SIDS Facts: Countering the Myths

Editor: Please be warned that this post contains potentially triggering content about SIDS. We feel its important to discuss this issue in order to prevent myths from being perpetuated.

The bottom line: Infants must be placed on their backs to sleep. Do not let your baby sleep on his/her stomach.

SIDS FactsMy best friend Sunny and I were so excited when we found out that we were going to share the joy of becoming parents together. I found out I was pregnant two weeks after she made an excited phone call to me to tell me that she was expecting. Her son, Brody Andrew King, was born just two weeks prior to my daughter. We often talked about what good friends our children would be. I remember laughing over her story about a major diaper blow out in the mall while feeding my daughter carrots that she spit all over my shirt. The messes that our babies were making seemed never ending, and despite all the dirty diapers and sticky fingers, we loved being mommies.

I never for a moment thought I’d get the call that I got one August morning on my way to work. Sunny called and when I answered I could only hear sobbing on the other end. It had to pull my car over on the side of the road and let her words sink in, “Brody isn’t breathing!” she told me over and over and over.

That morning when Sunny went to check on her son, he was blue, stiff, and lifeless. She called me on the way to the hospital. The paramedics had taken him after she had tried relentlessly to breath life back into him by doing infant CPR. I was not able to soak in the reality. Somehow I kept thinking he would be okay. I asked her to call me back after she spoke with the doctors because I truly believed that he would be revived and okay because the alternative was unthinkable. Babies aren’t supposed to die I reasoned. I prayed and I drove on to work awaiting the call that he was fine. By the time she called me back I was almost shocked again to hear that Brody was dead.

The events that followed were a culmination of every parent’s worst nightmare. I had to hold my friend up when she passed out at the sight of a tiny coffin. I had to help her plan a tiny funeral. I held her hand while she picked out a gravestone, burial plot, and outfit for her son’s funeral constantly muttering to myself that no parent should ever have to go through this. No parent – especially not my friend. She was a loving, involved, responsible, and attentive mommy.

During this time I replayed a conversation I had with my friend several months earlier over and over in my head. She told me she was placing Brody on his stomach to sleep. “He just doesn’t sleep as soundly any other way,” she told me. The risk of SIDS crossed my mind during this conversation. I religiously placed my daughter on her back at night. I am a social worker so I was taught about SIDS a lot during my career. I was also a sleep-deprived mommy of a very fussy 5-month-old. I thought about discussing the SIDS risk with my friend that day, but opted not to. I chose not to because I was a nervous first time mom myself. I had no idea if my way was the right way. I was simply following my pediatrician’s advice and the advice I had learned through my professional training. I reasoned that her son had rolled over on his own already. He was strong, his mom checked on him often during the night, and she knew him best. Basically, I was in no position to pass judgment on her parenting style, so I said nothing about the risk of SIDS that day. I often wonder if I could have changed the course of events if I had simply stated my reasoning for placing my daughter on her back during that phone call. Perhaps I could have reminded my friend that doctors typically make recommendations for safe sleeping arrangements based on a mountain of empirical research. Maybe I could have changed her mind by simply stating that I felt that stomach sleeping was unsafe. I will never know because I was silent. Unfortunately, hindsight is 20/20 and I cannot re-visit that phone call. Life is cruel in the way that it often does not give you the chance to re-do certain situations.

What I can do now is use my experience to help others. What I’ve learned in both my personal and professional life is this: when it comes to the safety of a child no amount of caution is too much. Thus, I have compiled my thoughts on those all too often repeated SIDS myths in hopes that it will help other parents along the way to try and make safe decisions for their babies.

Amidst piles of diapers, sleepless nights, loads of baby gear, and the whirlwind of changes that accompany everyday life for a family of a new baby comes a myriad of decisions that must be made for an infant. New parents have the huge responsibility of making each and every arrangement for a new human being while simultaneously attempting to do the right thing for everyone in their household. When and how should my baby be fed, changed, bathed, held, vaccinated, taken to the doctor, or placed in a childcare setting? Bewildered, tired, new parents often turn to friends, relatives, or the Internet for help in figuring out how to navigate their way through such an impossible jungle of decision making. Unfortunately, when it comes to infant sleep safety there is a slew of bad information readily available to new parents. Friends and relatives will often advise that “babies sleep better on their stomachs”. The Internet contains millions of documents written by people from all over the world. Some information is accurate and based on factual information, much of it is not. Often it is very difficult to filter out factual literature amidst an array of viewpoints, some based on little more than personal opinion. Because of that, I wanted to share some myths and realities about SIDS in hopes of providing some accurate information for those parents seeking to make good decisions for their babies. I hope that this will help tired parents make the right decision for their babies because no amount of sleep is worth your baby’s life.

MYTH 1: Nobody knows what causes SIDS, so preventing it is impossible.

While there is a lot of ongoing research about the cause of SIDS, the research on the best ways to prevent SIDS is clear and convincing.

Most researchers believe that SIDS is likely multi-causational. Thus, SIDS is probably caused by a combination of genetic and environmental factors. One thing that is certain is that stomach sleeping increases a baby’s risk for SIDS related death. Some research indicates that stomach sleeping could increase a baby’s SIDS risk by as much as eighteen percent. When that is combined with genetic factors or other environmental factors (such as crib blankets, pillows, crib bumpers, a hot room, etc.) it can place a baby in danger of SIDS death. The American Academy of Pediatrics recommends that babies be placed on their backs to sleep. They should be placed in a crib with a firm mattress, and their crib should not have any soft bedding (i.e.) pillows, blankets, or crib bumpers. Since the “Back to sleep” campaign began in 1994 the SIDS rate has decreased by fifty percent. So, while research on the “cause” of SIDS is on going, there is clear and convincing research about how to prevent SIDS from occurring. Place your baby on his back to sleep in a crib free from hazards.

For more information reference the American Academy of Pediatrics:
http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2284.full.pdf+html

MYTH 2: Our parents and grandparents all placed their babies to sleep on their stomachs and we all turned out just fine, so there is no reason to place a baby on his back to sleep.

While we may be fine, there are many babies (approximately twice as many as today) that died from SIDS related deaths during this time. We don’t hear the point of view of those children because they are not here to comment.

Our parents and grandparents did what they felt was best for their children. This included following the recommendations of their pediatricians. Those recommendations were made based on the available research at the time. The recommendation to place babies to sleep on their stomachs was made because there wasn’t any research available on SIDS risks. Thus, most doctors told parents to place babies on their stomachs to assist the baby in expelling spit-up (if that should occur during the night). Research completed in the last 30 years has shown that babies have a natural reflex to expel spit-up from their mouths. It has also demonstrated that babies are less likely to choke if they are on their backs since their windpipe is above their esophagus when placed in that position. Basically, a baby placed on his or her back to sleep is in a better position to keep food (or spit-up) from passing into their windpipe. Research has also consistently demonstrated that stomach sleeping increases a baby’s likelihood of SIDS. Thus, you can prevent SIDS AND decrease the likelihood of choking by placing your infant on his or her back to sleep.

The truth here is that your parents and grandparents followed their doctor’s recommendations for their babies. You should too. The American Academy of Pediatrics now recommends that babies be placed on their backs to sleep.

If that argument isn’t convincing enough please consider that many of our parents and grandparents carted their children around in cars without seat belts. During that time many pregnant women took over-the-counter medications that have since been deemed unsafe. They were also not tested routinely for gestational diabetes. They gave their babies aspirin out of a medicine bottle that did not have a childproof lid. Children during those days played with toys coated in lead paint, and they would often go to the shoe store and get an x-ray of their feet just for fun without a second thought about the risk of exposure to radiation. Many infants and children exposed to those hazards turned out just fine, but likewise many did not. We know now that may of these things are not safe and thus we have changed the way we do things in order to provide safer care to our children. If your parents had the information available to them that you have available to you today, they likely would have done things a bit differently because everyone wants to provide the very best care to their baby.

See: http://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Profile-of-SIDS-Risk-Shifts-After-Launch-of-Back-to-Sleep-Campaign.aspx

http://www.firstcandle.org/grieving-families/sids-suid/about-sids-suid/sids-suid-faq/#11

MYTH 3: My baby won’t sleep on her back.

The truth is that babies, like all human beings, will eventually sleep no matter what position they are in. Babies are amazingly adaptable and able to acclimate themselves to sleep in whatever position they are placed. Some people believe that babies sleep longer and more deeply on their stomach. This is probably true for some babies, and for those babies, back sleeping may be particularly important. Some researchers believe that deep sleep is actually a contributing factor to SIDS since it seems that SIDS deaths often occur when babies re-breath uncirculated air instead of moving their faces to get fresh air. Re-breathing uncirculated air lowers a baby’s overall oxygen levels and places him or her at higher risk for SIDS. Babies that sleep soundly on their stomachs may keep sleeping on despite the need for fresh air. I’ve heard many mothers rationalize that a rested mommy is better for a baby’s overall health, so placing a baby on her stomach will help her sleep longer and give her tired parents more time to sleep too. The problem with this idea is that it places the baby in a dangerous environment at a vulnerable time when their caregiver is asleep. A baby in this situation is not only sleeping in a hazardous environment, but their parent may not be inclined to check on them as often because they are expecting their baby to sleep for an extended period of time. The truth here is that if you begin by placing your baby on her back to sleep, he or she will become used to sleeping in this position and both mommy and baby will be safe and well rested.

See Also: http://sids.org/nprevent.htm

http://www.firstcandle.org/cms/wp-content/uploads/2009/08/Rebreathing_Carbon_Dioxide.pdf

MYTH 4: The SIDS rate is really low so it is unlikely that my baby would ever be affected.

From personal experience, Brody is not the only baby I know that has died a SIDS related death. I also have a family member that last a baby to SIDS and during my career I have encountered two SIDS related deaths among my clients.

SIDS is not rare. According to the CDC, SIDS is the number one cause of death among babies ages 1-12 months in age. This means that for this age group, SIDS is statistically more likely to affect your family than accidents, communicable diseases, or other environmental factors that new parents worry about. When it comes to protecting your baby, the risk of SIDS should not be minimized. Take precautions to prevent SIDS by following the AMA’s guidelines for infant sleep safety.

In order to lower the SIDS rate, education is key. A recent survey by Parent’s Magazine indicated that 18 percent of their readers responded that they placed their babies under 12 months of age on their stomachs to sleep. Please help lower the SIDS rate by placing your infant on his or her back to sleep and also by educating friends and family about the risk of SIDS, and ensuring that babies are provided with safe sleeping arrangements.

See: www.CDC.gov
For additional information please visit the following credible sites:
The American SIDS Institute conducts research and offers education and round-the-clock support to pediatricians and families. Call (800) 232-7437. http://www.sids.org/

The Back to Sleep Hotline, sponsored by the National Institutes of Health,
offers information, support, and referrals. Call (800) 505-2742

The CJ Foundation for SIDS is the largest nongovernmental funder of SIDS-related programs in the United States. Visit the foundation’s website for news about SIDS http://www.cjsids.org/

First Candle (formerly SIDS Alliance) provides information and supports research aimed at preventing SIDS and stillbirth. It also offers grief counseling to those affected by the death of a baby. http://www.firstcandle.org/

The National SIDS/Infant Death Resource Center provides information sheets, annotated bibliographies, and referral services to parents, caregivers, and researchers. http://www.sidscenter.org/

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  • Danay

    Wow what an excellent article.

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