A hint, but no answers, to SIDS mystery

Much is being made of the news of a possible connection between the brain chemical serotonin and the risk of sudden infant death syndrome.

As the Associated Press reports: "Now researchers in Italy have engineered mice born with serotonin that goes haywire — and found the brain abnormality is enough to spur sudden death, in ways that mesh with other clues from human babies."

The research, reported in the journal Science, contributes to other recent findings that could ultimately shed light on a way to predict, and prevent, such deaths.

But such concrete data is a long way off. In the meantime, parents should know there's much they can do to reduce risk to their babies in the here and now, even if we don't yet understand all of the underlying causes of SIDS.

For starters, put infants to sleep on their backs — and in their own beds. This message can be difficult to accept. Some parents, particularly nursing mothers, find it convenient to share a bed with their child. And the practice seems so nurturing and loving.

But doing so increases the chance that the infant will suffocate in the blankets or because an adult has rolled atop it.

The nation's SIDS cases have declined from 38,351 in 1990 to 27,936 in 1994, as the National Sudden Infant Death Resource Center notes with these statistics. The promotion of safer sleeping environments has played a key role in that reduction.

Check out the SIDS Information Web Site for a list, with explanation, of ways to reduce the likelihood of SIDS — while we wait for more answers.

— Tami Dennis

Comments

[mem]

"For starters, put infants to sleep on their backs — and in their own beds."

Be careful though, sleeping in the same position every night can cause the growth of the skull to be lopsided. I doubt the consequences are anything more than cosmetic, but it happened to our baby and his head is not the perfect symmetry he was born with *c section.

[Chris]

An infant sleeping in the same beds as two adults who are neither drunk, no overly exhausted is a preventative measure AGAINST SIDS, not a cause of it. (See research by William Sears and others, as well as SIDS rates in countries were co-sleeping is the normal behavior.)

One of the most basic benefits of co-sleeping is the regulation of the infants hypothalamus and the breathing patterns of the infant. Upset infants begins to produce unusual levels of cortisone, and children whose breathing is regulated by that of a mature adults example breath more regularly. So, this article both tells you about irregular cortisone levels and their connection to SIDS, and then turn right around with a suggestion to leave the kid alone and upset in their room, possibly breathing in an irregular pattern. Think for yourselves people, do some research.

[Cate]

Mem: Isn't temporarily having a flat head better than dying of SIDS?

I have a 2 month old baby, and know a lot of moms who "co-sleep" with their children. I think it's horrifying that it is so acceptable because it seems like a "natural" thing to do- it is so dangerous! Hundreds of babies are "rolled over" every year but for some reason moms are still co-sleeping because of convenience and more sleep, and coroners feel so bad and don't want to outright blame the parents for accidentally killing their poor babies- so there are many wrongly diagnosed "SIDS" deaths and so on. Just do your research- how could you sleep with your baby in bed with you? EVEN the tag on my mattress says not to let babies sleep on it!!

[michelle]

Alarmist information- our children all co-slept, as have most in our community, and no harm at all- as long as niether parent smokes or does drugs or is drunk, it's the safest and most humane way to raise a baby.

Also, some more fun info; Ferber recanted, the vaccine companies are taking us all for a ride, and there are too many chemicals in baby mattresses!

[Darren]

I am shocked and deeply offended at this article. The evidence tying SIDS to babies sleeping alone in cribs has been conclusive and widely accepted since the 1970s--by everyone, of course, except the crib industry, which, as luck would have it, has been put in sole charge of giving parents official advice on how to avoid SIDS. (If you think I am joking, please do your homework. Chris, above, clearly has, and it seems that getting informed is the least a parent could do for their child.)

If you care about your babies, if you *really* care, then please find out who Bill Sears is, and please go and get his baby book. In countries that co-sleep, SIDS essentially does not exist, and never has. It only exists in the few countries (yes, it really is just a very few) that use cribs and put babies to sleep by themselves.

I won't be reading the LA Times again, ever, unless a formal retraction of this article is given.

[Heid]

My opinions.... Infants should be in constant company of their mother or other responsible adult . Co-sleeping is OK when done properly. Infant sleeping (tummy, back, side, whatever) needs to be closely supervised with no fluffy mattresses or blankets

1. I know of a couple who recently put their 5 week old baby to bed in his own room, on his back, and when the infant threw up he choked on his own vomit and died.

2. I have slept with all my babies in my room in a bassinet or with me. I have NEVER squished my babies. I always heard when they would choke or grunt or anything. And YES I have had to flip a baby choking on puke on more than 1 occasion. Babies that tiny cannot flip themselves to stop choking. Babies puke a lot.

[obra]

Sleep with baby is good
Baby needs comfort
Yes there is risk
There is risk in all of life
The only place to avoid risk is death

[sophiemichaels]

You know what's horrifying? You morons who "co-sleep" aren't going to be the ones who end up on the cover of our local paper. It's going to be some other poor uneducated sap who thinks that the 90 percent of doctors who say DON'T DO IT are wrong, because your motherly instinct tells you so, and you posted such messages on this site for other people to become equally ill-informed. For what it's worth, I say:

You know what? The doctors really ARE smarter than you! Just cuz you freak out that your baby doesn't want to sleep face up in a blanket/toy free crib, and that seems shitty to you - doesn't outweigh scientific evidence. Life is a NUMBERS game, and you can give your baby the best odds or go with your "instinct." Put your baby on her/his back. At the very least. And don't sleep with him/her. No matter what your silly friends tell you. And if you don't do that stuff and your baby dies, don't come bitching to us. You had the information.

[Kimberly]

The flat head issue, caused by sleeping on the back, is such an easily-resolved issue. Our ped noticed it in our son and she recommended we: a) give him more tummy-time when he's awake, and b) lay him down in the other direction in his crib. Babies tend to look toward the doorway of their rooms, where the action usually comes from, so if you switch his orientation with every nap, he'll even out the compression (laying on the left one nap, on the right the other.) That one didn't really help our son because he had already developed the habit of sucking his right thumb. Finally, if those two suggestions don't help with flat head, the baby can be fitted with a "helmet" to reshape the skull while it's still soft. It's not just an aesthetic issue--it can affect the growth of the entire head, in terms of the eyes and ears being centered.

Re: co-sleeping. We never did it with our kids--we let them cry it out and learn to get to sleep on their own. We felt that was better for them and us. But I find it hard to believe that it really contributes to SIDS when it is SO COMMON in other countries, and has been for centuries. However, it really depends on the people involved--even if they're not drinking, some people are very heavy sleepers, and would not be aware enough of the others in the bed.

[Sharon]

I am deeply saddened by the false information in this article. Unless a mother is under the influence of drugs or alcohol, it is nearly impossible that she will pose a risk to her baby if co-sleeping. In fact, a co-sleeping, nursing mother and baby are at LESS RISK of SIDS because the mother is so in-tune and close to her child. More than half the world co-sleeps - and has co-slept since the beginning of time. It is one of the most natural ways for optimal protection and closeness to a baby, and lays the foundation for a lasting relationship of love and trust between mother and child. It is sad that in the United States, people have been misled over the years to look down upon things like co-sleeping and extended breast feeding, and instead have pushed the so-called importance of establishing "independence" at an unnaturally young age. I have co-slep witht and breast fed at length all of my babies (now ages 3,6,8, and 11). Each of them gradually transitioned to their own beds and we NEVER had an unsafe situation in bed. I am proud to say that my children are well adjusted, mature, respectful and very loving. We have a great relationship - much better than most I observe of my children's friends with their parents. Shame on the author of this article and whoever provided the false information that co-sleeping can contribute to SIDS. I again reiterate that it is virtually IMPOSSIBLE, unless a mother is under the influence of drugs or alcohol. That natural instinct of the mom to protect the baby is too strong.

[toxouts]

Understand more about excitotoxicity

http://www.sailhome.org/Concerns/Excitotoxins.html

then consider what babies are exposed to

http://www.sailhome.org/Concerns/Vaccines.html#ingredients

[Leslie Brooks]

Infants need to be close to their mothers. Their nervous systems are still underdeveloped and the mother's heartbeat and breathing secures theirs. It would be dangerous to sleep with a baby if you drink or take drugs to sleep, or if a you're a parent who isn't mindful of their child, but in those cases, a child is is at risk wherever it sleeps. A caring mother sleeps lightly, with half her mind alert to her child's wellbeing. I never felt fearful I would smother my children while we slept, and always knew I kept them safe in my arms, safer than if they were alone in a crib in another room!. And they all left the family bed on their own and enjoyed their own beds and rooms when they grew old enough, with no insecurity about sleeping alone..

[Amit Joshi]

The author is absolutely right in stating "For starters, put infants to sleep on their backs — and in their own beds." I think an even better suggestion would be to put infants in a crib in the same room but do not share bed.

Check out the recomendations by the task force at http://pediatrics.aappublications.org/cgi/content/full/105/3/650

This is what the American Academy of Pediatrics Task Force recommends:

"Bed sharing or cosleeping may be hazardous under certain conditions. As an alternative to bed sharing, parents might consider placing the infant's crib near their bed to allow for more convenient breastfeeding and parent contact.If a mother chooses to have her infant sleep in her bed to breastfeed, care should be taken to observe the aforementioned recommendations (nonprone sleep position, avoidance of soft surfaces or loose covers, and avoidance of entrapment by moving the bed away from the wall and other furniture and avoiding beds that present entrapment possibilities).Adults (other than the parents), children, or other siblings should avoid bed sharing with an infant.*Parents who choose to bed share with their infant* should not smoke or use substances, such as alcohol or drugs, that may impair arousal."

[Anna]

Please pay attention to SCIENCE that shows a statistically greater risk to babies with bed-sharing. Babies have died from being smothered -- even by parents who weren't under the influence. They can also smother if a blanket or pillow falls over their faces. You think you would wake up, but you might not -- especially in those exhausted first months. Also, the risk of SIDS has been shown to be greater.

The "experts" who advocate bed-sharing don't have sound science backing up their claims. There are no credible scientific studies supporting their theories -- which in my opinion are based purely on their philosophies and politics.

We chose to have our baby sleep in her own room and she did just fine, but I respect parents who want their babies closer. Just use one of those co-sleepers that attach to your bed -- why take a chance with your baby's life??

[obra]

regarding comments of sophiemicheals
yes, life is a numbers game, but not all share the same objective
you must agree that maximizing life span is not the only objective for your baby
if it were the only objective then you would keep the baby fairly locked away all through life
it is much safer locked in a room than playing outside where you're much more likely to get killed by cars, big dogs, bad guys, meteors, driveby shooters and the admittedly-improbable dehydrated roaming rabid monkey... do you see this point? now, doctors are very smart. agreed.
what is their motivation? what is their objective? here is the argument in a nutshell. we (humanoids) have likely slept with our babies for thousands of years. it is absurd to deny that such a close interaction 8+ hours per day must be devoid of benefit to the baby or mama. it is quite likely that such closeness imparts some benefits and perhaps they are subtle, such as, for example, imparting on average %3 more emotional sanity at age 35. these are all guesses on my part. just speculation. but, some other posters have pointed out some benefits (breathing, etc) regarding co-sleeping. but anyway, just suppose these benefits are real and return to the doctor. is the doctor, a *pediatrician*, an adviser whose term ends inevitably in a few years MAXIMUM, likely to take any chance to endorse a behavior with a myriad of more subtle, distributed, psychological advantages if that behavior carries a small risk or even appearance (stigma) of risk that an accidental death will result? you know the answer. there are advantages and disadvantages to both paths. educate yourself and choose wisely. everyone has motives and they are not always aligned with your objectives.
i don't like the term "co-sleep".
why don't people use use the simple term "sleep" (with) ?
it does not imply shenanigans
i propose new acronym: IHAS (intentional horizontal adjacent slumbering)
peace to all humanoids

[Mom of a 9 Year old]

This article was misinformed. Science *supports* co-sleeping with babies, as a number of posts have already pointed out.

In my opinion, the bonds formed between parent and child when co-sleeping are extremely important, shaping the relationship in a postitive way for many years and making it easier to get along and have a harmonious family situation.

Breast feeding for babies is better in many ways, and co-sleeping, for many mothers is the best way to achieve this, because infants do need to nurse during the night - their stomaches aren't big enough to hold enough food to last through the night. Our country is extremely unusual, as compared to nearly all others both now and in the past, in that we do not routinely co-sleep. I think many discipline and behavior problems stem from this failure.

[Dave]

I would have to disagree with a couple of previous posters. My friend's sister was none of the things mentioned: a smoker, drunk or does drugs. She unfortunately was just a heavy sleeper. Some people just are. She accidentally smothered her daughter while co-sleeping. It was tragic. The family is absolutely devastated, and it seems that she will be guilt-ridden the rest of her life. Please realize that these things happen even when you don't intend them to, and death is permanent. It isn't worth risking. I am glad it has worked for others, but just because it worked for all of your kids, doesn't mean it is foolproof. I have seen the downside, and it is very heartbreaking.

I am sorry to be disagreeable, but the whole thing has just been too sad to go through.

[TJ]

All major studies done on back sleep (Major Authors: Fleming, Moon, Majnemer) show it is associated with developmental delays. And contrary to the comment about plagiocephaly it is not just a "cosmetic" condition. Kordestani has shown that it is associated with delays 27% of the time and no child in their study of children with plagiocephaly was "above" average which is quite disconcerting. Corvaglia has also shown that increased rates of Gastroesophageal Reflux are associated with Back Sleep. In addition Kahn and Grosswasser have shown that Sleep Apnea is worsened by the Back Sleep position. Also, Pelayo has questioned if the theory that underlies the Back to Sleep campaign which is severely restricting Stage 3 and Stage 4 NREM sleep in infants isn't unhealthy in itself. An infant put to sleep on it's back gets very little Stage 3 and Stage 4 NREM sleep and instead skips right into REM sleep. Considering the delays shown to be caused by back sleep campaigns (Re: Fleming, Moon, Majnemer) and that plagiocephaly is likely an indicator of a parents adherence to the Back Sleep recommendations and not the cause of the underlying developmental delays this is very disconceriting.

http://tummysleepcentral.blogspot.com/

[Tannim]

"For starters, put infants to sleep on their backs — and in their own beds. This message can be difficult to accept. Some parents, particularly nursing mothers, find it convenient to share a bed with their child. And the practice seems so nurturing and loving.

But doing so increases the chance that the infant will suffocate in the blankets or because an adult has rolled atop it. "

BULL!

On their backs, yes. In their own beds, no.

Infants suffocating in blankets is more likely in their own bed than with their parents, because the parents will take up the majority of the covers and the kid is fine.

Second, parents rolling on top of them? HAH! People have nocturnal proximity detections in play when they sleep, which is what keeps people in the same comfort spot on the bed and keep from falling out. They also prevent people from rolling onto others in their sleep.

You're going find that SIDS, like most infant illnesses, has everything to do with vaccines and chemicals and their reactions in the bodies, not beds. Most likely vaccines, when they mess up the immune system, spur a body response that induces a deeper rest (and more serotonin) to try to recover, especially from the overdoses in the infant vaccines, and then a roll over happens, causing a constriction on the windpipe, and then suffocation. The deep sleep prevents a normal body reaction to deal with the oxygen loss (like you do when you're choking, for example), and the child dies.

Also, if the kid is in their own bed in their own room the parents will be unaware of what is going on, removing any chance of saving the child.

BTW, I'm a parent, and my kid co-slept, and he's just fine.

[Joe]

Selenium is essential: There was a study in Sweden, that selenium.

In selenium that selenium is quite deficiency in Sweden. When they gave children selenium. The cot deaths dropped dramatically.

[Lisa]

There needs to be a distinction made between infant deaths caused by low levels of serotonin that spontaneously cause the child to stop breathing, and accidental smotherings of children caused by blankets, soft mattresses, adult rollovers, etc. When infants are held, or touched by other people (as in co-sleeping arrangements), levels of cortisol do decrease. When levels of cortisol decrese, levels of serotonin rise. So it is certainly possible that co-sleeping does decrease the risk of an infant spontaeously stopping breathing. However, it is also possible that co-sleeping increases the risk of an accidental smothering. There needs to be more research done before anyone can know if the danger is greater due to co-sleeping or sleeping alone. For now, though, the best choice may be to place an infant to sleep on his back, in a crib, bassinet, or co-sleeper without blankets, next to his parents' bed. This way the parents can still touch the child often during the night, but the child will be safe from the dangers of an adult bed.

[Bill Sardi]

A mattress wrapping program in New Zealand has zeroed the incidence of SIDS there. This means there is something toxic in the mattress, possibly mold or a toxic gas, says James Sprott who initiated the mattress wrapping in NZ. This would explain why placing babies on their backs would result in a decline in SIDS.

[A. Arbuckle]

THANK YOU for correctly headlining this story as a "hint". It's being covered widely as a direct cause of SIDS, a "breakthrough" and so forth when in fact it is only a pointer to one possible cause.

It's grossly irresponsible the way this is being reported. Check the Google News results on "SIDS serotonin imbalance" etc. if you want to see it illustrated.

The fact that serotonin imbalance can cause SIDS-like death in a mouse is interesting and bears follow-up; and there is some other suggestive evidence.

But these clues haven't yet led to any useful preventive measures, and this may not in fact be the sole cause of a single human death.

What we know as SIDS appears likely to have multiple causes. It's probably inaccurate to characterize it as a singular "syndrome".

Again, thanks for presenting this particular news responsibly.

[Amy]

When my daughter was a few weeks old she stopped breathing while sleeping. the reason I was able to wake her and make sure she kept breathing was because I was right there. I was ALWAYS right there with my babies. If I wasn't wearing them in a sling I was holding them on my lap or in my arms. The reason the sids risk is zero in developing nations is because they put a high value on their infants and take care of them. Instead of leaving them in a box with bars around it down the hall.

[Robert Constant]

What about obesity? Since so many Americans are fat, I wonder if the excess weight increases the chances of smothering a baby. First of all, there is more flesh to cover the baby; Next, the extra fat would make the parent less aware that there was something under them.