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The consensus on sudden infant death
Submitted by SHNS on Tue, 04/15/2008 - 15:31.
A first-ever gathering of medical specialists and investigators in the field of sudden infant deaths came to an alarming consensus: America grossly undercounts the number of babies who suffocate in avoidable sleeping accidents.
And, the conference in Pittsburgh was told, 80 percent of sudden infant deaths are related to their sleep environment -- most frequently either by sharing a bed with an adult or being placed on an inappropriate sofa cushion or adult pillow.
The conference was convened in response to groundbreaking reporting by Scripps Howard News Service reporters Tom Hargrove and Lee Bowman who found wildly erratic diagnoses of sudden infant deaths and widely varying standards of investigation, reporting and record keeping. Whether an infant was diagnosed with the almost-meaningless finding of Sudden Infant Death Syndrome depended largely on where the child died.
Jurisdictions with trained investigators and uniform standards generally find that accidental suffocation is the culprit in most sudden infant deaths. But only one-seventh of the 5,000 infants who die without obvious cause are attributed to accidental asphyxiation. Most are labeled SIDS.
Unfortunately, the conference could not reach a consensus on an obvious next step. The government has conducted a successful campaign to persuade parents to place their infants on their backs. And it shouldn't be too difficult to educate the public to the dangers posed to infants by sofa cushions and adult bedding and pillows.
But there are obstacles to a public service campaign against bed sharing with adults. The American Academy of Pediatrics Sudden Infant Death Task Force believes more statistical evidence is needed, which will come, but slowly as reporting and investigating techniques are improved. And there are groups who have vociferously objected to earlier campaigns against bed sharing because they believe it fosters breast-feeding or family unity.
But given the hard facts of infant deaths, adults can make their own decisions. The babies cannot.
(Distributed by Scripps Howard News Service, http://www.scrippsnews.com)
First Do No Harm
The Hippocratic Oath is "First Do No Harm."
Infant back sleep causes "transient" developmental delays and "mild" plagiocephaly according to the American Academy of Pediatrics.
Considering that the "feet to foot" campaign and anti-smoking campaigns have greatly contributed to the decrease in SIDS I'm wondering how much the back sleep campaigns have actually contributed to decreasing SIDS rates? Maybe it's time to re-evaluate whether or not back sleep risks actually outweigh back sleep benefits for infants.
I highly recommend anyone interested to read the paper "A reassessment of the SIDS Back to Sleep Campaign" by Ralph Pelligra. Also, many in the SIDS community have had children of their own die of SIDS so they think it is inconsequential that children who probably don't even have the brain-stem birth defect that causes SIDS are harmed by getting too little SWS/Delta sleep (stage 4 NREM) as infants. SWS/Delta sleep is necessary for the development of Declarative Memory. Back (Supine) sleep supresses SWS/Delta Sleep (stage 4 NREM). One of the hallmark signs in children with Autism Spectrum Disorder (I'm not referring to Asperger's or Classical Autism here) and ADHD is malfunctioning declarative memory. Considering both the Back to Sleep Campaigns and the ASD/ADHD epidemics began at similar time periods (i.e. early 1990's) is it possible that they are in someway related?
Considering there has never been a long-term, double-blind, randomized study (or any long-term study for that matter) to research the safety of the SIDS Back to Sleep Campaign I think it is appropriate to begin doing so?
Dr. Kattwinkel should resign as head of the U.S. SIDS Task Force because he is too biased because he had a 3 day old daughter die in 1966. It's appropriate for him to raise money and awareness for SIDS but it is highly inappropriate for him to be involved in policy decisions. Would we want a judge who's daughter was killed by a drunk driver to be the final arbiter (with a bunch of other people who's kids have been killed by drunk drivers) to develop the sentencing guidelines for people who are pulled over for drunk driving? Should we stop sending children to Elementary School because we might have a 40% chance in the reduction of deaths and say this outweighs the benefits of attending school? Should we put all newborn infants on an anti-cancer regimen if it decreased childhood cancer rates by 40% and then say all the developmental delays caused by this are worth it?
Life is a risk. People who have biases as emotional and painful as SIDS should not be making policy decisions. They should be raising money and awareness. The developmental delays caused by suppressing SWS/Delta Stage 4 NREM sleep on Declarative Memory in newborn infants (Deep Sleep) because this stragegy increases "arousals" seems to be very short-sighted at best. Throwing a generation of defenseless human beings under a bus to assuage the guilt of parents is indefensible.
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