Everyone has heard the story. Healthy baby. Good parents. One night the 2 month old child never wakes up from her sleep. Suddenly unfounded suspicions arise. Blame is distributed quicker and more frequently then sympathy. But is there really always some one at fault?
Despite advances in research, Sudden Infant Death Syndrome (SIDS) still accounts for one death in every two thousand births according to the National Centers for Health Statistics. SIDS is a natural cause of death. While the American Academy of Paediatrics's Back to Sleep campaign, has help cut the SIDS rate in half by advocating that babies sleep on their back, healthy babies still die. Approximately 2,500 infant deaths from SIDS are projected this year. Most SIDS deaths occur when the infant is between 2 and 4 months old. Another 2,000 will also die in their sleep without the formal label of SIDS.
Why is SIDS under reported? When a baby is found lying on her tummy or in a bed with an adult, or with a soft toy, the coroner can't rule out the possibility that the baby was accidentally smothered. Consequently, such deaths may be labeled as "possible accidental asphyxia" or "threats to breathing" rather than SIDS. That's why the number of SIDS deaths are likely under reported. If SIDS cases are being assigned a other diagnoses, it makes it nearly impossible for researchers to intelligently extrapolate from the reported data. Regardless, the best advice to parents is to follow the sleep recommendations, including putting babies down on their backs. As Dr. Krous has explained, "Nothing we know at the present time will absolutely prevent SIDS, but the risk can be substantially reduced."
While current data is not conclusive, there are some trends that have appeared. For example, African-American, Native American, and premature babies, are at a greater risk of SIDS. Similarly, sleeping on a soft surface and exposure to secondhand smoke raises the risk of SIDS for all babies. Babies who sleep on their stomachs or on their sides have two times higher risk of SIDS then back sleepers. Babies should not sleep near bedding because of the risks of increased inhalation of carbon dioxide from rebreathing exhaled air.
Serotonin helps regulate breathing and arousal. An Italian study suggests that if a baby's arousal center isn't functioning properly, then that baby might not wake up so as to reposition and improve its oxygen supply. Children's Hospital Boston has conducted research to explain why SIDS rates drop dramatically after six months and disappear entirely at one year. Their conclusion is that with age, the brain stem matures and appropriately adjusts serotonin levels.
SIDS likely has more than one explanation. Besides brain stem abnormalities, undiagnosed genetic anomalies and a metabolic disorder called MCADD (medium chain acyl-CoA dehydrogenase deficiency) may also be possible culprits. QT syndrome, an electrical disorder in the heart, may also account for some SIDS deaths. (MCADD and long QT syndrome can be successfully treated if caught in time by a blood test.)
An AAP analysis, suggests that 20 percent of all SIDS deaths occurred while the baby was in the care of someone other than a parent. One third of these infants died during the first week of childcare. It has been suggested that babies who typically sleep on their backs are statisticlaly more likely to die from SIDS when put down to sleep on their stomachs. This highlights the need to use well qualified, licensed facilities whenever possible.
Posts
