New Study Reinforces SIDS Prevention Guidelines
By Ed Edelson, HealthDay Reporter
THURSDAY, Jan. 15 (HealthDayNews) -- A large European study supports existing guidelines for protecting babies from sudden infant death syndrome (SIDS).
Data on 745 cases of SIDS and 2,400 control cases was gathered from 20 European centers. And the finding "strongly suggests a basis for further substantial reductions in SIDS incidence rates," says study author Robert G. Carpenter, a medical statistician at the London School of Hygiene and Tropical Medicine. The research appears in the Jan. 17 issue of The Lancet.
The risk is greatest for babies who sleep on their stomach; whose mothers smoke; who are covered with bedding; and who sleep in the same bed as the mother. The researchers found six of 10 SIDS cases were attributable to babies lying on their stomachs or their sides. As for sleeping in the same bed as the mother, 77 percent of those SIDS cases involved a mom who was a smoker.
These are all risk factors that have previously been identified, says Betty McEntire, executive director of the American SIDS Institute, but the apparent lack of news is actually good news.
"One good thing is that looking at all these different countries, putting all their data together in one data set, confirms what we've known before," McEntire says. "Parents can do a lot of things to make a baby safer and reduce the risk of SIDS quite a bit."
The advice that has evolved over the years already has lowered the incidence of SIDS substantially. From 1983 to 1992, there was an average of 5,000 to 6,000 SIDS deaths a year, according to the U.S. Centers for Disease Control and Prevention.
This year, that number is predicted to be under 2,500, McEntire says, and it could be even lower if parents followed all the advice.
"The safest thing you can do is to put a baby in bed with nothing but the baby and what it wears, except a pacifier," she says. "The baby should be on its back, warm but not too warm, in bed in the mother's room but not in the mother's bed. It should not be exposed to cigarette smoke..."
Why the advice works is not exactly known, Carpenter says. "As with so many of these things, we don't know why sleeping with the face down increases risk," he says. "Why sleeping in the mother's bed and the mother smoking increases risk is not clear."
A theory that is gaining attention holds that vulnerable children are born with a subtle defect in the autonomic nervous system, which governs such basic functions as breathing, McEntire says.
"Most babies born with the defect may never be known to have it and will outgrow it," she says. "But if during the early time of life the baby suffers some other problem, physical insult or stress, that might be enough to push it over the top."
For example, the problem for a baby with that subtle autonomic disorder who sleeps face down might be that he or she is breathing in exhaled air, which contains a slightly higher-than-normal level of carbon monoxide, McEntire explains.
For another baby, the slight degree of over-warming caused by bed clothes that are too heavy might be lethal, she says.
"The more we know about it, the more we are able to give advice about preventing SIDS," McEntire says.
More information
To learn more about SIDS, visit the American SIDS Institute and the National SIDS/Infant Death Resource Center.
SOURCES: Robert G. Carpenter, Ph.D, medical statistician, London School of Hygiene and Tropical Medicine, England; Betty McEntire, Ph.D, executive director, American SIDS Institute, Marietta, Ga.; Jan. 17, 2004, The Lancet
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