Archived Weblog Entry - 12/09/2003: "SIDS Research 'Flawed;' Clues Ignored"

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12/09/2003 Archived Entry: "SIDS Research 'Flawed;' Clues Ignored"

An Australian researcher, writing in the latest issue of the Archives of Disease of Childhood, contends that the decreasing rate of sudden infant death syndrome (SIDS) is more likely the result of natural variation than the heavily promoted change in sleeping position

SIDS Research 'Flawed;' Clues Ignored -Researcher

By Megan Rauscher

NEW YORK (Reuters Health) - An Australian researcher, writing in the latest issue of the Archives of Disease of Childhood, contends that the decreasing rate of sudden infant death syndrome (SIDS) is more likely the result of natural variation than the heavily promoted change in sleeping position.

Dr. Paul N. Goldwater from The Women's and Children's Hospital in North Adelaide also wonders why the major pathological clues to the cause of SIDS have not been adequately investigated.

"It has puzzled me for many years as to why the pathological findings in cases of SIDS have not been the guiding stimulus for directions of research," Goldwater told Reuters Health.

"There have been too many assumptions that have become dogma and are now set in concrete," he continued. That SIDS is the result of an episode of oxygen deprivation has gained such popularity that it is considered to be fact. "The problem is that there is little, if any, scientific data to support this idea."

"Why do mainstream researchers see the apparent success of the back-to-sleep campaign as a major victory?" Dr. Goldwater asks. "Clearly, if we care to look at the rates of SIDS in 1970, these are the same as the low rates of today. Many babies were sleeping prone in 1970, yet SIDS was relatively uncommon."

In the 1980s and early 1990s SIDS incidence rose considerably. "It is not possible to attribute this rise to changes in sleeping behavior," he said. "It is much more plausible that the rise was related to a changing epidemiology of an infectious agent or agents, i.e. natural variation," Dr. Goldwater said.

From the start, research on SIDS has been "flawed," Dr. Goldwater writes, and "major clues provided by pathological findings have largely been overlooked."

An example is liquid, unclotted blood within the heart, "a common, if not constant finding in SIDS," according to Dr. Goldwater. Another is very small hemorrhaging in the chest cavity, again, an almost universal finding in SIDS babies.

Heavy, fluid-laden, congested organs -- most notably the thymus, lungs, liver, and brain -- is another neglected area of SIDS research, Dr. Goldwater writes. The contribution of inflammation of the throat and bronchial area, bacterial toxins, viral infections, and tobacco smoke exposure also need to be researched more thoroughly.

In a commentary, Dr. P. S. Blair from the Institute of Child Health in Bristol, England, writes: "if the enigma of SIDS is to be solved, the pathologists need to work closer with the epidemiologists and the funding organizations need to educate the public on why the pathologists play such a pivotal role in trying to understand why our babies sometimes die."

SOURCE: Archives of Disease in Childhood, 2003.