SIDS - Still a risk to infants

SIDS, or sudden infant death syndrome, is a name given to natural infant deaths that occur suddenly during sleep and with no medical cause, with highest rates occurring in infants between 2 and 4 months old. The rate of SIDS has been significantly reduced in the past fourteen years thanks to the Back to Sleep campaign led by the American Academy of Pediatrics, which has cut the rate of SIDS related deaths in half. According to the National Centers for Health Statistics, SIDS occurs in about .05 percent of infants, or one SIDS case for every 2,000 babies born. But, even though these statistics have been reduced, infants are still dying from the unexplained syndrome. There are other classifications now given to cases where healthy infants die unexpectedly during sleep, which may be a reason why the SIDS rate has decreased and the rates of these other cases has increased. A situation known as code-shifting occurs when examiners give other unrelated reasons for why an infant has died, and classifies the case as something other than SIDS, causing the official numbers of SIDS related deaths to be lower than they actually are. Another reason why fewer cases have been reported as SIDS may be that in order for a death to be diagnosed as SIDS, an extensive investigation must take place, requiring funds that are simply unavailable to some areas. The lack of an investigation may result in a code-shift where cases that are in fact SIDS related are classified as something else. Many SIDS cases may have also been misdiagnosed due to the complicated forms that medical examiner’s were required to fill out regarding the death. The forms have recently been updated, although they still prove unclear, leading to missed SIDS cases.

It is important that parents carefully follow the safe-sleep recommendations, which include putting infants to sleep on their backs, keeping soft toys and bedding out of the crib during sleep, never letting infants sleep in a bed with adults and keeping them away from secondhand smoke. Research has shown that African-American, Native American and premature infants are at a greater risk of dying of SIDS, along with any infant exposed to dangerous sleeping conditions or secondhand smoke. Babies that are put to sleep on their stomachs or sides are twice as likely to die from SIDS infants that are placed on their backs. There is a greater chance that an infant will not be able to inhale as much oxygen when sleeping on their stomach because the carbon dioxide that has been exhaled is re-inhaled instead of fresh air. For babies that do not get enough oxygen because of their sleeping position and do not wake up to change position when this happens, there is a possibility that SIDS will occur. When an infant’s brain-stem is abnormal, serotonin production, which assists in the regulation of arousal and breathing, is not properly being produced. According to researchers at Children’s Hospital Boston, this may cause an infant to remain sleeping even when there is a decrease in oxygen, creating a risk for SIDS. When an infant reaches 6 months, their risk of SIDS is significantly lowered, and vanishes completely at age 1, due to the fact that development occurs to the point where even abnormal brain-stems can produce serotonin normally, taking away the risk of a SIDS related death.

Researchers are also exploring other reasons why SIDS may occur, including MCADD, or medium chain acyl-CoA degydrogenase deficiency, a metabolic disorder where an infant does not process fatty acids, causing heart function to cease. QT syndrome, a heart disorder causing a sporadic recurrences of hurried heart beat sometimes resulting in heart attack, is also being explored as a cause of SIDS. Both QT syndrome and MCADD are treatable if they are discovered in a blood test.

It was also found that if an infant is placed in daycare before they have reached 4 months may be at a greater risk of SIDS. Research shows that approximately 20 percent of SIDS related deaths occurred while the infant was not under the care of parents. The chance of SIDS is multiplied by 18 if an infant that is routinely put to sleep on its back is placed on its stomach, making it critical that parents make sure that their infants, if placed in a daycare program, are being put to sleep using the safe-sleep guidelines both in daycare and at home.

SIDS may be to blame for the sudden, unexpected death of an infant, however a proper investigation should take place in order to rule out any other cause of death, especially if the infant is under the care of a hospital or daycare center. If you or a loved one has medical malpractice questions in New York, please contact the medical malpractice attorneys at Silberstein, Awad & Miklos serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.

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