Prone Sleep Position

We hear a lot about the importance of placing a baby on its back (the surpine position) to help reduce the risk of SIDS. What does this mean, though, and is it helpful?


There are a couple of reasons why it is recommended to place a baby on its back in regards to SIDS. For starters, there is the CO2 theory. This is the theory in which the baby dies because it lacks the trigger to turn its head when it is rebreathing its own CO2, effectively poisoning itself. This is one of the most popular theories, but like the other ones, it has flaws. It wouldn't, for instance, explain the deaths that happen when babies are on their backs, in swings, or in carseats. Or when they have no obstruction.

There is also a theory that seems to think that babies sleep better on their tummies (they do!) and that the ones who are predisposed to whatever causes SIDS fall into a deep sleep and can't be roused when they are on their tummies. Obviously, that theory is more complicated than what I just said but that's the gist of it.

When babies are face down in their bedding and obstructed from moving for whatever reason, that is not SIDS. That is accidental suffocation. So we won't go there.

Many parents wonder about the safety of placing their babies on their backs to sleep. I know I do. Could there be risks to that? Maybe.

With my oldest son who suffered from severe acid reflux and large tonsils, obstructive sleep apnea was a very real danger. Although we placed him flat on his back to sleep because we were afraid of SIDS I have since learned that was just as risky. Some of the risks were developmental. I'm not exaggerating when I say that Sam was more than a year old before he slept through the night. Before then, he gagged, choked, cried, grunted, and moaned starting at about 5 minutes after he fell asleep until he finally woke himself up less than an hour later.

We eventually found an ENT who talked to us about that and he said that the fears here were developmental delays since Sam was not getting good quality of sleep. When you sleep, your body grows and repairs itself. When you don't, you're opening yourself up to infections, a poor immune system, and a stunting of several systems.

We finally got a swing when he was around 6 months old and the inclined position helped him sleep for at least two hours at a time. This helped. The sleeping habits he developed as an infant, though, have not served him well as a toddler. Friends know the troubles we have regarding Sam's sleep habits. He generally falls asleep around 4:00 am, proceeds to wake up several times during the "night", and then finally gets up at bout 3:00 pm. Waking him up at 7:00 am and forcing him through activities in hopes of getting him to sleep at an early time does not work. In those rare cases that he does drift off at 10:00 pm or even 11:00 pm he is wide awake and bushy tailed at 2 o'clock in the morning. That's not an improvement.

Toby also had these problems. The gagging, straining, crying, and moaning in his sleep from the reflux sounded like something from a horror movie. In public settings, people would actually come running to make sure he was okay. I should add, Toby was on his back when he died. He was not a tummy sleeper. The few times I did place him on his tummy were when I was sitting there with him. During those moment, there was no throwing up in his sleep, no gagging, and no choking.

I found some information regarding the prone position and its link to SIDS and thought I would share:

"In another study of infants aged 3-37 weeks who never slept on their stomach, it was found that they do not learn the behaviors that may reduce their risk of SIDS if they are prone. In this study, researchers placed a comforter over a foam rubber mattress directly under the babies' faces. All babies awoke after approximately 5 minutes and sought fresher air. The babies with prone sleeping experience lifted and turned their heads to the side; however, the babies inexperienced in sleeping prone only nuzzled the bedding or briefly lifted their heads and then resumed sleeping facedown." http://emedicine.medscape.com/article/804412-overview#a0104


So what does that mean? If we place them on their backs when they sleep that when they do finally turn over on their tummies they are unable to turn their heads for fresh air because they haven't learned that behavior? There are a lot of parents that believe this. Many parents lost their babies to SIDS on the first night their babies learned to turn over in their sleep. They say that they always placed their babies on their backs but when they found them the morning of their death they were on their tummies. 


If that is the case, then putting them on their backs to sleep is not a good thing. At least not all the time. 


I've written about this before and talked about the over-inflated statistics regarding the Back to Sleep Campaign. The fact is, we can't be sure if putting infants on their backs to sleep is related to the lower incidence of SIDS or not. The deaths were already dropping significantly before the campaign and the campaign itself uses those numbers in their tallies. A lot of people think that less exposure to secondhand smoke and better prenatal care (both of which were on the uprise before the campaign) are the real reasons for the SIDS death declines. 


There's also the fact that reporting has changed since the Back to Sleep campaign. Before the campaign started, SIDS covered a larger pool of deaths. Now, deaths can be reported as SUID and under other acronyms that mean the same thing as SIDS but are counted under different stats. So while it might look like SIDS is significantly decreasing, it might not really be. 


I actually wish I'd had the nerve to put Sam to sleep on his tummy. What a different baby he would have been. As much as I might talk, though, and agree that the prone sleep position is probably better I, like most people, am afraid to do it. There might be little understanding of SIDS but the back to sleep thing is one of the first mandates of the syndrome. 


I hope that in the future we can figure out what causes SIDS for a number of reasons. When we do, though, I hope the first thing they decide is that tummy sleeping is NOT a trigger. Then, the parents who found their babies on their tummies won't feel so guilty and the ones who have reflux babies like Sam and Toby can put them on their tummies and feel less guarded about it. 

Prevent SIDS with These!

Prevent SIDS with These!

Okay, so if you’ve read anything that I’ve written about SIDS then you know that my title is sarcastic. However, people are probably going to find this blog entry by typing in “SIDS prevention” so I thought I’d start off by mentioning that.

Ahhh…SIDS prevention. I like those words about as much as I like hearing the words “kidney infection” when I’m at the doctor’s office. The FDA has gotten in on the act and doesn’t like it either. Recently, they put forth this notice:

“Some baby products are being marketed over-the-counter with claims to cure, treat, or prevent a disease or condition. Because of these claims, these baby products are medical devices, subject to FDA regulation.

A common medical claim being made is the prevention of Sudden Infant Death Syndrome (SIDS). The National Institute of Child Health and Human Development defines SIDS as "the sudden death of an infant under one year of age, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history."

The FDA has never cleared or approved a baby product to prevent or reduce the risk of SIDS. The Agency is not aware of any scientific studies showing that a medical device prevents or reduces the risk of SIDS.

Examples of common over-the-counter baby products with unproven claims to prevent or reduce the risk of SIDS include:

·         baby monitors,

·         mattresses,

·         crib tents,

·         pillows,

·         crib bedding, including bumpers and blankets, and

·         infant positioners.”

Still, there are many companies and doctors that claim to be able to prevent the thing that the medical community isn’t even clear about. So what’s the word on the street these days, product wise?

1.       Nanny Monitor- For $130 you can order this from Europe. It “prevents SIDS” by setting off an alarm if your baby stops breathing. Unfortunately, many experts believe that the breathing is actually the last thing that stops and that the baby is brain dead first which is why parents who were even holding their babies at the time were unable to resuscitate them. What this might do, however, is help with other medical problems, such as alerting to sleep apnea or choking incidents if the baby stops breathing. (Those, however, are not SIDS.)

2.       Amby Baby Hammock- Wow! Nearly 2500 of these have been sold and not one single baby has died of SIDS in one. Yet. Of course, a couple of babies DID die in them from accidental suffocation. They don’t use that in their marketing ploys, though.

3.       BabeSafe Mattress Cover- According to their own statistics, this is the ONLY 100% effective way of preventing SIDS. And no baby has ever died when sleeping on one of these. The evidence shows that toxic gasses escape from mattresses and that’s what is causing SIDS. This doesn’t explain, however, how babies die of SIDS when they are in car seats, arms, or other surfaces that are NOT mattresses. Oh, there is even a book to “prove” this theory called the “Cot Death Cover Up.” Just another moneymaking ploy, although safe mattresses are important. The company’s argument is that while their theory hasn’t been scientifically proven, it hasn’t been disproven, either.

4.       Halo Sleep Sacks- Yep, put them in one of these and you can “prevent SIDS” according to the labels. Yeah, right. Just tell that to a few of my friends who lost babies while they were sleeping in these sacks.

5.       Infant sleep positioners- Not only do these NOT prevent SIDS by keeping your baby on its back but they’ve actually been recalled in some cases because they’ve caused death by suffocation.

Now, before I’m called a hypocrite here, we did purchase the Snuza. The Snuza is a breathing monitor that you clip to the diaper. It can be worn and used in any situation, except in the bath. While we know that if SIDS really occurred there is nothing we could do about it, we at least want to be alarmed this time if it happens so that we can try and say we did our best.

The problem with using the word “prevention” is that it gives people the idea that SIDS can actually be stopped, when it can’t at this point. Risks may or may not be reduced, depending on who you talk to. But with a word like “prevention” it gives people the idea that if you did lose a baby to SIDS then there must have been something that you didn’t do correctly. And, as well all know, that’s just not the case. 

Positive Benefits of Co-Sleeping

For awhile now, I have had mixed feelings about co-sleeping. It feels unnatural for me NOT to, but the media, my culture, and the medical profession has ingrained it into me that it is "bad." Despite the fact that we are pretty much the only mammals that don't co-sleep and that Westernized cultures (that have higher rates of SIDS) are against co-sleeping while more Easternized cultures (like South Korea) encourage it and have lower SIDS rates we're still pretty much anti-co-sleeping here.

When I had Sam I got LOTS of unwarranted advice from practically everyone I knew, from helping his so-called "colic" (it wasn't colic but acid reflux and because we listened to friends and family members who told us that we were doing something wrong he went untreated for a year) to helping him sleep better to what we should dress him in. If we had listened to our instincts and ignored everyone I believe we would have had a much happier baby.

So Dr. Sears has taken the matter of co-seeping up and written an article about it. Finally, some research to back up things that I have been saying for awhile. Of  course, you can't please everyone and some will disagree but others might find it interesting.

Scientific Benefits of Co-Sleeping

Popular media has tried to discourage parents from sharing sleep with their babies, calling this worldwide practice unsafe. Medical science, however, doesn’t back this conclusion. In fact, research shows that co-sleeping is actually safer than sleeping alone. Here is what science says about sleeping with your baby:

Sleep more peacefully
Research shows that co-sleeping infants virtually never startle during sleep and rarely cry during the night, compared to solo sleepers who startle repeatedly throughout the night and spend 4 times the number of minutes crying ¹. Startling and crying releases adrenaline, which increases heart rate and blood pressure, interferes with restful sleep and leads to long term sleep anxiety.

Stable physiology
Studies show that infants who sleep near to parents have more stable temperatures ², regular heart rhythms, and fewer long pauses in breathing compared to babies who sleep alone ³. This means baby sleeps physiologically safer.

Decreases risk of Sudden Infant Death Syndrome
Worldwide research shows that the SIDS rate is lowest (and even unheard of) in countries where co-sleeping is the norm, rather than the exception ^{4, 5, 6, 7, 8, 9}. Babies who sleep either in or next to their parents’ bed have a fourfold decrease in the chance of SIDS ¹⁰. Co-sleeping babies actually spend more time sleeping on their back or side 1 which decreases the risk of SIDS. Further research shows that the carbon dioxide exhaled by a parent actually works to stimulate baby’s breathing ¹¹.

Long term emotional health
Co-sleeping babies grow up with a higher self-esteem, less anxiety, become independent sooner, are better behaved in school ¹², and are more comfortable with affection ¹³. They also have less psychiatric problems ¹⁴.

Safer than crib sleeping
The Consumer Product Safety Commission published data that described infant fatalities in adult beds. These same data, however, showed more than 3 times as many crib related infant fatalities compared to adult bed accidents¹⁵. Another recent large study concluded that bed sharing did NOT increase the risk of SIDS, unless the mom was a smoker or abused alcohol ¹⁶.

1. McKenna, J., et al, "Experimental studies of infant-parent co-sleeping: Mutual physiological and behavioral influences and their relevance to SIDS (sudden infant death syndrome)." Early Human Development 38 (1994)187-201.
2. C. Richard et al., “Sleeping Position, Orientation, and Proximity in Bedsharing Infants and Mothers,” Sleep 19 (1996): 667-684.
3. Touch in Early Development, T. Field, ed. (Mahway, New Jersey: Lawrence Earlbaum and Assoc., 1995).
4. “SIDS Global Task Force Child Care Study” E.A.S. Nelson et al., Early Human Development 62 (2001): 43-55
5. A. H. Sankaran et al., “Sudden Infant Death Syndrome and Infant Care Practices in Saskatchewan, Canada,” Program and Abstracts, Sixth SIDS International Conference, Auckland, New Zealand, February 8-11, 2000.
6. D. P. Davies, “Cot Death In Hong Kong: A Rare Problem?” The Lancet 2 (1985): 1346-1348.
7. N. P. Lee et al., “Sudden Infant Death Syndrome in Hong Kong: Confirmation of Low Incidence,” British Medical Journal 298 (1999): 72.
8. S. Fukai and F. Hiroshi, “1999 Annual Report, Japan SIDS Family Association,” Sixth SIDS International Conference, Auckland, New Zealand, 2000.
9. E. A. S. Nelson et al., “International Child Care Practice Study: Infant Sleeping Environment,” Early Human Development 62 (2001): 43-55.
10. P. S. Blair, P. J. Fleming, D. Bensley, et al., “Where Should Babies Sleep – Along or With Parents? Factors Influencing the Risk Of SIDS in the CESDI Study,” British Medical Journal 319 (1999): 1457-1462.
11. SIDS book, page 227, #162
12. P. Heron, “Non-Reactive Cosleeping and Child Behavior: Getting a Good Night’s Sleep All Night, Every Night,” Master’s thesis, Department of Psychology, University of Bristol, 1994.
13. M. Crawford, “Parenting Practices in the Basque Country: Implications of Infant and Childhood Sleeping Location for Personality Development” Ethos 22, no 1 (1994): 42-82.
14. J. F. Forbes et al., “The Cosleeping Habits of Military Children,” Military Medicine 157 (1992): 196-200.
15. D. A. Drago and A. L. Dannenberg, “Infant Mechanical Suffocation Deaths in the United States, 1980-1997,” Pediatrics 103, no. 5 (1999): e59.
16. R. G. Carpenter et al., “Sudden Unexplained Infant Death in 20 Regions in Europe: Case Control Study,” Lancet 2004; 363: 185-191.

SOURCE:  http://www.askdrsears.com/topics/sleep-problems/scientific-benefits-co-sleeping

SIDS, Sleep Apnea, and Austism…Oh My!

One of the biggest problems that I have with the “Back to Sleep” campaign is that it uses statistics to prove its point that have no relevance to the actual campaign. SIDS cases were declining BEFORE the Back to Sleep campaign at the same rate that they began declining after it. Many people use the “after” numbers to prove that the campaign has been effective when, in fact, it might just be due to better prenatal care and other outside influences.

I came across a great blog entry where someone broke down those statistics. While I don’t agree with all of it, I applaud the person who took the time to write an intelligent entry with facts to back it up. You can find that complete entry here: http://www.heracliteanriver.com/?p=97 

In finding this person’s blog, I also uncovered some other startling statistics. For instance, I wasn’t aware that cases of autism have increased since pediatricians began encouraging parents to place their infants on their backs, or that cases of acid reflux have increased.

Honestly, when we first found Toby my initial thought was that he had choked on his sleep and died that way. His acid reflux was so bad that I actually researched it for days leading up to his death and was very concerned. I have met a couple of parents who did lose their babies this way and the deaths were initially labeled “SIDS” although they were later changed after the autopsies. I have woken Iris up on multiple occasions when her Snuza went off after a choking spell so acid reflux is more than just an inconvenience.

I, myself, often wonder HOW putting the infant to sleep on its stomach helps “prevent” SIDS. I am not the only one.

(ref) “It’s actually quite difficult to find good information on the exact risk of sleeping on the stomach, even though numerous studies have been done.  The lack of information on relative risk is so jarring that I really do wonder if it is deliberately omitted for fear that if parents made an informed choice, they wouldn’t necessarily follow the recommendation.  When statistics are given, they are sometimes exaggerated or given in such a way as to be misleading.” 

Yes, the statistics are misleading. Since there is nothing referred to as “near SIDS” anymore (I’m sorry, the “D” in SIDS stands for “death”) how can they possibly say that those who slept on their tummies are more likely to die of SIDS since they are either a) still alive or b) gone but their COD is a term of exclusion rather than an actual cause?

There are lots of parents who state that their babies died after rolling over onto their stomachs for the first time. Or, that they passed away at daycare and were found in a different position than what they were used to. So how do these statistics work? This blogger has a theory and I might buy it:

“Studies have shown that babies who only sleep on their backs don’t develop the skills they need to breathe properly when slept on their stomachs, so a baby consistently slept on his back has a greatly increased risk of dying when he is placed on his stomach to sleep or flips himself (as all infants eventually start to do).  Infants are much more likely to die of SIDS in their first week of daycare than just about any other time.  (Another statistic often quoted.)  Why?  Often because they are put to sleep in a way they aren’t used to.”

I really do believe that babies are meant to sleep on their tummies. Many doctors agree that if the infant has acid reflux, or just won’t stay on their backs, then their bodies are telling them something and you shouldn’t force them to sleep in that position. It has also been proven that the voice box is further up when they are infants and gradually drops down, more or less. As the infant ages, this could obstruct their breathing if they are on their backs.

So if this theory is correct, and it sounds as good as any, then it’s not putting them on their tummies that’s bad-it’s getting them used to an unnatural position (their backs) which interferes with their breathing when they do manage to turn over on their tummies.

If you don’t want to read that entire blog entry that I linked to, then at least read this part. It explains why SIDS statistics might be skewed and how this could be a bad thing in terms of interpretation:

“If you want a number that people understand intuitively, you generally use “relative risk.”  Say the rate of getting a particular cancer when you eat a healthy diet is 1 in 1000.  Say the rate of getting that cancer when you eat non-healthy food X is 3 in 1000.  I might therefore say, “You have three times the chance of dying of cancer by eating X,” which is a relative risk ratio of 3:1, or simply 3.  We intuitively understand what that means.
But SIDS studies rarely report relative risk.  Instead, they use a more abstract measure called “odds ratio,” although some researchers seem to confuse the terms and mistakenly call them risk ratios or something.  It’s a little bit difficult to explain “odds ratios” in a simple way, but basically they always show the same correlation as “relative risk,” except with a different magnitude.  That is to say, if the risks are equal for conditions A and B, the odds ratio and the relative risk will both be 1:1, or simply 1.  If condition A has a greater risk than B, both the odds ratio and relative risk will be greater than 1.  If the reverse is true, they’d be less than 1.
The problem with odds ratios is that they don’t correspond in size to relative risk, and under certain conditions they can greatly exaggerate a particular trend.  For example, in our earlier example of a relative risk of 3 for eating food X and getting a kind of cancer, the odds ratio might be around 3, or it might be 6, or it might be even 9 or greater.  It all depends on a bunch of variables including how prevalent a condition is in a given population, how a control group is chosen, etc.  In simple terms, an odds ratio doesn’t easily allow you to compare the exact risks in an intuitive way between two conditions.”

And for those of you that just think I am out to attack the “Back to Sleep” campaign, consider this:
“SIDS was also decreasing rapidly before the back-sleeping recommendation, mostly due to general improvements in infant health-care.  In the U.S., SIDS rates decreased by about 25% in the decade from 1982 to 1992, while 90% of infants still slept on their stomachs. “

In my eyes, 25% is not an insignificant number. There are many reasons why the number of cases decreased during that time. More women stopped smoking during pregnancy, prenatal care got better, newborn screenings started picking up more obscure health conditions, and SIDS got more notice which might have caused more parents to consider the risks of accidental suffocation (sometimes mislabeled as SIDS). You also have to consider the fact that the general reporting of SIDS as a COD changed in many states which might also have made the numbers go down.

For those of you that want actual numbers, they break down like this:

– about 1 in 1000-1500 prone-sleeping babies die of SIDS
– about 1 in 2000-3000 supine-sleeping babies die of SIDS

These are NOT significant numbers. Even the author agrees that “a relative risk less than 3 is generally considered insignificant enough that many major medical journals wouldn’t generally publish such research without a proven causal mechanism explaining the reason for the risk.”

The author states that “No matter what position, 999 of 1000 babies will be just fine.  If we randomly chose a sleeping position for infants, about 1/3 of SIDS deaths would still occur in babies on their backs.”

This is something that many pediatricians, researchers, and scientists are starting to agree upon, even though you wouldn’t know it by the number of posters, pamphlets, and talks regarding SIDS that you can find in hospitals and health departments.

The fact is, since we don’t know what SIDS is, I think it highly irresponsible to claim that one thing over another “causes” it. While there might be a correlation, we still don’t yet have a causation. With the numbers being so low, it might just be a coincidence.

The author states that since we don’t know what causes SIDS we really can’t say that sleeping on their stomachs caused their death. In fact, putting some babies on their backs might cause SIDS. The numbers are not that much different. Babies on their backs are at an increased risk for sleep apnea and not only has obstructive sleep apnea caused infant death, but it’s also been linked to SIDS.

I’m going to include the autism link here, not because I believe it myself, but because it was there and it’s not something I’d heard of myself:

“There are even people proposing possible links to the so-called “autism epidemic” of the past couple decades and this “Back to Sleep” campaign.  For various reasons dealing with changing diagnostic criteria, it’s difficult to estimate how much autism has actually increased versus how much it was simply not diagnosed before.  But most people seem to think it has increased at least somewhat, and it definitely follows the trend of the back-sleeping.  Both autism and SIDS have been linked to problems regulating seratonin levels.  Moreover, there’s a 4:1 male-female ratio in autism, which also happens to be the same 4:1 male-female ratio in babies who develop sleep apnea on their backs. “

And lastly, one of my favorite parts of the article had to do with the comparison of tummy sleeping to car accidents.

– Chances of a supine-sleeping infant succumbing to SIDS with no other risk factors: about 1 in 50,000 (range 25,000–60,000)
– Chances of the average person dying within the next year as a pedestrian involved in an accident: about 1 in 50,000

I know I’m simplifying things here, but when you think about it that way…There’s just as much of a chance of your infant dying of SIDS if you put them on their back as there is of you walking down the road and getting hit by a car and dying? I should point out that those statistics are for those infants that had no other risk factors.

For another similar view on this topic, you might check out this article, written by a physician who has his doubts about the back to sleep thing: http://doctorstevenpark.com/sids-back-sleeping-and-sleep-apnea

Again, I don’t know what any of this means but I was a little concerned to read that the campaign itself was based on an experiment and that there really hasn’t been any additional research to back it up, despite everyone going around talking about the benefits and how it reduces SIDS.

I felt obliged to include my thoughts on this in my blog because a recent discussion opened up concerning statistics in the support group and that spurred me to do my own research on it. Take it as you will, but hopefully it might spur your own hypotheses. Whether you agree or not, it’s definitely something to think about.

(Note: I thought that after losing Toby to SIDS I would be scared out of my mind and follow every precaution and advice out there. Instead, I seem to have gone in the opposite direction. I feel like I’ve played by the rules a lot and now I’m trying to find my own way in these things.)

Another opinion on the number of SIDS cases declining

One of my online friends that had a son pass away from SIDS last year had another confirming opinion that SIDS cases aren't really decreasing. I've said for awhile that it's not so much that the numbers are going down as it is that different coroner's offices and even states are reporting the deaths in a different manner. Some states, for instance, no longer use "SIDS" as a cause of death at all. Instead, they use "Sudden Unexpected Infant Death (SUID)". Although these deaths happen in the same manner and mean the same thing, they aren't included in SIDS statistics. So while it might appear that a state such as Oregon has had no SIDS deaths in the past three years, really it's just because they are reporting those deaths using a different terminology.

My friend's son is one of these children that was reported as a "SUID", even though his death follows the classic characteristics of SIDS.

She writes: "There were no risks, no contributing factors; the ME told me ____ was a very “healthy” baby. As many of you know this term is used as a classification for any infant death that does not have an apparent cause of death to begin with, meaning if after the investigation is done and they find viruses or accidental suffocation as a cause – it can also be under this classification. I asked the ME why SIDS was not used. Oregon (the state we are in) no longer uses SIDS as a cause of death. I looked at the health statics from my state previous years and SIDS was used previously (as late as 2007). The ME said the term SIDS was used as a catch all and was too vague; they wanted to be more accurate."

This is extremely confusing because I personally don't see how the term SUIDS is anymore accurate than SIDS, considering the fact that it's still unexplained. It might just be a question of semantics. 


When this parent questioned organizations and agencies as to whether or not her son's death was counted as a SIDS case, the answer was no. She writes: "(His) death is classified along with about 1700 other SUIDs that are explained (like accidental suffocation) and unexplained (like his)."

This happens to go along with the risk factors and preventive methods that I was talking about earlier. I really urge you to read the article on NPR about SIDS cases that I posted in the previous entry. Still fuming over that one.

I have no intention of making this a cause and getting all gung-ho over it, but this is really irritating to me. Many organizations use the supposed decline of SIDS cases as ways to promote their products and urge parents to use the "prevention" methods. the fact is, SIDS might NOT be decreasing. In fact, it might just be a matter of the reporting of the deaths that is actually changing and not the deaths themselves.

Inner ear problem linked to SIDS?

March 15, 2011

In doing my weekly SIDS research survey I came across some information regarding one of the newer theories. This one pointed to a risk factor and had to do with the infant hearing test. In at least two states the majority of the babies who died from SIDS failed their hearing test as newborns and had to be re-tested. What interested me in this was that Toby also failed his. Unfortunately, there haven’t been any updates on this since 2009.

I don’t know what anyone could do with this information but it’s still interesting.

Here are some links:

http://www.ctv.ca/CTVNews/World/20070730/sids_070730/

http://www.webmd.com/parenting/baby/news/20070727/newborn-hearing-test-may-predict-sids

http://www.seattlechildrens.org/about/stories/listening-to-a-hunch/

http://content.usatoday.com/communities/sciencefair/post/2011/01/inner-ear-damge-linked-to-breathing-difficulty-in-mammals/1

SIDS cases NOT really declining

This is by far one of the best articles that I have come across in awhile. I read over and over again that the number of cases of SIDS have gone down dramatically due to the “Back to Sleep” campaign and from the fact that parents are being “educated” about not putting soft things in the cribs, not co-sleeping, using fans in the rooms, etc. However, it is widely suggested that infant death rates have NOT gone down at all-that different states and even different counties within the states are simply calling the deaths something other than SIDS, making it appear as though the number of SIDS cases are declining when they really aren’t.

I have met many people who followed ALL of the precautions and their babies still died from SIDS. There is no “foolproof” way to prevent it. What this article explains, too, kind of backs up what I was saying earlier about research. We NEED to keep researching SIDS and looking for answers, because if we don’t, then this is a problem that is never going to go away.

I would personally love to see a study conducted not only on the health and symptoms of the infants themselves, but on the pregnancy in general. I would like to know if there are any similarities between the mothers. One of the prevailing SIDS theories right now has to do with low levels of serotonin in the infants, but we don’t know what causes that and it’s not something that you can test for until after death. I wonder, though, if there are any pregnancy complications (preeclampsia, hyperemesis, depression, problems with the placenta, malnutrition, gestational diabetes) that might contribute to this. Just a thought.

ARTICLE:

 
Every day in America at least 10 babies die suddenly and mysteriously.

Opportunities to prevent some of the more than 4,000 sudden infant deaths every year are being squandered because of a failure to implement simple, national standards for infant death investigations, a seven-month review by Scripps Howard News Service has found.

In fact, we are getting further away from solving the mystery of Sudden Infant Death Syndrome because of sloppy procedures, manipulation of statistics, misguided efforts to protect the feelings of grieving parents, and deliberate attempts to make SIDS go away, at least on paper.

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.

As a result, the odds that an infant's death will be correctly diagnosed are often determined by geography rather than science. In other words, the same death might be called SIDS in one county and called something else just down the road.

"There's no rhyme or reason to what medical examiners are diagnosing as SIDS, suffocation, strangulation or undetermined," said Theresa Covington, director of the National Center for Child Death Review Policy and Practice at the University of Michigan. "The variability is across the country and within the states."

The confusion comes with a very high price: the deaths of more babies who might have been saved through medical research.

The deeply muddled approach even has many experts questioning if a much-celebrated decline of SIDS deaths since the early 1990s was actually as significant as first believed.

"If we had a standard approach to investigating and classifying these deaths, our approach to prevention and research could be a lot clearer," said Dr. James Kemp, a leading SIDS researcher at St. Louis University. "The whole reason for keeping count is to figure out how to avoid the next infant death."

Yet questionable statistics from this haphazard system continue to guide public policy and outreach campaigns, as well as government research efforts that have devoted more than $110 million to SIDS research in the past five years from the National Institutes of Health alone, plus millions more from foundations seeking to understand why babies continue to die.

"You have to worry about the quality of this data (from death certificates), but there are researchers still using them," said Covington. "I simply don't put any credibility on any research that uses those numbers anymore."According to standards set by the World Health Organization and the Centers for Disease Control and Prevention, SIDS should be diagnosed when an infant less than 1 year of age dies suddenly and unexpectedly and no clear cause of death is found after a thorough investigation that includes an autopsy, examination of the death scene and review of the child's clinical history.

Scripps conducted an extensive study into how infant deaths are investigated in the United States using records provided by the CDC. The records detail the sudden deaths of 40,239 infants, half of whom died in the 1990s and the rest in a five-year period from 2000 to 2004.

The records of the most recent infant deaths, from 2000 to 2004, can be examined in the first searchable database of its kind at www.scrippsnews.com/sids.

The review found enormous variation in how the deaths of infants are investigated and classified. The SIDS rate, according to the data, is 12 times higher in Mississippi than in New York. Most experts agree that the big differences are caused by how the deaths are classified, not by how the babies died.

Variations are sometimes even greater from county to county within a state because coroners take widely different approaches to how they determine the cause of infant deaths in their areas.

Federal records show a dramatic decline in reported cases of SIDS, dropping from 4,895 cases in 1992 to only 2,247 in 2004, the most recent year for which complete data is available.

The records reviewed by Scripps showed that cases of SIDS virtually disappeared in some states and cities over the last several years, but closer examination of the data makes it evident that thousands of those lives have not been "saved," but rather lost under another name.

Coroners and medical examiners said SIDS was responsible for nearly 80 percent of all sudden infant deaths 15 years ago and only 55 percent in 2004. What increased during this time were diagnoses that CDC statisticians labeled as "threats to breathing" and "other ill-defined causes of mortality."

Some researchers think that this "code shifting" of infant death causes has substantially overstated the success of public health efforts against SIDS. The diagnosis of SIDS has been replaced on death certificates by new and vague terms like "undetermined cause" and "sudden and unexplained death."

The result is that, while deaths attributed to SIDS are down, the overall number of sudden infant deaths has remained steady, and even ticked up in some years, since 2000.

Death by another name

"A lot of us are concerned that the rate (of SIDS) isn't decreasing significantly, but that a lot of it is just code shifting," said John Kattwinkel, chairman of the Centers for Disease Control and Prevention's special task force on SIDS. "We don't know where the best place is to put our emphasis on further reducing the risk of SIDS. It is still a very high killer of babies."

The danger is that medical researchers can't trust the causes listed on infants' death certificates, clouding hopes for a solution to the mystery of SIDS — and also masking other risks to babies.

"We are told that physicians should first do no harm," said Henry Krous, a prominent child pathologist and director of the San Diego Sudden Infant Death Syndrome Research Project. "But we need to be aware that we can do harm by using terms that don't gain anything to the understanding of this disorder."



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