Can someone comment whether this is a significant result, vs minor contributing factor? I can’t really interpret the results... there is a significant coef on (quantity of something in blood) in a logistic regression... how big is the residual?
SIDS seems to be a catch all for a lot of things. Putting babies on their back, removing objects and bumpers from the crib, etc did reduce SIDS but didn’t eliminate it.
This may be a major chunk of what is still considered SIDS but is not 100% of what is considered SIDS
I'm also very much not a doctor, but I read a lot of medical texts for fun and I have a naive interpretation to float out there (that hopefully someone in the know can correct or refute!)
The paper talks about "cholinergic deficit" (a situation that is also common in dementia sufferers). The parasympathetic nervous system is heavily reliant on cholinergic agents which is why if you take medication that's anticholinergic (including many antihistamines like promethazine) it tends to dull the senses, send people to sleep, make it harder to wake up, etc. (This is what a lot of those "sleep aids" you find in US airports are doing at a low level.)
My layman's attempt at jumping to a conclusion, then, is that death is not caused merely by cholinergic deficit, but that if someone has such a deficit and is harder to self-rouse, asphyxiation during sleep becomes somewhat more likely?
Not a physician either. This is an interesting result and is deserving of being followed up. That being said, there are many acknowledged causes of SIDS so this biomarker is unlikely to end up being predictive (or correlated) with all causes of SIDS. As has been mentioned elsewhere in the tread, suffocation on objects within the crib was responsible for at least some cases.
What is interesting to me is that this is a biochemical marker and biochemical disorders are known causes of SIDS. Newborn screening, which varies from state to state, can catch many of these disorders. This result is interesting because it may lead to other studies that identify other pathways/enzymes that represent markers or causes of less common causes of SIDS.
MCAD deficiency, the most common inborn error in fatty acid oxidation, is a biochemical disorder that is one of the more common causes of SIDS. The infants simply run out of easily available fuel for their metabolism if untreated and can die during fasting (i.e. in their cot in the middle of the night). Giving starch or other complex carbs before bedtime is one of several treatments for this disease, with the overall goal of treatment to prevent the individual from entering a fasting state, as that is when they metabolically decompensate.
This didn't establish a causal mechanism or even whether this particular enzyme is a contributing factor. It looked at an enzyme also associated with disfunction of the autonomic nervous system & finding that it is associated with SIDs deaths, but not other deaths.
This is additional evidence supporting a hypothesis advanced in the last decade associating SIDs deaths with a reflex that causes infants to stop breathing instead of try to breath faster when they aren't getting enough oxygen. It doesn't establish much on its own, but it could enable screening for at-risk children, and eventually enable interventions that address the root cause.
(Current interventions are mostly about attempting to ensure infants never experience a drop in oxygen that could trigger that reflex, which can never reduce the risk to zero.)
Sensible, peer reviewed science, funded by a crowd sourcing campaign.
Spend a moment to click on the link to the funding campaign, lots of parents that lost a child there. I literally started crying, when I read the comments of the donating families,
One device I was familiarized with because of Covid was the pulse oximeter, which measures the oxygen in the blood. I was thinking if you made it wearable and hooked it up to an alarm, it could maybe avert disaster. Turns out they already exist.
There’s multiple devices to detect SIDS. They have socks that act as oximeters, they have a camera to detect breathing, and they have sensors that sit under the crib pad that can detect the small movements of the baby breathing.
Also if you add a fan to the room and keep it on while the baby is sleeping, it reduces SIDS by almost 80%.
>Also if you add a fan to the room and keep it on while the baby is sleeping, it reduces SIDS by almost 80%.
Even assuming that this very small and self-reported study is accurate (which is doubtful itself) making a causative link here seems wildly unreasonable. Unless you can suggest a mechanism I think it's much more likely that there is some link between people who use fans and something related to SIDs.
I am going to go ahead and call BS on gas concentration increasing beyond noise level in even the most stale air environment. Even assuming that could be the case, the area around an infant is practically a hurricane on the scale we're talking about- the smallest movement, the slightest temperature gradient, the tiniest breath of the infant is going to be very disruptive to any local gas pockets. It's incredibly unlikely to be related unless infants are sensitive to the tiniest possible CO2 concentration changes, in which case sitting in a car or other sealed space would be dramatically more likely to cause infant death.
You have, in fact, lit upon the mechanism at play: some infants are sensitive to even tiny CO2 concentration changes, particularly when risk factors are combined. There is a reflex where instead of breathing more when CO2 levels rise, infants stop breathing all together: https://www.frontiersin.org/articles/10.3389/fneur.2015.0022...
While a car is moving it has ventilation, and it's illegal to leave an infant alone in a parked car in part for this very reason. But sleeping in a car seat is one of the risk factors for SIDs.
huh. I guess I learned something, thanks. I guess it makes some sense - infants are somewhat still in the transitory phase between breathing being a fun side activity and breathing being essential to living.
I'm not sure when the study was done, but that article was first (c) 2000. I have never had a doctor or nurse mention running a fan, and neither my wife or I have come across that when researching care of our children... but a 72% decrease in fatality is pretty damn close to an outright cure. How is this not broadcast loudly to every parent of a newborn?
That paper is from 2012, but I can’t find a newer paper that changes that. For example https://pubmed.ncbi.nlm.nih.gov/27940805/, from 2016, doesn’t mention fans in its abstract.
It's also very frustrating because of so many competing and changing loudly broadcast advice, especially on SIDS. Yeah the science evolves but it's hard to follow when even pediatricians themselves don't always manage to stay up to date.
Isn’t this correlation? Could this bio marker simply be caused by being born into poverty to a mother who smokes and drinks for example?
From the Mayo Clinic
“ Risk factors
Although sudden infant death syndrome can strike any infant, researchers have identified several factors that might increase a baby's risk. They include:
Sex. Boys are slightly more likely to die of SIDS.
Age. Infants are most vulnerable between the second and fourth months of life.
Race. For reasons that aren't well-understood, nonwhite infants are more likely to develop SIDS.
Family history. Babies who've had siblings or cousins die of SIDS are at higher risk of SIDS.
Secondhand smoke. Babies who live with smokers have a higher risk of SIDS.
Being premature. Both being born early and having a low birth weight increase your baby's chances of SIDS.
Maternal risk factors
During pregnancy, the mother also affects her baby's risk of SIDS, especially if she:
Is younger than 20
Smokes cigarettes
Uses drugs or alcohol
Has inadequate prenatal care”
Well the authors have at least proposed a plausible mechanism that B-ase is important for arousal so they are detecting that the baby is less able to rouse in response to emergencies.
Do you have any reason to think this enzyme is correlated with something else? Because the paper has a plausible causal mechanism for how it contributes to the auto-inhibition of Kölliker–Fuse nucleus functionality that is thought to be responsible for most cases of SIDs.
It's well known that many 'SIDS' are parents killing their children.
Its so common in my country that a murder investigation is conducted each time it happens
Those factors you mentioned are all risk factors of general family violence.
Our country has parental classes a lot of it was dealing with the stress of having a child while talking about SIDS and talking about how you don't want it to happen because you will be investigated for murder.
We even had public service campaigns,
don't shake a baby
another about baby crying in a cot and a mother looking like she is about to loose it, then a message to get help.
Another about, don't hold a babies mouth ect
There is even a difference in methods. For males its blunt force trauma, for mothers its suffocation.
From memory their is a large difference between unplanned child and planned child.
I think my country is realistic about addressing these issues and not hiding behind 'risk factors'
I always thought that SIDS stands for "parents likely accidentally killed their child through negligence or error, and a prison sentence seems too harsh". So we make it a medical condition instead of a crime.
I do wonder how many of those SIDS cases are really just a woman suffering from postpartum depression smothering her newborn because she is no longer receiving the full amount of attention she received when pregnant.
I don't think it's common for women with PPD to kill their child. If anything they kill themselves. I agree it's nothing to do with attention, and I think it's facile and callous to imply otherwise without any factual/scientific basis.
Some infants respond to a drop in oxygen by stopping breathing all together, instead of breathing faster or trying to get more oxygen. It is thought this is leftover from time in the womb: https://www.frontiersin.org/articles/10.3389/fneur.2015.0022...
Anything that reduces how much oxygen the infant gets can potentially trigger this. So while it might be "there was a pillow the baby managed to roll into", it could also be a mild allergic reaction, acid reflux, a respiratory virus or insufficient air circulation. None of those things would be enough to be a "cause of death", because they were just the trigger for the infant's brain deciding to stop breathing.
I thought SIDS had been debunked as more ordinary suffocation aggravated by a few types of respiratory irritation or development issues combined with unsafe sleeping conditions. A dying child being so traumatic that reasons beyond the ordinary have been searched for quite hard without finding any real underlying condition beyond baby can’t breathe and is too small to wake and rearrange itself.
It's really hard to tease out given the sensitivity of the issue but while the vast majority of SIDs deaths are environmental or situational (smoke, unsafe sleep, cushions, accidental parent suffocation, intentional parent suffocation...) afaik there does seem to be some low base rate of SIDs deaths which have no obvious explanation.
Do you have any source for this? I didn't see anything to that effect on Wikipedia (which cites articles from NEJM and other reputable journals when discussing the phenomenon) or the Mayo Clinic's page.
You (and others in this thread) are talking about this debunking as if it's common knowledge, but I'm not seeing it. Am I looking in the wrong places?
The SIDS rate dropped from ~1.4 to ~0.5 per thousand with a pretty strong correlation to back-sleeping and a campaign to promote it, combined with shifting cause of death diagnoses to "accidental suffocation".
If you can reduce the prevalence of a diagnosis by 65% by having babies sleep on their back, there's a good chance the cause of death in a good few of the remaining cases (and ones not prevented in the path) ought to be something like "suffocated while not sleeping on their back" instead of a mysterious illness.
Even the linked paper quotes
>The “triple risk model” hypothesises that SIDS deaths result from coincident occurrence of a vulnerable infant, a critical developmental period, and an exogenous stressor
which if this is the model for SIDS should get real philosophical questioning as to the appropriateness of bundling this together into a syndrome instead of labeling the actual cause and trying to fix it specifically (as in, promoting back sleeping as it is a risk for infant suffocation)
I don't want to vet individual claims of physicians to quote them, but there are many out there questioning the merits of SIDS as a diagnosis.
There is, however, not a boss in charge of science who is going to stamp SIDS as "doesn't exist", and the diagnosis will likely stick around for a long time because of the social issues attached with the trauma and attempts to find non-blaming answers for why a child died.
Trying to write off the rest of the deaths as improper sleeping doesn’t really make sense to me - that’s like saying that since the majority of strep cases can be treated with broad spectrum antibiotics, therefore MERS doesn’t exist.
There are indeed always going to be unknown causes of death at any age, sometimes it is just hard to determine.
It seems inappropriate to give a name and diagnosis to “cause unknown”
MERS and strep both have easily attributed causes.
SIDS seems really not to, it really seems that there is not an underlying cause that doesn’t already exist. “Babies are more susceptible to suffocation and more care needs to be taken in their sleeping arrangement” doesn’t seem like a disease, even if some babies are more susceptible than others (and those many individual susceptibilities already have names)
Baby humans are vulnerable to lots of things because that’s what they are, SIDS and modern attempts to attribute it to things seems to be a harmful distraction from the actual causes of death.
Interesting. Would you consider type 2 diabetes to be a disease? There are clear, well known steps people can take to reduce the likelihood of it happening, after all...
I would be more sympathetic to your position if it were likely for death to occur if an infant sleeps in their belly, but that doesn't seem to be the case. It sure seems like SIDS is pretty rare even when belly sleeping, it just increases the risk factor.
But, I've only started reading about it in the past two hours, so who knows. Thanks for the reply, in any case.
> I would be more sympathetic to your position if it were likely for death to occur if an infant sleeps in their belly
Given the statistics of back sleeping campaign success it seems fair to say that having your baby sleep on its belly instead of its back would kill 1 in 1000 babies. That doesn’t seem particularly rare.
Riding in a car without a car seat is considerably safer, getting covid is considerably safer.
It would make up about 20 percent of child mortality deaths in the US, that’s not insignificant.
That is false. SIDS is a term that refers to an unexplained death. Any death which can be root caused in any of the ways you refer to, or any other manner, cannot be diagnosed as SIDS.
It is not possible to root-cause SIDS because the term semantically refers to deaths without a known root cause. If a death can be attributed to a cause, it stops being SIDS.
SIDS is a generic catch-all for unexplained sudden infant deaths . That's why it's literally "sudden infant death syndrome".
At population scale, certainly some deaths would be counted in the SIDS bucket due to missing ordinary suffocation during the autopsy, but it's not correct to say that every SIDS case is just suffocation or that SIDS has been "debunked".
And that diagnosis should be considered harmful if it is just a catchall for "unknown cause of death" because people go looking for answers which won't exist like this study while ignoring actual causes of death which may be preventable (like encouraging back-sleeping saves a huge percentage of SIDS-attributed deaths).
The narrative of individual responsibility has been pushed for a long time because it was all we had, but it's always been the case that even doing everything perfectly correct doesn't reduce the risk to zero. We discovered in the past decade that infants have a neurological difference where, when deprived of oxygen, instead of trying to get more air they simply stop breathing: https://www.frontiersin.org/articles/10.3389/fneur.2015.0022...
It's not "ordinary suffocation". Instead, anything that reduces how much oxygen an infant is getting, including colds, mild allergic reactions, rolling over onto their face, acid reflux, not enough ventilation, etc, will potentially trigger a complete shut-down of their breathing & eventually death.
You have to be cautious here, babies need to be protected from many things that don’t necessarily need to be classified as diseases. Babies are just vulnerable. There is a point where a vulnerability gets classified as a disease, which is sort of the core of the issue.
"Since 2016, the FDA has corresponded with Owlet that the Owlet Smart Sock meets the definition of a device under the FD&C Act and does not fall under the compliance policy for low-risk products that promote a healthy lifestyle (General Wellness guidance)."
Yikes it does seem that they were playing games with their marketing and stringing the FDA along.
I thought SIDS is basically a category for an unexplained deaths. If there is a clear cause of deaths, it's not SIDS.
Someone edit the Wikipedia if it's wrong: "Sudden infant death syndrome (SIDS), also known as cot death or crib death, is the sudden unexplained death of a child of less than one year of age.[1] Diagnosis requires that the death remain unexplained even after a thorough autopsy and detailed death scene investigation."
If you can explain any deaths diagnosed as SIDS, then they can no longer be diagnosed as SIDS; but all other unexplained deaths remain SIDS.
We have made recent progress in identifying the mechanism: basically, many babies don't respond to rising carbon dioxide levels in their lungs the way older people do. They don't start breathing faster, or flail around trying to get a breath. Instead, they stop breathing & then, unless someone notices, die.
It's why a ceiling fan can help: it produces positive air pressure that makes the infant get more oxygen. It's also why sleeping in a bed with a parent who smokes is such a risk factor: in an infant, even a mild an allergic reaction to cigarette smoke can be fatal.
It is still unexplained by any specific diagnosis, because it's actually pretty common for infants to have an over-developed dive reflex and not to respond to excess carbon monoxide. But we know why it happens now.
I don't know why, but as a new parent SIDS scares me more than almost anything else. We follow all the recommended best practices - back sleeping, no bumpers, no lose blankets, no co-sleeping, etc. Intellectually, I know that if you follow the recommendations the risk of SIDS is lower than the risk of your infant dying in a car accident, and yet driving with him in the car does not worry me. But I worry about SIDS to the point that I find that I sometimes startle awake and need to check the bassinet to make sure everything is okay. Hopefully, research like this can lead to a way to screen babies for risk and come up with some sort of treatment option. So parents like me can have more peace of mind.
First 2 months I was up most nights coding the night away, with my twin baby girls asleep on my lap against my torso. I'd just check they were breathing all the time. Though it was probably overkill I can't think of that time as anything else than one of the best moments of my life.
Glad to know I'm not the only one. I'm not quite as productive as you though. I tend to watch Netflix, but lately I've been going through the fast.ai videos. I have a hard time getting him situated in a way that lets me use my laptop while he sleeps.
Yeah writing a compiler was the only thing that would keep me awake all night every night and with less than 4 hours sleep (still had to help my very tired and bruised spouse - episiotomy sucks but breastfeeding twins is just devastatingly tiring - lost all the pregnancy weight in weeks, had to up food intake) keeping all the moving things in my head, making small progress, alternated with some learning (formal proof).
I struggled for some time to keep them static and my hands free and after some time we found a great position that we would slip into every night. It's around that time I realized that most things with kids are about patience, trying gently and giving them opportunity to help/do (even in their sleep ;-)).
This really resonates with me. The first time my daughter slept 6h in a row, I woke up in sweat and fake a bathroom run to stop at her bassinet and feel her breathing with the back of my hands. Unexplained situation are hard because you cant pin point the exact reason it happened. While situations like driving is statistically way more dangerous than SIDS, the feeling of being powerless is hard to digest.
Interesting, we avoided back sleeping because of the flat head syndrome. The recommendation where I live was to let the baby sleep on the side with a rolled towel supporting the back, being careful to prefer both sides equally.
I would often listen or check for children breathing, well into their grade school years.
You learn when to switch off and honor their privacy. I don't know how to articulate the signals that would tell me they were fast asleep, such a visceral experience.
> The “triple risk model” hypothesises that SIDS deaths result from coincident occurrence of a vulnerable infant, a critical developmental period, and an exogenous stressor.
The finding of a correlation between low butyrylcholinesterase and SIDS looks consistent with an old proposal [0] for the "exogenous stressor": basiclly, fire retardents in PVC contain arsenic, phosphorus, and antimony compounds which are broken down by scopulariopsis brevicaulis, a fungus fond in babies' mucus. This generates toxic gases *which are cholinesterase inhibitors*.
Gut butyrylcholinesterase is actually transcribed at the same locus as gut sucrase-isomaltase, which breaks down sucrose. At 3q26.1!
It's on the opposite arm of chromosome 3 from oxytocin + thyroid hormone receptor beta + peroxisome proliferation associated receptor gamma (all around 3p24.3-3p25.3).
I guess its nice that they have a biomarker, but the underlying reasoning has been known for decades. I was born in the late 70s and was diagnosed very quickly with infant sleep apnea, they might have not known why I suffered, but they knew to check for it. I was in the first group of babies to have a take home monitor. if I was born a handful of years earlier, I might have not survived. if I was born just a little bit earlier I'd have been in the hospital for an extended period of time. As it was, I was able to be taken home and every time put to sleep, my parents had to attach the electrodes (the pajamas I wore all had hold cut in them to allow that) that was supposed to wake me and my parents up whenever I stopped breathing for a set period of time.
I was under the impression that sleep apnea was seriously reduced as a cause of SIDS because of this. (i.e. I was raised to believe that before I was born sleep apnea was the primary cause of death for infants who died of what was characterized as SIDS).
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[ 1.5 ms ] story [ 225 ms ] threadIs probably how I'd pronounce it, but could be accent differences.
Can someone comment whether this is a significant result, vs minor contributing factor? I can’t really interpret the results... there is a significant coef on (quantity of something in blood) in a logistic regression... how big is the residual?
SIDS seems to be a catch all for a lot of things. Putting babies on their back, removing objects and bumpers from the crib, etc did reduce SIDS but didn’t eliminate it.
This may be a major chunk of what is still considered SIDS but is not 100% of what is considered SIDS
The paper talks about "cholinergic deficit" (a situation that is also common in dementia sufferers). The parasympathetic nervous system is heavily reliant on cholinergic agents which is why if you take medication that's anticholinergic (including many antihistamines like promethazine) it tends to dull the senses, send people to sleep, make it harder to wake up, etc. (This is what a lot of those "sleep aids" you find in US airports are doing at a low level.)
My layman's attempt at jumping to a conclusion, then, is that death is not caused merely by cholinergic deficit, but that if someone has such a deficit and is harder to self-rouse, asphyxiation during sleep becomes somewhat more likely?
What is interesting to me is that this is a biochemical marker and biochemical disorders are known causes of SIDS. Newborn screening, which varies from state to state, can catch many of these disorders. This result is interesting because it may lead to other studies that identify other pathways/enzymes that represent markers or causes of less common causes of SIDS.
MCAD deficiency, the most common inborn error in fatty acid oxidation, is a biochemical disorder that is one of the more common causes of SIDS. The infants simply run out of easily available fuel for their metabolism if untreated and can die during fasting (i.e. in their cot in the middle of the night). Giving starch or other complex carbs before bedtime is one of several treatments for this disease, with the overall goal of treatment to prevent the individual from entering a fasting state, as that is when they metabolically decompensate.
This is additional evidence supporting a hypothesis advanced in the last decade associating SIDs deaths with a reflex that causes infants to stop breathing instead of try to breath faster when they aren't getting enough oxygen. It doesn't establish much on its own, but it could enable screening for at-risk children, and eventually enable interventions that address the root cause.
(Current interventions are mostly about attempting to ensure infants never experience a drop in oxygen that could trigger that reflex, which can never reduce the risk to zero.)
Spend a moment to click on the link to the funding campaign, lots of parents that lost a child there. I literally started crying, when I read the comments of the donating families,
Also if you add a fan to the room and keep it on while the baby is sleeping, it reduces SIDS by almost 80%.
https://www.nationwidechildrens.org/family-resources-educati...
Even assuming that this very small and self-reported study is accurate (which is doubtful itself) making a causative link here seems wildly unreasonable. Unless you can suggest a mechanism I think it's much more likely that there is some link between people who use fans and something related to SIDs.
Yes, they are. This is documented scientific fact.
in which case sitting in a car or other sealed space would be dramatically more likely to cause infant death
This is also not recommended. Note that nearly all modern automatically vent new air into the vehicle...
While a car is moving it has ventilation, and it's illegal to leave an infant alone in a parked car in part for this very reason. But sleeping in a car seat is one of the risk factors for SIDs.
I'm not sure when the study was done, but that article was first (c) 2000. I have never had a doctor or nurse mention running a fan, and neither my wife or I have come across that when researching care of our children... but a 72% decrease in fatality is pretty damn close to an outright cure. How is this not broadcast loudly to every parent of a newborn?
That paper is from 2012, but I can’t find a newer paper that changes that. For example https://pubmed.ncbi.nlm.nih.gov/27940805/, from 2016, doesn’t mention fans in its abstract.
Having a child is an extremely frustrating experience from this point of view.
"Only 6 of the 167 coroner-pronounced SIDS cases used fans, while only 36 of 309 controls used fans."
and
"The case and control groups were not similar at the beginning of the study."
---
1: https://pubmed.ncbi.nlm.nih.gov/19414701/
https://pubmed.ncbi.nlm.nih.gov/18838649/
From the Mayo Clinic
“ Risk factors Although sudden infant death syndrome can strike any infant, researchers have identified several factors that might increase a baby's risk. They include:
Sex. Boys are slightly more likely to die of SIDS.
Age. Infants are most vulnerable between the second and fourth months of life.
Race. For reasons that aren't well-understood, nonwhite infants are more likely to develop SIDS.
Family history. Babies who've had siblings or cousins die of SIDS are at higher risk of SIDS.
Secondhand smoke. Babies who live with smokers have a higher risk of SIDS.
Being premature. Both being born early and having a low birth weight increase your baby's chances of SIDS.
Maternal risk factors
During pregnancy, the mother also affects her baby's risk of SIDS, especially if she:
Is younger than 20 Smokes cigarettes Uses drugs or alcohol Has inadequate prenatal care”
https://www.mayoclinic.org/diseases-conditions/sudden-infant...
Its so common in my country that a murder investigation is conducted each time it happens
Those factors you mentioned are all risk factors of general family violence.
Our country has parental classes a lot of it was dealing with the stress of having a child while talking about SIDS and talking about how you don't want it to happen because you will be investigated for murder.
We even had public service campaigns,
don't shake a baby
another about baby crying in a cot and a mother looking like she is about to loose it, then a message to get help.
Another about, don't hold a babies mouth ect
There is even a difference in methods. For males its blunt force trauma, for mothers its suffocation.
From memory their is a large difference between unplanned child and planned child.
I think my country is realistic about addressing these issues and not hiding behind 'risk factors'
And why would that be incorrect?
Some infants respond to a drop in oxygen by stopping breathing all together, instead of breathing faster or trying to get more oxygen. It is thought this is leftover from time in the womb: https://www.frontiersin.org/articles/10.3389/fneur.2015.0022...
Anything that reduces how much oxygen the infant gets can potentially trigger this. So while it might be "there was a pillow the baby managed to roll into", it could also be a mild allergic reaction, acid reflux, a respiratory virus or insufficient air circulation. None of those things would be enough to be a "cause of death", because they were just the trigger for the infant's brain deciding to stop breathing.
> low base rate of SID[S] deaths which have no obvious explanation.
All SIDS deaths have no obvious explanation; that is how SIDS is defined.
You (and others in this thread) are talking about this debunking as if it's common knowledge, but I'm not seeing it. Am I looking in the wrong places?
The SIDS rate dropped from ~1.4 to ~0.5 per thousand with a pretty strong correlation to back-sleeping and a campaign to promote it, combined with shifting cause of death diagnoses to "accidental suffocation".
If you can reduce the prevalence of a diagnosis by 65% by having babies sleep on their back, there's a good chance the cause of death in a good few of the remaining cases (and ones not prevented in the path) ought to be something like "suffocated while not sleeping on their back" instead of a mysterious illness.
Even the linked paper quotes
>The “triple risk model” hypothesises that SIDS deaths result from coincident occurrence of a vulnerable infant, a critical developmental period, and an exogenous stressor
which if this is the model for SIDS should get real philosophical questioning as to the appropriateness of bundling this together into a syndrome instead of labeling the actual cause and trying to fix it specifically (as in, promoting back sleeping as it is a risk for infant suffocation)
I don't want to vet individual claims of physicians to quote them, but there are many out there questioning the merits of SIDS as a diagnosis.
There is, however, not a boss in charge of science who is going to stamp SIDS as "doesn't exist", and the diagnosis will likely stick around for a long time because of the social issues attached with the trauma and attempts to find non-blaming answers for why a child died.
It seems inappropriate to give a name and diagnosis to “cause unknown”
MERS and strep both have easily attributed causes.
SIDS seems really not to, it really seems that there is not an underlying cause that doesn’t already exist. “Babies are more susceptible to suffocation and more care needs to be taken in their sleeping arrangement” doesn’t seem like a disease, even if some babies are more susceptible than others (and those many individual susceptibilities already have names)
Baby humans are vulnerable to lots of things because that’s what they are, SIDS and modern attempts to attribute it to things seems to be a harmful distraction from the actual causes of death.
I would be more sympathetic to your position if it were likely for death to occur if an infant sleeps in their belly, but that doesn't seem to be the case. It sure seems like SIDS is pretty rare even when belly sleeping, it just increases the risk factor.
But, I've only started reading about it in the past two hours, so who knows. Thanks for the reply, in any case.
Given the statistics of back sleeping campaign success it seems fair to say that having your baby sleep on its belly instead of its back would kill 1 in 1000 babies. That doesn’t seem particularly rare.
Riding in a car without a car seat is considerably safer, getting covid is considerably safer.
It would make up about 20 percent of child mortality deaths in the US, that’s not insignificant.
It is not possible to root-cause SIDS because the term semantically refers to deaths without a known root cause. If a death can be attributed to a cause, it stops being SIDS.
SIDS is a generic catch-all for unexplained sudden infant deaths . That's why it's literally "sudden infant death syndrome".
At population scale, certainly some deaths would be counted in the SIDS bucket due to missing ordinary suffocation during the autopsy, but it's not correct to say that every SIDS case is just suffocation or that SIDS has been "debunked".
The narrative of individual responsibility has been pushed for a long time because it was all we had, but it's always been the case that even doing everything perfectly correct doesn't reduce the risk to zero. We discovered in the past decade that infants have a neurological difference where, when deprived of oxygen, instead of trying to get more air they simply stop breathing: https://www.frontiersin.org/articles/10.3389/fneur.2015.0022...
It's not "ordinary suffocation". Instead, anything that reduces how much oxygen an infant is getting, including colds, mild allergic reactions, rolling over onto their face, acid reflux, not enough ventilation, etc, will potentially trigger a complete shut-down of their breathing & eventually death.
https://web.archive.org/web/20160311081124/https://www.pbs.o...
Yikes it does seem that they were playing games with their marketing and stringing the FDA along.
Someone edit the Wikipedia if it's wrong: "Sudden infant death syndrome (SIDS), also known as cot death or crib death, is the sudden unexplained death of a child of less than one year of age.[1] Diagnosis requires that the death remain unexplained even after a thorough autopsy and detailed death scene investigation."
If you can explain any deaths diagnosed as SIDS, then they can no longer be diagnosed as SIDS; but all other unexplained deaths remain SIDS.
See, for example: https://www.frontiersin.org/articles/10.3389/fneur.2015.0022...
It's why a ceiling fan can help: it produces positive air pressure that makes the infant get more oxygen. It's also why sleeping in a bed with a parent who smokes is such a risk factor: in an infant, even a mild an allergic reaction to cigarette smoke can be fatal.
It is still unexplained by any specific diagnosis, because it's actually pretty common for infants to have an over-developed dive reflex and not to respond to excess carbon monoxide. But we know why it happens now.
I struggled for some time to keep them static and my hands free and after some time we found a great position that we would slip into every night. It's around that time I realized that most things with kids are about patience, trying gently and giving them opportunity to help/do (even in their sleep ;-)).
I hope you'll keep enjoying these nights.
You learn when to switch off and honor their privacy. I don't know how to articulate the signals that would tell me they were fast asleep, such a visceral experience.
The finding of a correlation between low butyrylcholinesterase and SIDS looks consistent with an old proposal [0] for the "exogenous stressor": basiclly, fire retardents in PVC contain arsenic, phosphorus, and antimony compounds which are broken down by scopulariopsis brevicaulis, a fungus fond in babies' mucus. This generates toxic gases *which are cholinesterase inhibitors*.
[0] Richardson, B.A. (1990) Cot mattress biodeterioration and SIDS. https://sci-hub.se/10.1016/0140-6736(90)90463-F
It's on the opposite arm of chromosome 3 from oxytocin + thyroid hormone receptor beta + peroxisome proliferation associated receptor gamma (all around 3p24.3-3p25.3).
I was under the impression that sleep apnea was seriously reduced as a cause of SIDS because of this. (i.e. I was raised to believe that before I was born sleep apnea was the primary cause of death for infants who died of what was characterized as SIDS).