Sudden Infant Death Syndrome (SIDS) Research 2006

Sudden Infant Death Syndrome (SIDS, aka "Crib Death") is but one of the many paradoxes to be found within the science of medicine and is yet the one paradox that causes the greatest emotional trauma of all the others combined. As it is well known, apparently healthy infants less than 1 year of age are placed in their cribs only to be found dead a few hours later. There is no sign of trauma or that a struggle had taken place. At autopsy, no evidence pointing to a specific cause of death can be found and the diagnosis of SIDS is given "by default" as other conditions are "ruled out by their absence."

SIDS is the leading cause of death prior to one year of age in the . Demographically, SIDS appears to strike twice as many Afro-American infants and three times as many Native American children as infants of Caucasian / Western European parents, strikes males twice as often as females, and occurs more often in the winter months. In spite of extensive research, no single factor has been conclusively linked to SIDS. There are, however, some factors or events that show at least an anecdotal (linked by coincident rather than by scientific evaluation) relationship to its occurrence. These include:

* Placing an infant on its stomach rather than its back inside the crib. There is some statistical data suggesting that infants sleeping on their stomachs have a higher rate of SIDS. This topic will be discussed in more detail in another section of this posting.

* One or both parents that allow tobacco smoke in their child's environment. This finding is suspect in that no prospective studies(studies that begin with two populations, smoking and nonsmoking parents) are available to either prove or disprove a possible contribution to SIDS.

In a recent review article (see below) Jonathan Makielski of the University of Wisconsin at Madison traced the evolution of the current understanding of the pathophysiology of SIDS and the possibility that a known genetically-transmitted condition known as "Long Q-T Syndrome (named for its characteristic EKG pattern)," a condition that has been proven to cause unexplained, sudden death in teenagers and adults, may play a significant role as the underlying condition predisposing infants to SIDS. Since a major precipitating condition in Long Q-T Syndrome is respiratory acidosis (a condition in which the acidity of the blood increases due to the inability of respiratory activity to "blow off" excess acidity) considerable research has been done in this area and is currently ongoing. While some of this research shows promise, another school of thought has emerged within the past month.

At the 2006 annual meeting of the American Society for Clinical Pathology, retired pathologist and former coroner Hazel L. McGaffey, MD presented a paper based on her experiences as a working coroner and her personal involvement in some 40 cases of SIDS. Blood and body fluids taken at autopsy for later analysis did show that acidosis was present, but it was a metabolic acidosis (acidosis due to some derangement in the body's metabolism, such as the acidosis seen in diabetics when they have too little insulin to properly use glucose) that was detected. Although a detailed discussion of the causes and nature of respiratory versus metabolic acidosis is beyond the scope of this posting, her findings do suggest that some form of routine screening could be developed should her findings be duplicated by other investigators.

In the interim, the most effective preventive measure regarding SIDS is the "Back to Sleep" program sponsored by the AmericanAcademy of Pediatrics and the National Institutes of Health (see below). This program has been in active use for almost 20 years and, to date is the only proven strategy that can reduce the chances of SIDS.

For More Information

The American SIDS Institute maintains up to date resource pages related to Sudden Infant Death Syndrome.

Jonathan C. Makielski: SIDS: genetic and environmental influences may cause arrhythmia in this silent killer, J. Clin. Invest.116:297-299 (2006) [Full Text].

The Back to Sleep program, and its newest guidelines, can be found at this URL maintained by the NIH.

Disclaimer

The information presented in this article and its included links is of an informational nature only and is not intended as a recommendation of any changes in the reader's health care program. Before making any changes in diet, medications, or other treatments the reader is strongly advised to consult with their health care provider.