SIDS has also been called crib death. The term is applied to deaths of infants due to no other apparent cause (e.g. carbon monoxide poisoning, heart failure, ...). Most such deaths occur when babies are sleeping. There is great discussion as to whether the endedness of babies (whether they sleep on their tummies or their backs) has any influence on SIDS risk.

Sudden Infant Death Syndrome (SIDS) is the phenomenon of infants dying suddenly and unexpectedly with no apparent cause, often called cot death or crib death. This occurs throughout the world, although the total number of children who die from this is hard to determine. Particularly in third world countries, there may be a huge range of reasons why infants might die, and picking out the sudden unexplained ones may be difficult.

In non-third-world countries, SIDS is the most common cause of death in the post-perinatal period. Most deaths occur between 1 and 7 months, although the accepted age range for SIDS is between 2 weeks and 2 years old.

Males are statistically slightly more likely to suffer from it; however, this is true of many kinds of death and isn't due to any of the features of SIDS specifically. Twins are also slightly more likely to suffer from it; partially this is because twins are more likely to be born prematurely.

It is also more common in winter, and in poorer families.

Nobody knows what causes SIDS. However, the rate has been reduced in recent years by a campaign informing parents to do the following:

  • sleep the baby on its back
  • do not smoke during pregnancy or around the child
  • do not overheat the baby by wrapping it too tightly
Countries where this advice hasn't been given out haven't had a reduced rate of infant mortality.
Formula feeding has been linked to increased rates of SIDS in some studies. Breastfeeding literature has long reflected this but acceptance and publication has been slow in North American mainstream media. The 1990s "Back to Sleep" campaign was well accepted while the connection between bottle feeding and SIDS was largely ignored.

A new (but sadly small) study, done in the US and presented at a Centers for Disease Control and Prevention conference in Atlanta directly places the blame for 55% of the SIDS cases studied to formula feeding (or a lack of breastfeeding).

This study is receiving considerable North American mainstream media coverage. I have heard on Lactnet of reports in the Washington Post, The Associated Press, CNN headline news, Reuters news service and various local newscasters.

The report from the Washington Post 4/24/01 (under "Findings") page A10 follows:

"New mothers who don't breast-feed and those who smoke after giving birth place their babies at strong risk for sudden infant death syndrome, government researchers said yesterday.

Placing babies on their backs for sleep has long been the focus of the campaign to prevent SIDS, which kills about 3,000 infants each year.

But a study presented at a Centers for Disease Control and Prevention conference in Atlanta suggests that breast-feeding and protecting babies from secondhand smoke may be just as important.

The study of 117 SIDS cases in Louisiana in 1997 and 1998 found 55 percent of the deaths could have been prevented had the mothers breast-fed their children. Studies have shown breast- feeding can help prevent respiratory problems sometimes related to SIDS.

The study also said 27 percent of the deaths could have been prevented if mothers had not smoked after delivery, exposing their children to secondhand smoke.

		- Compiled from reports by the Associated Press"
Gwendolyn Elizabeth was born quite unexpectedly one afternoon. Babies are supposed to come out head first, while some ornery types come out bottom or feet first. (I was a breech baby, btw.) But, they just can't come out sideways.

The doctor tried coaxing Gwen head down, and she obliged. For about 10 minutes. And again, but the heart rate monitor started showing signs of distress. So, we went to the hospital, so hands and soft words could try and convince her while we watched under the ultrasound to stop being quite so transverse.

After another hour, the doctor shrugged, and told us that he wanted to perform an emergency C-section. Immediately. Babies don't come out sideways, leastways not while they are still alive, and the experience is none too good for the mother, either. He didn't want to send us home and risk labor progressing too far before we got back to the hospital. And, she was far enough along that she would not need to stay in a preemie box.

Our childbirth classes had talked about C-sections, in an intellectual sort of way. After all, according to most of the instructors, only pregos who were failures had C-sections. Worse, a transverse lie meant that the doctor would use the old-fashioned kind of incision - the sort that it is very difficult to have a VBAC afterward. But, everyone agreed that a live baby and unfulfilled principles was better than a dead baby and stubbornly-adhered-to principles.

The actual operation was very unnerving. I wore a complete set of blues, complete with hair net and shoe covers. There are a zillion people in the operating theatre, and everything is brightly lit, with glistening steel and stark white everywhere. Alana was tied down, and I held her right hand.

Three minutes after the doctor started cutting, I had a very unhappy, slippery baby girl in my hands. She was so small. Carl and Eileen both weighed in at over 10lbs, but Gwen was only 5.5lbs. I wrapped her up, and held her firmly next to my heart, until she settled down. Alana and I were both crying, and Gwen nursed for a short bit, as the doctor finished sewing Alana up.

Note to partners - take the doctor's advice to "not look" at what they are doing, unless you have a strong grip on reality. I found it very disturbing to see this great baby-sized hole cut open in Alana, where I was used to seeing skin.

The three of us spent 4 wonderful days in the hospital. Carl and Eileen were staying with my parents, and came to visit every day. They loved holding their new sister.

Gwen was quite different from her older siblings. Some of it was those extra five pounds - tiny babies sleep more, nurse more, like snuggling more, and, in general, wiggle less. It was a great struggle to get her to nurse after the edge was off her hunger. But both Alana and I got the impression that something else was different - Gwen was just too perfect.

Gwen never cried, she cooed. Whenever we went to the nursery to pick her up after lunch or a nap, one of nurses was always holding her - which was very unusual behavior for them. "Oh, she's no trouble at all", they would say. "We just want to hold her."

We came home Sunday night. Everything was higgly-piggly, because we hadn't expected to go into the hospital, so none of the baby furniture (changing table, clothes, diaper pail, swing, bouncy chair) was set up where it was supposed to go. Fortunately, we had diapers. Ever since an extremely messy incident 3 years before, I have been paranoid about not having enough diapers. So, for the past 4 months, we had had a two day's supply of newborn diapers.

Monday, we all sat around and vegged. Everyone wanted to hold Gwen, and she slept most of the time. I took some photos. Friends and neighbors visited. Around 8:00PM, Alana felt something was wrong. She called up Gwen's doctor, and tried to articulate her uneasiness.

Was Gwen breathing differently? No. Running a fever? No. Was she lethargic? No, not more than usual. Was her muscle tone off? No, not really. Anything else you can describe? No, but something is wrong with my baby. Well, bring her in the morning, and the doctor will take a look.

Tuesday morning, Gwen was dead. SIDS, the autopsy said.


A few weeks later, I was walking in the cemetery, and visiting Gwen's grave. I kneeled down, started quietly sobbing, and leaned forward so my forehead was on the headstone.

"Why?", I cried. "Why did my baby have to die?"

And I discovered some words inside me, deep inside where usually, I'm the only one thinking words. I wasn't hearing them, the words were just there, in the same way and place that I think in words. They said, "Don't cry, Daddy. I'll be OK."

And in a place deep inside me, where I usually only have my feelings being felt, I discovered a feeling that I should go make sure that Alana and Carl and Eileen felt better. So I did.


About two years later, Llerendel Guinevive was born. The C-section and the hospital stay gave both Alana and I flashbacks and nightmares. We took turns staying awake in the night that first week home, making sure that Llerendel kept breathing.

One night that week, I woke up with a start, and sat up in bed. Alana had dozed off, with her hand on Llerndel's head. I could hear her wuffling, so I didn't panic. Then, I noticed something on the end table on the other side of the room. I wasn't exactly seeing it, because it wasn't there. But it was there. As I gazed through the bright moonlight, I got the concept that there was a 2yr old girl with long brown hair sitting on the tabletop, swinging her legs through the drawers. She looked at me, and I heard "Hello, Daddy. Go back to sleep.", and went back to staring at Llerendel and Alana.

I lay back down, and went back to sleep.


When Llerendel was 2, her brother Francis Harrington was born. Carl was overjoyed at having another boy, if only as reinforcements against his two younger sisters. As with Llerendel's homecoming, the first week was a tense time for Alana and I. Alana arranged for an apnea monitor which Francis wore fairly regularly for the first two months. After that, we figured that our family would survive with yet another live baby.

Then, one morning, Francis was dead. SIDS, the autopsy said.

We didn't have the heart for a Irish Wake in the funeral home, with all the friends and relatives wandering by and not knowing what to say. (I tell my friends that 'I'm sorry your baby died.', with a handshake, or a hug, while looking the bereaved in the eye, is about the best you can do.) During the Funeral Mass, Gwen showed up, and took her baby brother in tow. He was still wearing his yellow sleeper.


For the next four years, I visualized Gwen as being a four year old. I guess it is old enough to be mobile, to travel short distances away from your parents, but young enough that no one asks or expects much in the way of chores from you.

One morning, while cleaning her grave of blown leaves and grass straw, I 'saw' a 6yr old following a grasshopper through the fog. I asked Gwen why she was growing up. She said, "Llerendel is 4! She's the little girl, not me!"

I looked on sadly at her running after the blown leaves for a while. They would come down out of the misty white fog, swirl around in the air, and land on the dew. She ran after one, ran back to me, and said, "You're still too sad. Be happy so your new baby will be happy, too."


Taran Nathaniel was born a week early, by C-section on November 26, 1995. He was on a heart/resperation monitor for the first year of his life, and is now (as of 2002) a bustling 6yr old boy, about to start the first grade.

SIDS is an acronym for Sudden Infant Death Syndrome, and is used to describe what happens when an infant suddenly dies with no apparent cause. SIDS causes an very small amount of deaths, though it is the leading cause of death among infants over one month of age. The cause is unknown, though several risk factors have been identified. These include, inadequate prenatal care, inadequate prenatal nutrition, use of heroin, cocaine and other drugs, subsequent births less than one year apart, alcohol use, infant being overweight, mother being overweight, Teen pregnancy (if the baby has a teen mother, it has a greater risk), infant's sex (60% of SIDS cases occur in males). Being prematurely born increases risk of SIDS 4 times higher than normal. Apparently using a fan to circulate air in the bedroom reduces risk 72%,only 3% of mothers, reported having a fan on during the babies death. Babies co-sleeping, or sleeping with a parent, are said to have increased risk of Sudden Infant Death Syndrome. Information taken from Wikipedia.org and 8th grade health class.

After Reading Dr.Jimmy's write up, I felt I should add this. My cousin, the late Patricia Henley(3), sued Phillip Morris and won the landmark case against the tobacco industry. During the discoveries it came to light that second hand smoke is also a contributing factor in SIDS.


Secondhand Smoke Causes SIDS

SIDS is the sudden, unexplained, unexpected death of an infant in the first year of life. SIDS is the leading cause of death in otherwise healthy infants. (5) Secondhand smoke increases the risk for SIDS. (1)

* Smoking by women during pregnancy increases the risk for SIDS. (6)
* Infants who are exposed to secondhand smoke after birth are also at greater risk for SIDS.(1)
* Chemicals in secondhand smoke appear to affect the brain in ways that interfere with its regulation of infants' breathing.(1)
* Infants who die from SIDS have higher concentrations of nicotine in their lungs and higher levels of cotinine (a biological marker for secondhand smoke exposure) than infants who die from other causes. (1)

Parents can help protect their babies from SIDS by taking the following three actions: (7)

* Do not smoke when pregnant. (6)
* Do not smoke in the home or around the baby.
* Put the baby down to sleep on its back.

Secondhand Smoke and Children

Secondhand smoke can cause serious health problems in children.(8)

* Studies show that older children whose parents smoke get sick more often. Their lungs grow less than children who do not breathe secondhand smoke, and they get more bronchitis and pneumonia.
* Wheezing and coughing are more common in children who breathe secondhand smoke.
* Secondhand smoke can trigger an asthma attack in a child. Children with asthma who are around secondhand smoke have more severe and frequent asthma attacks. A severe asthma attack can put a child's life in danger.
* Children whose parents smoke around them get more ear infections. They also have fluid in their ears more often and have more operations to put in ear tubes for drainage.


Parents can help protect their children from secondhand smoke by taking the following actions:(8)

* Do not allow anyone to smoke near your child.
* Do not smoke or allow others to smoke in your home or car. Opening a window does not protect your children from smoke.
* Use a smoke-free day care center.
* Do not take your child to restaurants or other indoor public places that allow smoking.
* Teach children to stay away from secondhand smoke.


References:

(1) http://www.cdc.gov/tobacco/data_statistics/sgr/2006/index.htm
(2) http://www.nap.edu/catalog.php?record_id=12649
(3) http://www.independent.com/news/2009/sep/27/patricia-henley-won-landmark-judgments-against-tob/
(4)http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/health_effects/
(5) http://aappolicy.aappublications.org/cgi/content/abstract/pediatrics;116/5/1245
(6) http://www.cdc.gov/tobacco/data_statistics/sgr/2004/index.htm
(7) http://www.nichd.nih.gov/publications/pubs/safe_sleep_gen.cfm
(8) http://www.netwellness.org/feature/2006-11-smoke/default.cfm

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