February 27, 2006

Should That Be Explainable Infant Death Syndrome Now?

A three-year study in the medical examiner's office in Detroit shows that most cases of SIDS can be attributed to accidental suffocation. The findings are based on a researcher visiting the locations of 209 SIDS-related deaths and asking parents/caregivers to use a doll to demonstrate the positions they left and found the baby in.

Although 23% of cases were initially reported as asphyxiation, position analysis indicated the rate was much higher, around 85%. Babies were typically found face down and/or with their face covered by excessive bedding or a pillow. 53% of cases [111} occurred in an adult bed, and 12% [25] occurred on sofas.

The Guardian reports that in just over half the cases, adults were sharing the bed or sofa, but it's not clear if that's half bed/sofa cases [e.g., 68] or half the total [e.g. 105]. If it's the latter, then that's over 77% of the co-sleeping cases, which would be a real red flag. However the detailed numbers shake out, though the importance of not putting a kid to sleep face down and of clearing out all soft, smushy, or loose bedding seems pretty clear.

So far, unfortunately, these results aren't yet published. One of the lead researchers, Dr, Melissa Pasquale-Styles, just presented the study Saturday morning at the Kids Pathology session of the American Academy of Forensic Sciences annual meeting in Seattle. The paper was titled, "Infant Position and the Assessment of Risk Factors for Asphyxia: A Review of 209 Sudden Unexpected Infant Deaths."

Other talks more likely to come soon to a CSI episode near you: "Is Your Daughter Trolling for Pedophiles On The Internet?", "Death by Radio-Controlled Helicopter," and of course, "Killer Hairdryer," which has already been optioned by Paramount.

Most cot deaths due to accidental suffocation, says US study
AAFS 2006: "See you in Seattle!" [aafs.org]
Previously: Coming out of the co-sleeping closet
Other SIDS-related posts, including the JPMA's work for the all-powerful crib bumper lobby


Careful with the numbers -- by definition, since these are all post-mortem investigations, it's 100% of the co-sleeping cases.

The 77%-or-50% number is the answer to the question "how many of *these* infant-mortality cases involved co-sleeping", not what percentage of co-sleeping cases resulted in death, yeah?

Without knowing the *total* number of babies who in the area covered by this study and the percentage of those who co-sleep, it's hard to make meaningful statistical comparisons about that kind of thing. If more people are co-sleeping than not, then 50-or-77% may sound scary but co-sleeping risk could actually be _lower_ then the general incidence. Or conversely, if there's only, like, 1000 co-sleepers total in all of Wayne County Michigan (population 2.1 million), this'd definitely be a huge red flag.

[good point, The study is actually about determining the causes of specific sleep-related accidental deaths. But the Guardian reporter--and now I, too--both show how easy it is to extrapolate that into "musts" and "shoulds" for parenting. Of course, One co-sleeping bugaboo (sic) that the reporter mentioned without any stats is this "parents roll over and suffocate their kid" scenario. The real solution to preventing all those deaths could be "don't drink yourself blind when your baby's next to you," but would that ever show up in this data? -ed.]

As comforting as it would be to blame SIDS on suffocation (we could actually do something about it), stories like this make it clear we have a bigger problem.

[or a smaller, but no less dire problem. The Detroit ME's office cut the no. of SIDS-deaths from 34 to 2 in 2004, but that still means that there are unexplained deaths out there. If anything, clearing out mis-diagnosis and misreporting should help focus research efforts. -ed.]

in new zealand it seems they have gotten positive results from "mattress wrapping" a.k.a. protecting an infant from the heavy toxic gasses which are released by common mold mixing with the chemicals in a conventional mattress.

i posted about that mattress wrapping theory moving us closer to "explainable" infant death syndrome here.

might also just be a case of parents going to great lengths to *feel* they have protected their kid even though they really can't. who knows?

[hm, online references to that mattress-wrapping thing are long on echo-chamber-like, vague conclusions and short on specific data, never mind scientific method. Where's the data of how many bedwrappers there are in NZ? "many" and "a lot" don't count. You can't make claims using statistical sampling without providing info on the sample. And by 'you' I mean the NZ bedwrapping lobby, of course. -ed.]

And then you go to a country where co-sleeping is the rule, and SIDS is often literally unheard of. I too would love to know how many of the co-sleeping deaths in this study involved either alcohol or morbid obesity, but I highly doubt that either data were recorded.

[a 2002 NZ study did show a high correlation between co-sleeping and mothers smoking as risk factors for SIDS. While a co-sleeping culture like Japan had very low rates. And low smoking rates, too. -ed.]

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