Sudden Infant Death Syndrome, also called “SIDS,” is the number one cause of infant death within the first year of life and the third leading cause overall of infant deaths in the United States, according to the Centers for Disease Control and Prevention (CDC). The CDC says SIDS kills slightly more than 2,000 children in the U.S. every year.
The government’s Safe to Sleep campaign is said to have contributed to a reduction in the number of SIDS-related deaths. But Hannah Kinney, M.D., a neuropathologist at Boston Children’s Hospital, says there’s still a lot of work to be done.
“I receive calls from parents and grandparents haunted by their infants’ death, feeling at fault and wanting a second opinion,” she says.
For more than 20 years, Kinney’s lab has been one of the few in the world studying the biological underpinnings of SIDS. And during that time, Kinney has been able to document abnormalities in the brainstem circuits that help control functions such as breathing, heart rate, blood pressure and temperature control during sleep in many victims of SIDS.
Kinney postulated that in many infants who die suddenly, the brainstem circuits that help control these functions during sleep are abnormal. As a result, when faced with smothering or overheating, these infants fail to rouse, turn their heads or throw off covers as a normal infant would.
Because she believes that early detection and treatment is lacking to further reduce the number of SIDS fatalities, Kinney led a recent study that found how some children are pre-destined to die of SIDS.
The study supports her theory and states that a brainstem abnormality may be an indicator of babies who are more susceptible to SIDS.
“Even the infants dying in a potentially asphyxia-generating situation had an underlying brainstem abnormality that likely made them vulnerable to sudden death if there was any degree of asphyxia,” Kinney explains. “The abnormality prevents the brainstem from responding to the asphyxial challenge and waking.”
This study sheds light on the heartbreak of SIDS by offering the realization that not all infants who die in compromised sleep environments are normal: many have underlying brain circuitry vulnerabilities that may tip them toward SIDS.
“Certainly, there are compromised sleeping environments that can cause any baby to die, such as entrapment in the crib,” Kinney says, “but if it’s just sleeping face down, the baby who dies may have an underlying brainstem vulnerability.”
With more research, treatment can be done to prevent the predisposition.
While scientists continue to study possible genetic causes of SIDS, experts are also working on technology to detect the breathing abnormalities that contribute to SIDS.
To date, SIDS monitors have failed to be proven effective to prevent a tragedy, and the American Academy of Pediatrics stated in 2003 that monitors should not be used for SIDS prevention. No progress had been made in SIDS prevention in over a decade.
However, Ruey-Kang Chang, M.D., a pediatric cardiologist and lead researcher at Los Angeles Biomedical Research Institute (LA BioMed), hopes to change the way monitors are used in the fight against SIDS. Chang is part of a team that just developed a SIDS monitor, the Infant Sleep Environment Monitor (ISEM), that uses a small monitor on the baby’s upper chest to detect the two sleep states that put infants at high risk for suffocation and SIDS: sleeping in any position other than flat on their backs and having bedding covering their faces or heads
“Studies have shown that by keeping babies on their backs and bedding off their head, can potentially reduce SIDS occurrences by 75 percent. With a timely warning from the ISEM, these high-risk situations are easily corrected by parents,” says Dr. Chang. “The monitor we developed will alert parents whenever their infant is at risk of SIDS, giving them the assurance that they can avoid every parent’s worst nightmare.”
SIDS is a risk for any infant. However, through the years, researchers have identified factors that increase a child’s risk of SIDS, which include:
- Gender: Males are more likely to die of SIDS.
- Age: Infants are most vulnerable during the second and third months of life.
- Race: For reasons that aren’t well understood, black, American Indian or Eskimo infants are more likely to die of SIDS.
- Family history: Babies who’ve had siblings or cousins die of SIDS are at higher risk of SIDS themselves.
- Young mothers: Babies born to women younger than age 20 have been linked to an increased risk of SIDS.
- Maternal habits: A pregnant woman’s smoking, drug or alcohol use is also thought to increase a baby’s risk of SIDS.
Certain characteristics of the sleep environment can also increase the risk for sleep-related sudden and unexplained infant death. Experts say items in a baby’s crib, like pillows, blankets and toys, may lead to suffocation or breathing difficulties. Sleeping on the stomach or side may also lead to more difficulty breathing than if a child sleeps on his back. The Mayo Clinic says sleeping on a waterbed or fluffy comforter or in the same bed as their parents may also impair breathing and increase the risk of SIDS.
To learn more about safer sleeping habits for your baby, visit the Safe to Sleep campaign page.