Sudden infant death syndrome (SIDS) is a syndrome marked by the symptoms of sudden and unexplained death of an apparently healthy infant aged one month to one year. The term cot death is often used in the United Kingdom, Australia and New Zealand, while crib death is sometimes used in North America. Typically the infant is found dead after having been put to sleep, and exhibits no signs of having suffered.^[1] The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // R00-R99 - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R09) Symptoms and signs involving the circulatory and respiratory systems (R00) Abnormalities of heart beat (R000) Tachycardia, unspecified (R001) Bradycardia, unspecified (R002) Palpitations (R008) Other and unspecified abnormalities of heart beat (R01) Cardiac murmurs and other... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... “Baby” redirects here. ...

SIDS is a diagnosis of exclusion. It can only be applied to an infant whose death is sudden and unexpected, and remains unexplained after the performance of an adequate postmortem investigation including Wikipedia does not yet have an article with this exact name. ... This page is a candidate to be moved to Wiktionary. ...

1. an autopsy;
2. investigation of the scene and circumstances of the death;
3. exploration of the medical history of the infant and family.

SIDS is responsible for roughly 0.05%, or 1 death per 2,000 births in the U.S. It is responsible for far fewer deaths than congenital disorders and disorders related to short gestation, though it is the leading cause of death in healthy babies after one month of age. The medical history of a patient (sometimes called anamnesis [1][2] ) is information gained by a physician by asking specific questions, either of the patient or of other people who know the person and can give suitable information (in this case, it is sometimes called heteroanamnesis). ...

According to the American SIDS Institute, SIDS is "a tragedy which leaves [parents] with a sadness and a feeling of vulnerability that lasts throughout their lives." ^[2]

In November 2007, the Bill & Melinda Gates foundation contributed $11 million to distribute 200,000 cribs in the United States of America to families at-risk of SIDS or in need of financial assistance. Additionally, the grant will fund a study of infant mortality over 100,000 families. The hypothesis of the study is that availability of safe cribs and knowledge of safe sleep practices will reduce the occurrence of SIDS.^[3]. November 2007 is the eleventh month of that year. ...

Undiagnosed conditions

Some conditions that may be undiagnosed and thus result in a diagnosis of SIDS include

• Medium chain acyl CoA dehydrogenase deficiency (MCAD deficiency);
• Infant botulism;
• Long QT syndrome;
• Shaken baby syndrome;
• infections with the bacteria called Helicobacter pylori.

Medium-chain acyl-coenzyme A dehydrogenase deficiency is one of a group of conditions that is associated with inborn errors of metabolism in fatty acid oxidation. ... Botulism (Latin, botulus, sausage) is a rare, but serious paralytic illness caused by a nerve toxin, botulin, that is produced by the bacterium Clostridium botulinum. ... The long QT syndrome (LQTS) is a heart disease in which there is an abnormally long delay between the electrical excitation (or depolarization) and relaxation (repolarization) of the ventricles of the heart. ... Shaken baby syndrome (SBS) is a form of child abuse affecting between 1,200 and 1,600 children every year in the USA.[1] SBS encompasses a variety of outcomes that are attributed to shaking an infant or small child. ...

Risk factors

Very little is certain about the possible causes of SIDS, and there is no proven method for prevention. Although studies have identified risk factors for SIDS, such as putting infants to bed on their stomachs, there has been little understanding of the syndrome's biological cause or causes. The frequency of SIDS appears to be a strong function of infant sex and the age, ethnicity, and the education and socio-economic status of the parents.

According to a study published in October 2006 in the Journal of the American Medical Association, babies who die of SIDS have abnormalities in the part of the brain that helps control functions like breathing, blood pressure and arousal. Researchers examined the brains of 31 babies who had died of SIDS and 10 who had died from other causes. They found that abnormalities in the brain stem appear to affect the ability to use and recycle serotonin, which is responsible for regulating mood as well as vital body functions. According to the National Institutes of Health, which funded the study, the new finding is the strongest evidence to date suggesting that innate differences in a specific part of the brain may place some at increased risk of dying from SIDS.^[4] For the professional wrestling stable, see Ravens Nest#Serotonin. ...

Listed below are several factors associated with increased probability of the syndrome based on information available prior to this recent study.

Prenatal risks

• maternal nicotine use e.g. tobacco or nicotine patch ^[5]
• inadequate prenatal care^{[citation needed]}
• inadequate prenatal nutrition^{[citation needed]}
• use of heroin^{[citation needed]}
• subsequent births less than one year apart^{[citation needed]}
• alcohol abuse^{[citation needed]}
• being overweight^{[citation needed]}
• Under the age of 20^{[citation needed]}

The Nutrition Facts table indicates the amounts of nutrients which experts recommend you limit or consume in adequate amounts. ... For other uses, see Heroin (disambiguation). ... This article does not cite any references or sources. ...

Post-natal risks

• low birth weight (especially less than 1.5 kg (~3.3 lb))
• exposure to tobacco smoke^[6]
• laying an infant to sleep on his or her stomach (see sleep positioning below)
• not breastfeeding^[7]
• excess clothing and overheating
• excess bedding, soft sleep surface and stuffed animals
• infant's sex (61% of SIDS cases occur in males)
• infant's age (incidence rises from zero at birth, is highest from two to four months, and declines towards zero at one year)
• premature birth (increase risk of SIDS death by 50 times)

Shredded tobacco leaf for pipe smoking Tobacco can also be pressed into plugs and sliced into flakes Tobacco is an agricultural product processed from the fresh leaves of plants in the genus Nicotiana. ... Suckling redirects here. ...

Risk reduction for SIDS

Though SIDS cannot be prevented, parents of infants are encouraged to take several precautions in order to reduce the likelihood of SIDS.

Environment

Sleep positioning

Sleeping on the back has been recommended by (among others) the American Academy of Pediatrics (starting in 1992) to avoid SIDS, with the catchphrase "Back To Bed" and "Back to Sleep." The incidence of SIDS has fallen sharply in a number of countries in which the back to bed recommendation has been widely adopted, such as the US and New Zealand.^[8] However, the absolute incidence of SIDS prior to the Back to Sleep Campaign was already low in the US. Back to Sleep is an initiative backed by the National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health to encourage parents to have their infants sleep on their backs (supine position) to reduce the risk of Sudden Infant Death Syndrome, or SIDS. Since Back...

Among the theories supporting the Back to Sleep recommendation is the idea that small infants with little or no control of their heads may, while face down, inhale their exhaled breath (high in carbon dioxide) or smother themselves on their bedding -- the brain-stem anomaly research (above) suggests that babies with that particular genetic makeup do not react "normally" by moving away from the pooled CO₂, and thus smother. Another theory is that babies sleep more soundly when placed on their stomachs, and are unable to rouse themselves when they have an incidence of sleep apnea, which is thought to be common in infants. Sleep apnea, sleep apnoea or sleep apnÅ“a is a sleep disorder characterized by pauses in breathing during sleep. ...

Arguments against infant back-sleeping include concerns that an infant could choke on fluids it brings up.^[9] Hospital staff commonly place newborns on their side, although they advise parents to place their infants on their backs after going home from the hospital.

Other concerns raised about the Back to Sleep Campaign have included the possible increase the risk of positional facial and head deformities (see positional plagiocephaly),^[10] possible interference with development of good sleep habits (which in turn may have other bad effects),^[11] and possible interference with motor skills development (as infants delay attempts to lift their heads, crawl, etc.)^[12]. Positional plagiocephaly, also known as deformational plagiocephaly or flathead syndrome, is a condition most commonly found in infants and is characterized by a flat spot on the back or one side of the head caused by remaining in one position for too long. ...

Breastfeeding

A 2003 study published in Pediatrics, which investigated racial disparities in infant mortality in Chicago, found that previously or currently breastfeeding infants in the study had 1/5 the rate of SIDS as non-breastfed infants, but that "it became nonsignificant in the multivariate model that included the other environmental factors. These results are consistent with most published reports and suggest that other factors associated with breastfeeding, rather than breastfeeding itself, are protective."^[13] Pediatrics is an official peer-reviewed journal of the American Academy of Pediatrics. ... Suckling redirects here. ...

Co-sleeping

A controversial approach to lowering SIDS rates is limiting co-sleeping. A 2005 policy statement by the American Academy of Pediatrics on sleep environment and the risk of SIDS condemned all co-sleeping and bedsharing as unsafe. However, some data [2] has suggested that almost all SIDS deaths in adult beds occur when other prevention methods, such as placing infants on their backs, are not used. Infant deaths in adult beds are also reduced when parents are non-smoking, not impaired by drugs or alcohol, not obese, and are not using fluffy comforters and pillows. A firm sleeping surface is also required, which rules out waterbeds or soft mattresses. With these factors accounted for, SIDS rates for co-sleeping infants are actually lower than for crib-sleeping infants. Parents also have newer room and bedsharing options including bedside and bedtop sleeping devices to make co-sleeping safer and more convenient. Co-sleeping, also called the family bed, is a practice in which babies and young children sleep with one or both parents. ... The American Academy of Pediatrics (AAP) is an organization of pediatricians, physicians trained to deal with the medical care of infants, children, and adolescents. ...

A 2005 study states that "sleeping with an attentive, unimpaired mother is not only safe but biologically sound".^[14] The practice of solitary sleep for infants leads, among other things, to an absence of exogenous stimuli that influence breathing, cardiovascular function, and sleep architecture in the sleeping infant. Sleep and waking states and state transitions are apparently produced by suites of state regulatory mechanisms that function as a dynamical system. Modeling of dynamical systems has demonstrated that they are organized, or “tweaked” by episodic, irregular inputs. Some investigators (Mosko et al., 1993; McKenna, 1996) have argued that cosleeping provides infants with stimuli that organize their immature systems and thereby buffer them from risk for regulatory failures in sleep over a developmentally vulnerable postnatal period.^[15]

Research on co-sleeping indicates an excess risk with an adjusted Odds-Ratio of 2.71.^[16] There is a good deal of debate and discussion in the medical literature about this (see below). It is interesting to note that the first epidemiologic investigation of sudden unexpected infant deaths by Templeman in Dundee in 1892 were shown to be probably from suffocation by overlaying.^[17]

Secondhand smoke reduction

According to the U.S. Surgeon General’s Report, secondhand smoke is connected to SIDS.^[18] Infants who die from SIDS tend to have higher concentrations of nicotine and cotinine (a biological marker for secondhand smoke exposure) in their lungs than those who die from other causes. Infants exposed to secondhand smoke after birth are also at a greater risk of SIDS. Parents who smoke can significantly reduce their children's risk of SIDS by either quitting or smoking only outside and leaving their house completely smoke-free. This article is about the chemical compound. ... Cotinine is a metabolite of nicotine. ...

Sleeping area

Bedding

To prevent SIDS, many families use firm mattresses with tight-fitting sheets in cribs or bassinets. The families do not allow pillows, stuffed animals, or fluffy bedding in the cribs. In cold weather, the families dress the infants warmly in well-fitted clothing.^[19].

Sleep sacks

In colder environments where bedding is required to maintain a baby's body temperature, the use of a sleep sack is becoming more popular. A study published in the European Journal of Pediatrics in August 1998^[20] has shown the protective effects of a sleep sack as reducing the incidence of turning from back to front during sleep, reinforcing putting a baby to sleep on their back for placement into the sleep sack and preventing bedding from coming up over the face which leads to increased temperature and carbon dioxide rebreathing. They conclude in their study "The use of a sleeping-sack should be particularly promoted for infants with a low birth weight."

Pacifiers

A 2005 study indicated that use of a pacifier is associated with a 90% reduction in the risk of SIDS.^[21] It has been speculated that the raised surface of the pacifier holds the infant's face away from the mattress, reducing the risk of suffocation. Although suffocation is an actual cause, while SIDS refers to an unexplained infant death, in the absence of sufficient postmortem investigation, a SIDS diagnosis may result. This article is about the baby pacifier. ...

Bumper pads

Bumper pads may be a contributing factor in SIDS deaths and should be removed. Health Canada, the Canadian government's health department, issued an advisory^[22] recommending against the use of bumper pads, with the warning that they may decrease the amount of oxygen rich air available to the baby: sex Canada (French: Santé Canada) is the department of the government of Canada with responsibility for national public health. ...

The presence of bumper pads in a crib may also be a contributing factor for Sudden Infant Death Syndrome (SIDS). These products may reduce the flow of oxygen rich air to the infant in the crib. Furthermore, proposed theories indicate that the rebreathing of carbon dioxide plays a role in the occurrence of SIDS.

Speculated associations

A number of theoretical causes have been proposed as a trigger for SIDS, but many of them are unproven or have not been thoroughly studied and peer-reviewed.

Brain disorder

A recently published research article in the Journal of the American Medical Association showed evidence that cells in the brainstem fail to develop receptors for Serotonin in the womb. This abnormality continues until after birth, supposedly until the end of their first year. This would account for there being few to no SIDS deaths after the first year of infancy and the reason the risk is more for premature infants. The SIDS Alliance/First Candle has posted a message about this along with a link to the abstract on their website (www.firstcandle.com), which can be accessed from the front page. JAMA, published continuously since in 1883, is an international peer-reviewed general medical journal published 48 times per year. ... For the professional wrestling stable, see Ravens Nest#Serotonin. ...

Vitamin C

According to a 1993 article in Journal of Orthomolecular Medicine, Australian medical doctor Archie Kalokerinos performed research showing that high doses of vitamin C eliminates SIDS.^[23] As SIDS was shown to be caused solely by vitamin deficiency, the article stated that it was no longer a syndrome, and that the proper disease name is now SID. As of January 2007, the Journal of Orthomolecular Medicine was not included among journals selected by the U.S. National Library of Medicine for inclusion in their Medline database.^[24][25] This article or section contains information that has not been verified and thus might not be reliable. ... Archie Kalokerinos MBBS PhD FAPM is an Australian physician. ... In medicine, the term syndrome is the association of several clinically recognizable features, signs, symptoms, phenomena or characteristics which often occur together, so that the presence of one feature alerts the physician to the presence of the others. ... The United States National Library of Medicine (NLM), operated by the United States federal government, is the worlds largest medical library. ... It has been suggested that GoPubMed be merged into this article or section. ...

Toxic gases

In 1989, a controversial piece of research by UK Scientist Barry Richardson claimed that all cot deaths were the result of toxic nerve gases being produced through the action of fungus in mattresses on compounds of phosphorus, arsenic and antimony. These chemicals are frequently used to make mattresses fire-retardant. For the fictional character, see Fungus the Bogeyman. ... General Name, symbol, number phosphorus, P, 15 Chemical series nonmetals Group, period, block 15, 3, p Appearance waxy white/ red/ black/ colorless Standard atomic weight 30. ... General Name, Symbol, Number arsenic, As, 33 Chemical series metalloids Group, Period, Block 15, 4, p Appearance metallic gray Standard atomic weight 74. ... This article is about the element. ...

A major plank in this explanation is the widely-observed phenomenon that the risk of cot death rises from one sibling to the next. Richardson claims that the cause is that parents are more likely to buy new bedding for their first child, and to re-use that bedding for later children. The more frequently used the bedding is, the more chance there will be that fungus has become resident in the material; thus, a higher chance of cot death. A paper by Peter Fleming and Peter Blair [3] references evidence from other studies that both supports and refutes the increasing occurrence of SIDS with mattress sharing and suggests that this is still inconclusive.

In 1994, the New Zealand government, under the advice of Dr. Jim Sprott, issued advice recommending new parents to either buy bedding free of the toxic compounds or to wrap the mattresses in a barrier film to prevent the escape of the gases. Dr. Sprott claims that no case of cot death has ever been traced back to a properly manufactured or wrapped mattress [4].

However, a final report of The Expert Group to Investigate Cot Death Theories: Toxic Gas Hypothesis, published in May 1998, concluded that "there was no evidence to substantiate the toxic gas hypothesis that antimony- and phosphorus-containing compounds used as fire retardants in PVC and other cot mattress materials are a cause of SIDS. Neither was there any evidence to believe that these chemicals could pose any other health risk to infants."^[26] The report also states that "in normal cot-like conditions it is not possible to generate toxic gas from antimony in mattresses" and "babies have also been found to die on wrapped mattresses." Dr. Sprott's website, however, claims [5] [6] that the study does not actually refute his theory:

Contrary to media publicity, the 1998 UK Limerick Report did not disprove the toxic gas theory - as a highly qualified environmental scientist has stated in the New Zealand Medical Journal. In fact, the Limerick Committee's experiments proved the fungal generation of toxic gases (forms of stibine and arsine) from cot mattress materials.

According to Dr. Sprott, as of 2006, the New Zealand government has not reported any SIDS deaths when babies have slept on mattresses wrapped according to his method. While the Limerick report claims that babies have been found to die on wrapped mattresses, Dr. Sprott argues that a chemical analysis of the bedding should be performed. He additionally claims that this part of the report was flawed:

In February 2000 Dr Peter Fleming (a co-author of the Limerick Report and principal author of the UK CESDI Report) conceded that the claim that three babies in the United Kingdom had died of cot death on polythene-covered mattresses could not be substantiated.^[27]

Central Respiratory Pattern Deficiency

There is ongoing research in the pediatric/neonatal community that has begun to associate apnea-like breathing cessations in animal models with unusual neural architecture or signal transduction in central pattern generator circuits including the pre-Bötzinger complex.^[28] It is possible that irregularities in neurotransmitter release (such as GABA, adenosine, and NMDA) or deficiencies in their associated receptors (including both GABA_A, GABA_B subtypes and NMDA-glutamate receptors) are linked to incomplete prenatal development as is evident in pre-term infants. The Pre-Bötzinger Complex (pBc) is a cluster of interneurons in the ventrolateral medulla essential to the generation of respiratory rhythm in mammals. ... Gaba may refer to: Gabâ or gabaa (Philippines), the concept of negative karma of the Cebuano people GABA, the gamma-amino-butyric acid neurotransmitter GABA receptor, in biology, receptors with GABA as their endogenous ligand Gaba 1 to 1, an English conversational school in Japan Marianne Gaba, a US model... Adenosine is a nucleoside composed of adenine attached to a ribose (ribofuranose) moiety via a β-N9-glycosidic bond. ... NMDA (N-methyl-D-aspartic acid) is an amino acid derivative acting as a specific agonist at the NMDA receptor, and therefore mimics the action of the neurotransmitter glutamate on that receptor. ...

Genetic factors are also being studied with several rat and mouse knockouts.

Gender

There is a consistent 50% male excess in SIDS per 1000 live births of each sex. Given a 5% male excess birth rate (105 male to 100 female live births) there appear to be 3.15 male SIDS per 2 female SIDS for a male fraction of 0.61.^[29][30] The X-linkage hypotheses for SIDS and the male excess in infant mortality have shown that the 50% male excess could be caused by a dominant X-linked allele that occurs with a frequency of ⅓ that is protective of transient cerebral anoxia. An unprotected XY male would occur with a frequency of ⅔ and an unprotected XX female would occur with a frequency of ⁴⁄₉. The ratio of ⅔ to ⁴⁄₉ is 1.5 to 1 which matches the observed male 50% excess rate of SIDS.

Although many authors have found autosomal and mitochondrial genetic risk factors for SIDS they cannot explain the male excess because such gene loci have the same frequencies for males and females. Supporting evidence is found by examination of other causes of infant respiratory death, such as inhalation of food and other foreign objects. Although food is prepared identically for male and female infants, there is a 50% male excess of death from such causes indicating that males are more susceptible to the cerebral anoxia created by such incidents in exactly the same proportion as found in SIDS. See the data found at http://wonder.cdc.gov for 9ICD 911 and 912 death rates by sex.

The study which indicated that there was a relationship between fewer serotonin binding sites and SIDS noted that the boys "had significantly fewer serotonin binding sites than girls".

SIDS and child abuse

This section needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (September 2007)

British former pediatrician Roy Meadow believes that many cases diagnosed as SIDS are really the result of child abuse on the part of a parent displaying Munchausen Syndrome by Proxy (a condition which he was first to describe, in 1977). During the 1990s and early 2000s, a number of mothers of multiple apparent SIDS victims were convicted of murder, to varying degrees on the basis of Meadow's opinion. In 2003 a number of high-profile acquittals brought Sir Meadow's theories into disrepute, and many now doubt their credibility. Several hundred murder convictions were reviewed, leading to several high-profile cases being re-opened and convictions overturned. Image File history File links Question_book-3. ... This article is about the branch of medicine. ... Professor Sir Samuel Roy Meadow (born 1933) is a former British paediatrician. ... Child abuse is the physical, emotional or sexual abuse or neglect of children. ... Fabricated or Induced Illness (FII) is the formal name of a type of abuse in which a caregiver feigns or induces an illness in a person under their care, in order to attract attention, sympathy, or to fill other emotional needs. ... Year 2003 (MMIII) was a common year starting on Wednesday of the Gregorian calendar. ... In criminal law, an acquittal is the legal result of a verdict of not guilty, or some similar end of the proceeding that terminates it with prejudice without a verdict of guilty being entered against the accused. ... In law, a conviction is the verdict which results when a court of law finds a defendant guilty of committing a crime. ...

The Royal Statistical Society issued a media release refuting the expert testimony in one UK case in which the conviction was subsequently overturned.^[31] The Royal Statistical Society is a learned society for statistics and a professional body for statisticians in the UK. Founded in 1834 as the Statistical Society of London, it became the Royal Statistical Society in 1887. ...

Nitrogen dioxide

A 2005 study by researchers at the University of California, San Diego found that "SIDS may be related to high levels of acute outdoor NO₂ exposure during the last day of life."^[32] While nitrogen dioxide (NO₂) exposure may be one of many possible risk factors, it is not considered causal, and the report cautioned that further studies were needed to replicate the result. The University of California, San Diego (popularly known as UCSD, or sometimes UC San Diego) is a highly selective, research-oriented[1] public university located in La Jolla, a seaside resort community of San Diego, California. ... [1] R-phrases , S-phrases , , , , , Supplementary data page Structure and properties n, εr, etc. ...

Vaccination

The relationship between vaccinations and SIDS has been well studied. Babies that are vaccinated are possibly protected from SIDS according to one study in the British Medical Journal.^[33] Other studies^[34][35] indicate that there is no significant difference in risk. Vaccination is a term coined by Edward Jenner for the process of administering a weakened form of a disease to patients as a means of giving them immunity to a more serious form of the disease. ...

Inner Ear Damage

Records of hearing tests administered to certain infants show that those who later died of SIDS had a unique pattern of partial hearing loss, according to the journal Early Human Development.^[36] One suggestion for the cause of SIDS is that the deaths are caused by disturbances in respiratory control (from other than suffocation). The vestibular apparatus of the inner ear has been shown to play an important role in respiratory control during sleep. It is speculated that this inner ear damage could be linked to SIDS. It is speculated that the damage occurs during delivery, particularly when prolonged contractions create greater blood pressure in the placenta. The right ear is directly in the "line of fire" for blood entering the fetus from the placenta, and thus could be most susceptible to damage. If the findings are relevant, it may be possible to take corrective measures. Researchers are beginning animal studies to explore the connection.^{[citation needed]} The placenta (Latin for cake, referencing its appearance in humans) is an ephemeral organ present in placental vertebrates, such as eutherial mammals and sharks during gestation (pregnancy). ... For other uses, see Fetus (disambiguation). ...

Possible Bias

Dr. John Kattwinkel was a co-author of the 1992 American Academy of Pediatrics Policy statement that recommended to parents that they put infants to sleep on their backs to prevent SIDS. He was also the chair of the American Academy of Pediatrics Task Force on Infant Sleep Position in 1992. He is currently the chair of the American Academy of Pediatrics Task Force on SIDS. Dr. John Kattwinkel had a daughter die at 3 days of age in 1966.^[37].^[38]

Side Effects of SIDS Risk Reduction Recommendations

Dr. Rafael Pelayo from Stanford University and a number of other pediatric sleep researchers in the U.S. have stated that they believe that the American Academy of Pediatics recommendations regarding cosleeping and pacifier use may have unintended consequences. They have stated that the SIDS prevention strategy of the American Academy of Pediatrics which keeps infants at a low arousal threshold and reduces the time in quiet sleep may be unhealthy for children. They state that slow wave sleep is the most restorative form of sleep and limiting this sleep in the first 12 months of life may have unintended consequences to both the sleep and the infant. .^[39].

According to a 1998 study by British researchers that compared back sleeping infants to stomach sleeping infatns there were developmental differences at 6 months of age between the two groups. At 6 months of age the stomach sleeping infants had higher gross motor scores, social skills scores, and total development skills scores than the back sleeping infants. The differences were apparent at the 5% statistical significant level. At 18 months of age the stomach sleeping infants again had higher social skills scores, communication scores, and total development scores than the back sleeping group of infants. But, at 18 months the differences were no longer apparent at the 5% statistical signicance level. The researchers deemed the lower development scores of back sleeping infants at 6 months of age to be transient and stated that they do not believe the back sleeping recommendations should be changed.^[40]. Other scientists have stated that the conclusion that the negative effects of back sleep at 18 months of age is transient is based upon very little evidence and that no long-term randomized trials have been completed. .^[41].

Other side effects of the back sleeping position include increased rates of shoulder retraction, positional plagiocephaly, and positional torticollis.^[42]. Some scientists dispute that plagiocephaly is a negative side effect. Dr. Peter Fleming, who is co-author of the study that deemed delays at 6 months of age to be transient, has stated that he does not think plagiocephaly is a negative side effect of back sleep. In an interview with the Guardian Dr. Fleming stated "I do not think it is a medical problem - it is more of a cosmetic one. Mothers may feel it is a syndrome and a problem when it really is nonsense." ^[43] A research study on children with plagiocephaly found that 26% had mild to severe psychomotor delay. This study also showed that 10% of infants with plagiocephaly had mild to severe mental development delay. ^[44]

Because of the delays caused by back sleep some medical professionals have suggested that the "normal" ages at which children had previously attained developmental milestones should be pushed back. This would enable medical professionals to consider "normal" children who previously were considered developmentally delayed.^[45]

References

Surgeon General can have several different meanings. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 178th day of the year (179th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 265th day of the year (266th in leap years) in the Gregorian calendar. ... The U.S. National Library of Medicine (NLM), operated by the U.S. federal government, is the worlds largest medical research library. ... National Institutes of Health Building 50 at NIH Clinical Center - Building 10 The National Institutes of Health (NIH) is an agency of the United States Department of Health and Human Services and is the primary agency of the United States government responsible for biomedical research. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 265th day of the year (266th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 265th day of the year (266th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2001 (MMI) was a common year starting on Monday (link displays the 2001 Gregorian calendar). ... is the 296th day of the year (297th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 265th day of the year (266th in leap years) in the Gregorian calendar. ... The British Medical Journal (BMJ) is a medical journal published weekly in the United Kingdom by the British Medical Association (BMA)which published its first issue in 1845. ... The New England Journal of Medicine (New Engl J Med or NEJM) is a peer-reviewed medical journal published by the Massachusetts Medical Society. ...

External links

• The Foundation for the Study of Infant Deaths aims to prevent Sudden Infant Death and promote baby health
• Times Article - Scientists believe they have found the key to cot deaths
• SIDS Network web site
• US SIDS page, with links to a variety of information and statistics at Center for Disease Control
• SIDS Families
• SIDS News
• Article - Large rise in infant sofa deaths in UK at BBC
• Ten Reasons to Sleep Next to Your Child at Night
• A Fresh Approach To Sudden Infant Death Syndrome
• The Great Battle Against SIDS
• "Safe Sleep for Your Baby" at the National Institutes of Health
• American Guild for Infant Survival
• [7]
• [8]
• [9]
• [10]
• [11]
• [12]
• [13]
• [14]
• [15]