Study: Swaddling babies can increase risk of SIDS

The risk of sudden infant death syndrome doubled for children sleeping on their stomach or side when they were swaddled.

Babies who are swaddled and placed on their stomachs or sides may have an increased risk of dying from sudden infant death syndrome, according to an analysis of four studies.

Researchers found that babies who were swaddled, or wrapped tightly in a blanket or cloth, were twice as likely to die from SIDS, if they were laid on their stomachs or sides, according to the report, published in the journal Pediatrics.  The likelihood of SIDS was low for those placed on their backs.

While the study in no ways says parents should stop swaddling all together, it did find that swaddling could be dangerous for older children who can move from their backs into a dangerous position while sleeping, Anna Pease, lead study author and research associate at the University of Bristol in England, said in a statement.

“On a practical level what parents should take away from this is that if they choose to swaddle their babies for sleep, always place them on their back, and think about when to stop swaddling for sleep as their babies get older and more able to move,” Pease said.

In 1992, the American Academy of Pediatrics recommended that parents should place babies on their backs, instead of their stomachs, while they sleep. According to the academy, the recommendation resulted in a dramatic decrease in SIDS. But in 2014, about 1,500 infants died from SIDS in the United States, according to the CDC. 

An infant that is unable to flip from his or her back to their side or stomach can safely be swaddled, according to Chris Colby, division chair of neonatology at Mayo Clinic, who is not associated with the study.  He notes that swaddling is used to mirror the constricted nature of the womb and promotes the baby falling asleep more quickly.

“The concern is that as babies get older – even tho swaddled — they could wiggle around and end up in a prone position, face-down, looking at the mattress,” Colby said. “You have to be mindful as your baby gets older, and assess if swaddling your baby tight at 2-3 months if still a safe practice.”

He notes that further research will likely be needed to assess whether there is a general rule on when parents should stop swaddling their children.

To find out the connection between swaddling a child and SIDS, researchers pored over data from four studies which spanned over two decades and covered areas in England, Tasmania and Chicago, Ill. The studies included 760 infant deaths which were attributed to SIDS, out of a total group of 2,519 babies.

One of the biggest limitations of the study was that none of the studies gave the same definition of swaddling, Pease said in a statement.

“We only found four studies and they were quite different, and none gave a precise definition for swaddling making it difficult to pool the results,” Pease said. “We did find, however, that the risk of SIDS when placing infants on the side or front for sleep increased when infants were swaddled.”

Colby notes the main takeaway is to reemphasize that a baby should always be placed on their back to sleep and never face down.

Brain Abnormalities Found in 40% of SIDS Cases

A quirk in the brain may be causing unexplained deaths in babies

The unknown cause of Sudden Infant Death Syndrome (SIDS) could be a brain abnormality, a new studysuggests.

A team of researchers reported that around 43% ofinfants who died of SIDS shared a brain abnormality that affects the area of the brain called the hippocampus, which is responsible for basic functions like breathing andheart rate, in study published in the journal Acta Neuropathologica.

The team from Boston Children’s Hospital, Harvard Medical School, the San Diego County Medical Examiner’s office, and Baylor College of Medicine in Houston looked at sections of the hippocampus from 153 infants who underwent an autopsy in San Diego. All of the infants had died suddenly between the years of 1991 and 2012. Some of the infants’ deaths could be explained; those that could not be explained fell were ruled as SIDS. Eighty-three of the cases were classified as SIDS.

MORE: Don’t Count on Smart Baby Monitors To Prevent SIDS

Within the infants with SIDS, the researchers found an abnormality in a part of the hippocampus called the dentate gyrus. Specifically, at some parts of the dentate gyrus, it contained a double layer of nerve cells instead of the typical single layer. It’s possible that this abnormality interferes with the brain’s regulation of breathing control and heart rate while a child is sleeping. This abnormality was found in 43% of the SIDS cases.

Researchers believe that there might be a variety of factors that influence the risk of SIDS, which is why the researchers say not all of the cases had the brain abnormality.

It’s also possible that when a child is sleeping in an unsafe position or environment (it is recommended that infants sleep on their backs), the abnormality is triggered. More research is needed to conclude how exactly this quirk in the brain plays out.

Could This Be Driving The Epidemic of Sudden Infant Deaths SIDS?

Evidence is beginning to suggest that coffee and tea both have health benefits, but in different ways. Here, we look at a few of them, and some of the downsides too.

The benefits of coffee begin with the fact that people who drink coffee have a lower chance of suffering Alzheimer’s disease in later life, as well as lower the possibilities of getting heart disease. Studies have shown that coffee helps to prevent Type 2 diabetes, and in men over 40, the development of gout. Coffee helps short term recall, and improved reaction time. And coffee also protects the liver, from liver. The downside? Well, coffee has over 1000 chemicals in it, with 19 being known carcinogens. Coffee causes teeth discoloration, and research shows that coffee reduces blood flow to the heart.
It appears that perhaps consuming both, in the right amounts, may be the way to go.


Should infants and adults sleep in the same bed together?

Over the past two decades, great advances have been made in identification of hazardous sleeping environments for infants and young children, with significant reductions in numbers of deaths. However, one issue that continues to incite heated debate is whether adult caregivers should sleep on the same surface as infants, referred to as “shared sleeping”.

It is recognised that infants who sleep in the same room as their carers have a reduced risk of sudden infant death syndrome (SIDS), possibly due to an increased level of direct supervision. However, what of infants who sleep in the same bed as their parents or carers?

First, it is important to clarify terminology. Although it is claimed that shared sleeping increases the risk of SIDS, it is perhaps more accurate to state that it is associated with an increased risk of infant death generally. An indication that shared-sleeping deaths may be different to “classical” SIDS deaths that occur among infants sleeping on their own is a finding of an almost equal sex ratio in shared-sleeping deaths, compared with the 2 : 1 male–female ratio among infants who died of SIDS. If some of the risk factors for shared-sleeping death (eg, parental obesity, fatigue, soft sleeping surfaces) are examined in isolation, accidental suffocation appears to be a more likely mechanism of death than subtle processes leading to SIDS.These apply to any shared-sleeping surface, not just to beds.

It is difficult to formulate absolute recommendations on shared sleeping, as the current incidence in most communities is unknown, and the form that it takes varies greatly between families. There are also cultural issues to take into consideration — for example, shared sleeping is very common in South-East Asian communities, but with low incidences of unexpected infant deaths.

However, a study from Avon, United Kingdom, found a disturbing percentage increase in shared-sleeping deaths among two cohorts of infants who died of “SIDS”, from 12% (17/147 in 1984–1988) to 50% (18/36 in 1999–2003) (P < 0.001).7 The authors noted that although the number of shared-sleeping deaths that were not on sofas dropped (from 16 to 14), the decrease was not as great as that among infants who were sleeping on their own, perhaps explaining the increased proportion of unexplained infant deaths found in shared-sleeping situations. This difference may be due to mechanisms of death being different in the two circumstances. A similar effect was noted in South Australia, where the proportion of shared-sleeping deaths increased from 7.5% of “SIDS” deaths (23/306 in 1983–1990) to 32.3% (21/65 in 1991–1993). The percentage of deaths in shared-sleeping situations in the early part of the study also showed an overrepresentation compared with the shared-sleeping rate of 1.5% in the general community in 1988.

As some infants are particularly vulnerable to the effects of airway occlusion, and as there is often no clinical predictor of this vulnerability, all that can be stated is that certain infants may be inherently at increased risk in a shared-sleeping situation. It is generally agreed that in Western cultures, the safest place for an infant is in a cot that meets recommended safety features and is positioned beside the caregiver’s bed.

Supporters of shared sleeping cite advantages that include an increased incidence and longer duration of breastfeeding, enhanced maternal–infant bonding and improved settling.However, it has been reported that 50% or more of infants who are found unexpectedly dead are sleeping with an adult. The suggestion of possible accidental asphyxia by a parent “overlaying” a shared-sleeping child has been criticised, because it has been assumed that a parent would always arouse. However, parents can fail to wake if they are sedated or overly fatigued. There is an increased risk of infant death when caregivers have taken illicit drugs, smoked, or consumed more than two units of alcohol. In addition, it is not necessary for an adult to be lying over an infant completely for respiration to be compromised, as an infant who has rolled into a trough between a parent’s much larger body and a soft mattress may also be at risk. This is exemplified by the dangers of shared sleeping on a sofa.

On occasion, parents state that they successfully slept in the same bed as all of their children without any deaths occurring. While such anecdotes are undoubtedly true, few risks are absolute and so it cannot be used as definitive evidence that shared sleeping is always a safe practice.

The key to assisting with this issue lies in adequately informing caregivers of potential risks. Clinicians should discuss with caregivers the risk factors for accidental asphyxiation in shared-sleeping arrangements, such as sedation, excessive fatigue and hazards predisposing to suffocation. This may help prevent infant deaths in the future.





Increase in SIDS on New Year’s Day

Study Suggests Drinking by Caregivers May Play a Role in Sudden Infant Death Syndrome

Dec. 17, 2010 — New Year’s Day brings a dramatic spike in cases of sudden infant death syndrome (SIDS), and researchers say New Year’s Eve drinking by caregivers may be to blame.

An analysis of almost 130,000 SIDS cases nationwide over more than three decades revealed a 33% increase in deaths on New Year’s Day.

More babies die of SIDS on New Year’s Day than on any other day of the year, University of California, San Diego sociology professor David Phillips, PhD, tells WebMD.

He says the research, published online in the journal Addiction, is the first nationwide study to explore a possible connection between caregiver alcohol consumption and SIDS deaths.

“We are not saying that alcohol alone explains SIDS, but it may be one mechanism in many,” Phillips says. “A parent who is under the influence of alcohol may be less careful about putting their child to sleep or less attentive to signs of distress during the night.”

Decrease in SIDS Deaths

Despite a 50% reduction in SIDS deaths in the U.S. since the mid-1990s, SIDS remains the leading killer of babies between the ages of 1 month and 1 year.

The decrease in deaths is largely attributed to education efforts stressing the importance of putting babies to sleep on their backs. Back sleeping and keeping pillows, heavy quilts, and stuffed toys out of cribs were the major messages of the “Back to Sleep” campaign — a joint effort of federal health officials and the American Academy of Pediatrics (AAP).

Despite this effort, many SIDS deaths are still blamed on unsafe sleeping environments, but Phillips says the impact of caregiver impairment due to alcohol use has not been well studied.

In his study, Phillips and colleagues examined 129,090 SIDS deaths from 1973 until 2006.

They compared the expected number of deaths on New Year’s Day vs. the observed number. They also estimated alcohol consumption among the population as a whole by examining data on alcohol-related motor vehicle crashes.

Their analysis suggested that the largest spikes in both alcohol consumption and in SIDS occur on New Year’s.

The study does not prove a link between alcohol and SIDS, since no information on alcohol consumption by adults caring for babies who died was available.

But Phillips says the possible role of alcohol and drug use by caregivers in SIDS has not gotten enough attention.

“This is the leading cause of death after the first month and up until the first year of life,” he says. “It is important to fully explore the behavioral variables that may be involved.”

Second Opinion

Pediatrician and SIDS researcher Rachel Y. Moon, MD, tells WebMD that while alcohol may be a factor in some SIDS deaths, it is one of many risk factors.

Moon, who is with the Children’s National Medical Center in Washington, D.C., served on the AAP task force that last updated the group’s policy statement on SIDS.

Moon says the study does not provide many answers about the role of alcohol in SIDS deaths, and she called the methodology “unusual.”

“Usually in SIDS studies we compared babies who died of SIDS to those who didn’t,” she says. “This study looked at dates and estimated what the alcohol use was and then somehow tried to relate that to SIDS.”