health

The tragedy of sudden infant death syndrome: How to protect your baby

11 Comments
By Rachel Moon

Each year, about 3,400 U.S. infants die suddenly and unexpectedly while sleeping, according to the Centers for Disease Control and Prevention. SciLine interviewed Dr Rachel Moon, professor of pediatrics at the University of Virginia and the chair of the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Moon discussed the best ways for babies to sleep safely and the recent media reports heralding a study on “the cause” of SIDS.

Below are some highlights from the discussion. Answers have been edited for brevity and clarity.

What is SIDS?

Rachel Moon: It stands for sudden infant death syndrome, and it is a term that describes when babies die suddenly and unexpectedly. It has been superseded by a more comprehensive term called sudden and unexpected infant death, which encompasses SIDS and then other sleep-related deaths (such as accidental suffocation) and deaths that occur when a baby is sleeping or in a sleep environment.

What exactly causes these babies to die?

Rachel Moon: Ultimately what happens is that, for most babies, there is a lack of arousal. They can’t wake up to respond when they are not getting enough oxygen or there’s too much carbon dioxide in their system. This is not something that you can see in a lab test or blood test or any kind of test. We only find out when the baby has died.

What is the safest way for babies to sleep, and why?

Rachel Moon: We want every baby to sleep on their back on a surface that is firm and flat, which means not inclined, and safety-approved. So, ideally a crib, a bassinet, a playpen or another product that is approved by the CPSC, the Consumer Product Safety Commission. And then nothing should be in that area but the baby. We also want babies to be in a smoke-free environment and ideally to get as much human milk, breast milk, as possible.

What sleeping situations are dangerous for babies?

Rachel Moon: Babies should never, ever, ever sleep on couches, sofas or stuffed armchairs.

What is known about the safety of letting a baby nap in a sling or baby carrier?

Rachel Moon: The thing that we worry about is that when a baby is in that kind of device, the baby’s body position can be such that it blocks their airway or that their face is up against something that can obstruct their airway.

So it’s fine for the baby to be in a carrier or a sling, but we recommend that the baby be upright so that the head and neck are straight and that the airway is straight. And then we also recommend that the baby’s head and neck be above the top of the carrier so that you can always see the baby’s face and that there’s no obstruction of the nose and the mouth.

What is known about the safety of letting a baby nap in a car seat?

Rachel Moon: If you are traveling, a car seat is absolutely the safest place for your baby to be. However, when you get to where you’re going, then it is best if you take the baby out of the car seat and then put the baby on a flat, firm surface.

When babies are at an incline, it’s actually harder for them to keep their airway straight. Their heads are really big and heavy for the size of their bodies. And so it takes a lot more work when they are at an angle than if they’re flat on their back. They can develop muscle fatigue, and that can actually be dangerous for them. … There is actually some really compelling biomechanical data that led to the CPSC, the Consumer Product Safety Commission, restricting and hopefully banning inclined sleep products such as rockers and similar products.

What is the evidence on the safety of ‘co-sleeping,’ where babies sleep in bed with their parents?

Rachel Moon: The safest place for your baby to sleep is in a crib or bassinet or another safety-approved device that is next to your bed. We know that babies who sleep in the same bed as their parents are at higher risk for death.

We recommend for the space to be right next to your bed because that makes it easy for you to turn and pick up the baby or comfort the baby or bring the baby into bed for feeding. If you do bring the baby into the bed for feeding, that’s fine. But when you or the baby gets ready to fall asleep, then just move the baby back into the crib.

What should parents and other caregivers know about the recent headlines claiming a study had found ‘the cause’ of SIDS?

Rachel Moon: These researchers – they looked at dried blood samples. And these are the tests that are done on your baby when your baby is born to look for genetic diseases.

They took these dried blood samples and looked for a particular chemical that’s in the body called butyrylcholinesterase. And they found it to be at a different level in babies who died from SIDS than babies who did not die from SIDS … While I think it’s an interesting result, and while it may lead to other tests and other studies, at this point, it is not the be-all and end-all.

We don’t have a test that can diagnose who is going to die from SIDS and who’s not. And so you still have to follow the safe sleep guidelines.

Rachel Moon,** M.D., is the Harrison Distinguished Professor of Pediatrics and the division head of general pediatrics at the **University of Virginia.

SciLine is a free service based at the nonprofit American Association for the Advancement of Science that helps journalists include scientific evidence and experts in their news stories.

The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.

© The Conversation

©2022 GPlusMedia Inc.

11 Comments
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Excellent article with well based, detailed recommendations that can help parents reduce the incidence of SIDS, a problem that is fortunately infrequent but still a tragedy on every single case. Even by putting the problem in the minds of parents can help because right now there is a low of information available in many reliable sources that can help.

It is also good that the last part puts into an appropriate context the recent headlines about the cause of SIDS, at this point the best way to act is to assume every baby is at some risk and follow the recommendations to have them sleep as safely as possible.

-3 ( +2 / -5 )

ideally to get as much human milk, breast milk, as possible.

For decades, the "experts" claimed that formula was actually healthier.

Turns out that my grandma was right and the "experts" were wrong... as usual.

1 ( +6 / -5 )

For decades, the "experts" claimed that formula was actually healthier.

When exactly? even from before the change of the century breast milk has been heavily promoted over formula. All based on well documented, validated and characterized scientific data to prove it.

Turns out that my grandma was right and the "experts" were wrong... as usual.

When you depend on mischaracterizing the experts or what they actually said it is very easy to make up things for them to be wrong about. Even to the point of contradicting what they have been recommending for decades already.

-4 ( +2 / -6 )

I’d also add don’t let your Japanese wife sleep with your newborn in your bed. I wonder how many SIDS cases in Japan are actually due to the babies being suffocated to death because of Japanese aversion to letting them sleep on their backs in a crib?

1 ( +3 / -2 )

Did SIDS exist before the 20th century?

1 ( +4 / -3 )

Did SIDS exist before the 20th century?

It is described in the book of kings of the old testament in the bible, the fight that the kind Solomon has to solve between two mothers and one child is because the kid of one of them died because of "overlying" during the night, which is the description done for a child that was found dead in the morning.

0 ( +3 / -3 )

Did SIDS exist before the 20th century?

I was wondering the same thing. Could SIDS be caused by something infants have been given during the past century?

It is described in the book of kings of the old testament in the bible, the fight that the kind Solomon has to solve between two mothers and one child is because the kid of one of them died because of "overlying" during the night, which is the description done for a child that was found dead in the morning.

From wikipedia: "Overlaying or overlying is the act of accidentally smothering a child to death by rolling over them in sleep." This only covers one of the potential causes of SIDS, or might not even be considered SIDS.

0 ( +3 / -3 )

Did SIDS exist before the 20th century?

I was wondering the same thing. Could SIDS be caused by something infants have been given during the past century?

Indeed! And I hope they're also looking at the recent big rise in SADS.

1 ( +3 / -2 )

I was wondering the same thing. Could SIDS be caused by something infants have been given during the past century?

Since it has been described since ancient times this would mean a time machine would be necessary for this explanation.

From wikipedia: "Overlaying or overlying is the act of accidentally smothering a child to death by rolling over them in sleep." This only covers one of the potential causes of SIDS, or might not even be considered SIDS.

And this is the explanation given to all cases where a child wakes up in the morning death with the parents, a default explanation until the children began to sleep in a crib and the deaths continued. A false explanation got debunked by evidence and the existence of SIDS recognized, which is the actual position of experts right now.

https://adc.bmj.com/content/archdischild/60/3/278.full.pdf

Indeed! And I hope they're also looking at the recent big rise in SADS.

What "big rise" are you talking about? the increase of arrhythmic disease because of covid is already well explained, and having a cause obviously it does not constitute SADS

-2 ( +1 / -3 )

Indeed! And I hope they're also looking at the recent big rise in SADS.

What "big rise" are you talking about? the increase of arrhythmic disease because of covid is already well explained, and having a cause obviously it does not constitute SADS

No, there is a recent big rise in SADS (Sudden Arrhythmic Death Syndrome or Sudden Adult Death Syndrome) that is not related to Covid19. For some reason, they seem to have trouble finding the cause...

I think they know the cause, but aren't allowed to say....

0 ( +2 / -2 )

No, there is a recent big rise in SADS (Sudden Arrhythmic Death Syndrome or Sudden Adult Death Syndrome) that is not related to Covid19. For some reason, they seem to have trouble finding the cause...

So no reference then? the one you are talking about has been debunked

https://fullfact.org/health/sudden-deaths-connect-the-dots/

https://www.factcheck.org/2022/06/scicheck-posts-baselessly-link-sudden-arrhythmic-death-syndrome-to-covid-19-vaccines/

The actually important increase that has been reported is either associated with covid infection or to some kinds of heart medication during summer, neither of which can be said to be unexplained nor difficult to find the cause.

-2 ( +1 / -3 )

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