Understanding Sudden Infant Death Syndrome Sids

As a mother of ten, knowing the particulars of SIDS was a necessity. I started with my doctor. He told me that no one really knows what causes SIDS, but for preventative measures I could take, ask my pediatrician.

She was a vast empty well of information. Every piece of literature she provided said the same thing: We do not know the cause. If you do not know what causes it, how can you possibly prevent it?

Time for a new tack. I asked the coroner what he looked for in determining SIDS as a cause of death. I will never forget what he told me: “I don’t.” Seeing the dumbfounded look on my face, he explained in great detail.

When babies sleep in the hospital nursery, they are swaddled for comfort and to prevent rolling and choking and are laid on their backs. The American Association of Pediatrics began their “Back to Sleep” campaign in 1996, urging parents to put infants to sleep on their backs without blankets or toys. The forensic pathologist told me that this decreased the number of asphyxiation deaths due to smothering, not SIDS deaths.

Fumigation poisoning of infants is a another cause of infant mortality. Such common poisons include radon, carbon monoxide, and smoke inhalation. With the commercial availability of detectors for these noxious gases, poisoning deaths have also declined, yet SIDS remains constant.

I stopped him here and asked, “Why are these not SIDS? This would be the definition. An otherwise healthy infant dying suddenly.” His explanation was simple:

Improved gas chromatograph machines have led to the discovery that other causes of death were responsible for what would have been determined to be SIDS as little as 15 years ago, in the early 1990s. Blood is drawn from deceased infants as routine for autopsy today and scanned for the compounds now known to cause poisoning. If these are detected, the death is ruled poisoning, not SIDS.

Likewise, pulmonary edema is checked in each deceased infant. This swelling of the lung tissue is resultant from lack of oxygen. In combination with petechial hemorrhaging, breaking of the capillaries of the eyes, these symptoms indicate asphyxiation. These deaths are ruled as such, not SIDS.

Coroners routinely look for brain edema and bruising that is indicative of shaken baby syndrome, blunt force trauma and abuse. The routine examination of infant brains was not commonplace until the late 1990s. These deaths are ruled homicide, not SIDS.

Still not sure he answered my question, I asked, “So what do you look for to determine SIDS?” Again, I got that same cryptic “I don’t” from him.

When a coroner has exhausted all known causes of death, SIDS is the cause of death recorded. He explained that SIDS is an exclusionary cause of death only. Since SIDS has no known cause, it can also have no known symptoms. SIDS deaths are only characterized by one thing: a dead infant. After autopsy, if the infant is in good health and has sustained no trauma, SIDS will be ruled as the cause of death.

The good doctor went on to tell me that of the 5,000 SIDS deaths per year in the United States, research is no closer to finding a cause than they were 100 years ago. Although today much more exhaustive autopsies are done prior to assigning SIDS as the cause, there seems to be no fewer SIDS deaths, regardless of claims otherwise.

Research remains slow at best. Parents are unwilling to donate their children’s bodies to research in the event of SIDS deaths. Many need the closure of a burial or cremation to grieve. Investigation into SIDS continues to take the form of gathering details of the situation and surroundings of the infant prior to death. This will never produce scientific results, as air condition, ambient temperature and many other factors play a large role in the determination of death and cannot be infallibly replicated.

For two very simple words, “I don’t” took a lot of explaining.