SIDS: A Medical Mystery

In February I will become an aunt for the first time. As you can imagine, my family and I can hardly contain our excitement. This is the primary reason I wanted to learn more about Sudden Infant Death Syndrome and why it continues to be such a mystery to medical professionals. I intend to share this research with my brother and sister-in-law, the parents-to-be.

Background:
Despite the decline in Sudden Infant Death Syndrome death rates, SIDS is still the leading cause of death among babies under the age of one. Each year approximately 4,000 babies die of SIDS. Recently, the Scripps Howard News Service completed a study on, not the possible causes SIDS, but why there are no universal standards in place to diagnose it. Based on the study, infant death investigations are done differently across the country. Therefore, several infant death cases may be misdiagnosed or overlooked. According to the study, “the Scripps review of 40,000 infant deaths going back to 1992 revealed that the quality of infant death investigations, the level of training for coroners, and the amount of oversight and review vary enormously across the country. In many cases, professional bias -- both for and against a diagnosis of SIDS – trumps medical evidence.” The study emphasizes that a lack of a clear protocol will only continue to hinder our understanding of an already mysterious disorder.

The Science:
According to the American SIDS Institute, SIDS is the unexplained death of a seemingly healthy baby under the age of one. Generally, most SIDS deaths occur in babies between the ages of two to four months. Although SIDS is not fully understood, medical experts believe it is a combination of some biological predisposition and a stress in the immediate environment of the infant.

According to the Mayo Foundation for Medical Education and Research, a medical cause of SIDS may be directly related to the brainstem, a part of the brain that controls heart rate, breathing, lung function, and arousal (ability to wake-up). A study conducted by the National Institute of Health says an abnormality in this region causes a baby to re-breathe his or her own exhaled air. Because the air would contain a high level of carbon dioxide and a low level of oxygen, the body malfunctions and shuts down.

Another possible cause of SIDS under research is Long QT Syndrome. Each time your heart pumps, an electrical impulse travels through the four chambers of the heart. Long QT Syndrome is a disorder in which the heart experiences several fast, sporadic beats disrupting the electrical system. This leaves the heart vulnerable to sudden cardiac arrest. Studies indicate that there is a gene linked to Long QT Syndrome. Research says ten percent of SIDS cases are related to this disorder. If SIDS runs in your family, a doctor may check for the disorder using an electrocardiogram (ECG) and genetic studies.

Infant sleep apnea may be another cause of SIDS. According to WebMD, apnea is a temporary pause in breathing during sleep. Some babies suffer from infant sleep apnea due to a neurological defect or simply an obstruction of the airway.

The Environment:
Although there is a strong biological component to SIDS, doctors say there are several other factors that make a baby more susceptible to SIDS. Among these factors are:

1. Premature or low birth weight
   
2. Mothers who consume drugs during pregnancy
   
3. Poor pre-natal care


4. Baby’s exposure to second-hand smoke


5. Placental abnormalities
   

The Back To Sleep Campaign:
The Back to Sleep Campaign was launched in 1994. The campaign has made an effort to educate the public on ways to prevent SIDS. Specifically, the campaign emphasizes the fact that a baby sleeping on his or her back reduces the risk of SIDS. The National Institute of Child Health and Human Development leads the campaign, along with the Maternal and Child Health Bureau, the Center for Disease Control, and the Census Bureau. In March 1997, Tipper Gore became national campaign spokesperson.

What You Can Do:
It may seem like it is difficult for parents to be pro-active in protecting their baby from SIDS. However, since environmental stresses are also a major factor in causing SIDS there are several simple precautions new parents can take.

·Babies Should Sleep On Their Back: If a baby sleeps on his or her back there is a reduced chance of suffocation.
·Sleep In Crib Near Parents Or Other Caregivers: An infant should be in his or her own crib-not in the bed.
·No Toys Or Stuffed Animals In The Cribs
·Bedding: Babies should sleep on a firm mattress. Parents should not use fluffy blankets or comforters. Mores SIDS related deaths occur in the winter because parents tend to cover their baby with extra blankets.
·Pacifier

Here is what a safe environment for your baby should resemble.

Coping:
Often after a child dies from SIDS, parents feel agonizing guilt and the question “What could I have done?” constantly runs through their minds. Parents should join a support group and perhaps seek mental health counseling. It is also crucial for parents to acknowledge how a SIDS related death might impact other children in the family. Support groups are available specifically for siblings.

If you or someone you know is dealing with the loss of a child to SIDS, there are several resources available. University Hospital in Syracuse and Crouse Hospital have materials such as books, videos, and information on support groups in the Central New York region.