Since there is now good evidence that deficiency of selenium in our diet encourages the development of cancer, many people are taking supplementary selenium in the form of a tablet every day. One must be careful not to take too much selenium, however, since it can be very toxic if taken in excess.

Morbidity and Mortality Weekly Report (33:157) contains the story of a 57-year-old woman who took one selenium tablet daily and, after 11 days of this dosage, began losing her hair and developed sore fingertips. Continuing with the selenium because, at the time, she did not know that is was causing her problems, she slowly lost all of her hair during the next two months and developed a discharge around her nails, all of which she later lost as well. In addition, she suffered with episodes of nausea and vomiting, a sour-milk breath odor, and increasingly severe fatigue.

Eventually, her doctor found that her selenium blood level was four times higher than normal, and that this, in turn, was due to the selenium tablets being more than 100 times stronger than advertised.

The tablets (now recalled from the market) had been distributed in 15 states coast to coast. Knowing what to look out for, we should be able to quickly recognize selenium overdosage and protect ourselves against this danger.

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It is not possible to make any definite recommendations about treatment. The following are some suggestions for normal healthy baby care. It is not known for certain whether these will prevent cot death but they do improve the care of normal babies. Before making any changes to the way you care for your baby, please check with your pediatrician or maternal health sister.

• Before becoming pregnant try to be as healthy as possible.

• Ensure good antenatal care.

• Do not use morphine or other hard drugs.

• Avoid maternal smoking during pregnancy as this can contribute to lower birth weight or premature babies who are believed to be more at risk.

• If possible, try to breast feed as this appears to reduce the possibility of respiratory infections.

• Do not give the baby certain antihistamines or “knock out drops” which have a sleep-inducing effect.

• Parents should consult their maternal and child health nurse or doctor as to the best sleeping position for their baby.

• Maintain a warm, even temperature for the baby. In winter, keep the baby’s room heated evenly or have it sleep in your room in order to keep a check on major fluctuations in temperature.

• Maintain a smoke-free environment. Research shows that babies living with smokers are more at risk as they inhale significant levels of carbon monoxide.

• Keep the nose and mouth free from obstructions.

• Ensure your child is immunized at the correct age.

• Try not to take the baby to crowded places during winter and avoid having people with colds handling the baby.

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