A fascinating study published in this week’s JAMA, from The Children’s Hospital of Boston, may be an important discovery toward solving the puzzle of SIDS (sudden infant death syndrome). SIDS is defined as the sudden unexplained death of an infant under the age of one year.
Back to Sleep
In most cases an otherwise healthy infant is found dead after being put to sleep. It seems that these infant’s die during sleep or during a transition from sleep to waking.
The rate of SIDS has decreased since the “back to sleep campaign” which recommended that all infant’s sleep on their backs rather than in the prone position. Despite the changes in sleep position the SIDS rate in the United States is still 0.54/1000 live births, which translates into 2,300 deaths per year.
In this study it was found that infants who died from SIDS had lower serotonin levels in their brains in comparison to infants who died from other causes. In fact, the serotonin levels were 26% lower in the SIDS infants.
Serotonin helps regulate the autonomic nervous system in the brainstem that controls breathing, temperature, sleep and awakening. Serotonin is the neurotransmitter that is also thought to help an infant respond to increases in carbon dioxide levels (that may occur if a baby is sleeping on their tummy) by turning their head. If an infant has low serotonin levels they may not respond appropriately.
This is just an initial study to show that infants who die from SIDS may have intrinsic differences in the serotonin receptors and levels in their brain. The study also re-iterates that there are other underlying risk factors that may also play a role in SIDS.
Extrinsic factors such as prone sleep position, co-sleeping as well as other intrinsic factors such as prematurity or male sex may also affect the underlying vulnerability of a baby to have SIDS. There are likely multiple factors that occur in a vulnerable child that result in SIDS
This exciting study is just the beginning to solving this mystery. In the meantime as more research continues make sure that you put your baby “back to sleep, do not smoke around your baby, do not place pillows or other soft bedding in the crib with your baby, and do not overdress your infant for sleeping.
At the same time there have been some studies to show that the use of a ceiling fan and a pacifier may be “protective” and may be used. Lastly, never sleep with your baby, keep them close by in a basinet but not in your bed!!
That’s your daily dose. We’ll chat again soon!
Co-sleeping/bedsharing when done *safely* (that is, while not under the influence of drugs/alcohol and without bedding covering the infant, and only with parents and not any other care provider) is actually a preventative measure against SIDS. Dr. James McKenna at the University of Notre-Dame spends his time researching mother-child sleep and has found this to be the case, partly because the close sleeping prevents babies with arousal deficiencies from going into a deep sleep.
Overlying/suffocation is NOT the same as SIDS, for that matter, and almost all of those deaths occur when the care provider is drunk or drugged.
Bedsharing is extremely beneficial for families and children when done safely.