠中覺醒的能力，對嬰兒來說是很重要的保護機制，是為了對抗在睡眠當中可能遇到的各種危機。其實，我們應該把嬰兒睡睡醒醒這件事情當作是正常的，相反的，如果藉由趴著來讓寶寶睡更久，那並不是正常的自然現象。

趴睡比較不會胃食道逆流？

食道較靠近背部，所以趴著時，食道的相對位置是在胃的上方，較不容易逆流。但只有極少數嚴重呼吸道問題，例如某些喉裂的患者，因為容易受到胃食道逆流的威脅，才會讓他們使用趴睡。對一般寶寶而言，兩權相害取其輕，還是選擇仰睡比較好。當然，如果寶寶還醒著時，可以在剛吃完東西後，採用趴著的姿勢以減少胃食道逆流，但前提是要有人在一旁看顧才行。

當家長慢慢接受不要趴睡的觀念後，還是會有一些問題想問，例如：

嬰兒側睡可不可以？

有研究認為側睡和趴睡，兩者之於嬰兒猝死的風險，其實是不相上下。如果剛放下去時是側睡，但最後轉成趴睡，反而更加危險。

如果寶寶會翻身，睡到一半從仰睡翻成趴睡怎麼辦？要幫他再翻回來嗎？

目前還沒有足夠的資料可以明確地告訴我們，多大的小孩自己翻成趴睡後可以不用管他。因此，如果寶寶只會從躺著翻成趴著，還不會從趴著翻回躺著，那麼發現他翻成趴睡之後，最好還是幫他翻回仰睡的姿勢，即使這過程可能會將他吵醒。如果寶寶已經可以從躺著翻成趴著，也可以從趴著翻回躺著，那麼原則上在睡著之後，就讓他們自由選擇自己喜歡的睡姿了。

最後要提醒一點，研究指出，偶爾才趴睡的寶寶，可能因為不適應，反而比經常趴睡的寶寶更容易陷入危險。因此切記如果要仰睡，就要每次都仰睡，尤其是在請別人幫忙照顧時，更要再三交代：「不要給寶寶趴睡，一次都不可以！」

（本文由 Cubo 醫學顧問 - 葉勝雄醫師撰寫）

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解析嬰兒趴睡 3 大風險，寶寶仰睡才最安全--小兒科醫師葉勝雄專欄

【 2019 最新】解析嬰兒趴睡 3 大風險，寶寶仰睡才最安全｜小兒科醫師葉勝雄專欄