Infection possible cause of sudden infant death syndrome

by Terri Potratz | September 11, 2008 at 09:34 am

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New research in the UK points to disease as a possible cause of Sudden Infant Death Syndrome (SIDS):

The Archives of Disease in Childhood study found samples from babies who had died for no apparent reason often carried potentially-harmful bacteria.

Some experts believe toxins produced by these bacteria could trigger a chemical storm, which overwhelms the baby, resulting in sudden death.

"Crib death" is a perplexing issue because doctors and scientists have no definitive answer as to what causes it, despite years of research into the matter. Whereas in the past doctors recommended placing infants on their stomachs to sleep, now the reverse is true and infants should sleep on their backs:

The striking evidence that stomach sleeping might contribute to the incidence of SIDS led the American Academy of Pediatrics (AAP) to recommend in 1992 that all healthy infants younger than 1 year of age be put to sleep on their backs (also known as the supine position). Since the AAP's recommendation, the rate of SIDS has dropped by over 50%. Still, SIDS remains the leading cause of death in young infants, so it's important to keep reminding parents about the necessity of back sleeping.

George Haycock, scientific advisor to the Foundation for the Study of Infant Deaths, had this to say:

"The suggestion that infectious organisms such as S. aureus and E. coli play a part in a proportion of sudden infant deaths provides us with another important piece of the SIDS puzzle. It is important to recognise that both S. aureus and E coli are ubiquitous organisms carried by most, if not all, of the healthy adult population and that colonisation of infants does not imply lack of hygiene or normal care, but is bound to happen in a proportion of individuals."

Infection has been postulated as a cause of some cases of SIDS for many years. Parents of infants who died of SIDS were much more likely to report symptoms suggestive of infection in the days immediately preceding the death than parents of surviving infants. More than 20 years ago Professor James Morris of Leicester University formulated the common bacterial toxin hypothesis of SIDS (then usually known as cot death), which suggests that organisms capable of producing lethal toxins (particularly Staph aureus and E coli) may colonise the upper airway (pharynx) of infants in some circumstances, and that these toxins may be absorbed into the bloodstream across the lining of the pharynx and cause sudden death.

Hopefully this research will lead to more preventative measures that can be adopted by new parents, but in the meantime here are the top recommendations:

Always place your baby on his or her back to sleep, for naps and at night. The back sleep position is the safest, and every sleep time counts.

Place your baby on a firm sleep surface, such as on a safety-approved crib mattress, covered by a fitted sheet. Never place your baby to sleep on pillows, quilts, sheepskins, or other soft surfaces.

Keep soft objects, toys, and loose bedding out of your baby's sleep area. Don't use pillows, blankets, quilts, sheepskins, and pillow-like crib bumpers in your baby's sleep area, and keep any other items away from your baby's face.

Do not allow smoking around your baby. Don't smoke before or after the birth of your baby, and don't let others smoke around your baby.

Keep your baby's sleep area close to, but separate from, where you and others sleep. Your baby should not sleep in a bed or on a couch or armchair with adults or other children, but he or she can sleep in the same room as you. If you bring the baby into bed with you to breastfeed, put him or her back in a separate sleep area, such as a bassinet, crib, cradle, or a bedside cosleeper (infant bed that attaches to an adult bed) when finished.

Think about using a clean, dry pacifier when placing the infant down to sleep, but don't force the baby to take it. (If you are breastfeeding your baby, wait until your child is 1 month old or is used to breastfeeding before using a pacifier.)

Do not let your baby overheat during sleep. Dress your baby in light sleep clothing, and keep the room at a temperature that is comfortable for an adult.

Avoid products that claim to reduce the risk of SIDS because most have not been tested for effectiveness or safety.

Do not use home monitors to reduce the risk of SIDS. If you have questions about using monitors for other conditions talk to your health care provider.

Reduce the chance that flat spots will develop on your baby's head: provide "Tummy Time" when your baby is awake and someone is watching; change the direction that your baby lies in the crib from one week to the next; and avoid too much time in car seats, carriers, and bouncers.