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Sudden Infant Death: New Study Finds Cause – Or Merely Effect?

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I don't know if I can think of a worse nightmare for parents than walking into their newborn baby's room and finding their infant dead. Sudden Infant Death Syndrome (SIDS) is a horror that first started rearing its ugly head about twenty years ago. At least that's when the medical profession started to categorize the mysterious unexplained deaths of infants under the age of a year; who knows how long it had been occurring in the years prior to that.

Crib deaths, as they are also called, are characterized by the unexplained death while sleeping of an infant under the age of one year. A perfectly healthy child was put to bed by his or her parents and would simply stop breathing for no apparent reason. Parents, of course, would be guilt-ridden as well as grief-stricken, blaming themselves for what they saw as a seemingly preventable death.

Finally, there might be at least a partial explanation for this mysterious horror. Researchers in the United States have compared the brain autopsies of 31 SIDS victims over the past ten years with those of ten infants who have died of other causes and noticed an abnormality in the brain stems of the SIDS babies that might affect breathing. The defect seemed to affect the brain stem's ability to regulate serotonin, the chemical that helps to control vital bodily functions.

While this in no way can be seen as conclusive evidence due to the small numbers in the study, it does go a long way toward supporting what doctors at Sick Children's Hospital in Toronto, Canada, have long suspected: that some brain function in these children has been inhibited in order for the deaths to occur.

Dr. Ernest Cutz, who has studied the disease, believes the discovery is one step toward removing the mystery surrounding SIDS, and hopes it will help improve prevention and perhaps even lead to its eradication.

Aurore Côté of Montreal's Children's Hospital and a specialist in SIDS is the one who cautioned the sampling in these test results is too small to be conclusive in any way. She says the two major risk factors involving the syndrome are already established: putting babies to sleep face down and tobacco smoke during pregnancy.

In Canada, education campaigns have been highly effective, reducing the number of SIDS related deaths from over 400 a year annually a decade ago to 100. Even in this recent study, it was shown 65% of the deaths were babies that had not been put to sleep on their backs. In other words, there is still a worrying lack of awareness of basic prevention methods among parents in the United States.

It seems to me it's a matter of common sense. One of the first things you are told when handling a newborn infant is to ensure you always support its head. The head is the largest single part of the human body and the baby's neck muscles are nowhere near developed enough to be able to support its weight. If the child is laid face down in bed, he or she will never be able to move in order to take a deep breath if required.

But that also leads me to wonder about something: has this study found a cause, or have they merely found another effect? If the weight of a child's head causes the brain stem to be placed under undue strain because the muscles of the neck can't protect it, does this increase the likelihood of the lack of serotonin control? Would placing the baby face-down on its stomach cause its esophagus to close, resulting in decreased oxygen to the brain, which in turn would cause the brain stem's effectiveness to depreciate, resulting in reducing the control of serotonin? In other words, this effectively causes suffocation and the failure of the body's alarm system ability to warn of that potential simultaneously.

Might it not be possible this new study's findings are simply a report of cause and effect instead of being any major breakthrough? The question the study needs to answer is whether the lack of serotonin control was a pre-existing condition or simply an ancillary result of the cause of death – gradual asphyxiation caused by the collapse of the infant's windpipe due to its inability to support the weight of its own head.

Was the baby born with the brain defect that allowed for the impairment of the serotonin or did the defect develop because of the cause of death over its short lifespan and influences during gestation? It's easy to say "oh, look, this number of infants died and they all have X wrong with them" and conclude that X is the factor causing death. But to do so without ascertaining the cause of X is sloppy science.

Try a simple experiment on yourself: let your head fall backwards so that your chin points to the ceiling and your neck and the spinal column within it are compressed. While your head is in that position, do you notice you're not breathing as deeply as you should? When you return your head to its normal upright position, you may experience some dizziness or light-headedness, caused by lack of oxygen to the brain. But you didn't receive any warnings you weren't breathing normally did you?

The results of this latest study showed 65% of the infants had not been sleeping on their backs. There has been no report of whether or not there were any other mitigating factors, like smoking during pregnancy or exposure to secondhand smoke, considering these factors would have impacted on the other 35%, and it is important to find out. If all 31 infants in the study were exposed to high-risk situations of some sort, it would be negligent to ignore the facts.

While it would be wonderful to say the cause of this heartbreak has been discovered, it seems to me like there are too many question marks surrounding this latest study to raise anyone's hopes. Before we start rushing out to fill prescriptions for infant serotonin regulators, I think far more study needs to be done on when the brain defect developed and its cause.

Right now, there is as much likelihood they've discovered an effect of SIDS as a cause. For real peace of mind about SIDS, see your family doctor and get educated on all you can do to prevent it. That seems to be still the best cure.

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About Richard Marcus

Richard Marcus is the author of two books commissioned by Ulysses Press, "What Will Happen In Eragon IV?" (2009) and "The Unofficial Heroes Of Olympus Companion". Aside from Blogcritics his work has appeared around the world in publications like the German edition of Rolling Stone Magazine and the multilingual web site Qantara.de. He has been writing for Blogcritics.org since 2005 and has published around 1900 articles at the site.
  • http://plainavy.blogspot.com Plainavy

    Does the book mention any of the studies of breastfeeding and SIDS? My understanding is that breastfeeding is protective against it. Co-sleeping is also said to be protective (unless the parent is drugged) and helps the baby regulate breathing.

    Plainavy

  • http://bonamassablog.us Joan Hunt

    As a former pediatric and maternal health nurse, I know for a fact the standard new parent education prior to hospital discharge is “back to sleep”, meaning you place your child on his or her back at bedtime. Diaper, toy, and formula packages are labelled accordingly, too.

    For many of the tragic losses I’ve encountered with SIDS, there was no history of smoking or even of the baby being placed on its stomach to sleep. And it’s important to note SIDS goes back much further than 20 years, Richard.

    I also don’t believe anyone’s looking to start pumping babies full of serotonin. When serotonin uptake is inhibited, it’s often because the receptors are incapable of binding to the chemical already present. Plus, serotonin is not something normally given to anyone under the age of thirteen, except in extreme situations carefully overseen by a group of physicians. There are too many unknowns about the effects of serotonin on the young. As well, adults taking selective serotonin reuptake inhibitors are generally monitored for liver function changes.

    The cause of SIDS may never be learned, but comprehensive education of new parents must continue without hesitation.