Clarifying Confusing Research
This article appeared in the June 1, 1993 issue of SYNOPSIS, the Newsletter of the
SIDS Alliance. It appears here almost verbatim, with only a couple phrases changed in an
attempt to update the information.
What do sleep position, kidney disorder, passive smoke exposure, and Munchausen
Syndrome-by-Proxy have in common? If you've been watching television news or reading the
daily papers over the past several months, too many of the promotions and headlines will
have you think that each and every one is a cause of Sudden Infant Death Syndrome.
"The public has been on an information roller coaster, the result of an explosion
of medical reports, each heralding a 'breakthrough' in SIDS research," muses Tom
Moran, President of the SIDS Alliance. "We need to help people separate myth from
fact and risk factor from cause."
What follows is a summary of some recently publicized medical reports and our
interpretation of their impact:
||The American Academy of Pediatrics recommendation that mothers
position their babies on their sides or backs during sleep was based on a review conducted
primarily in New Zealand, Australia, and the United Kingdom. All experienced reductions in
SIDS rates from levels twice that of the U.S. It is important to keep in mind that while
there is no data indicating any harm in placing an infant to sleep on its back or side,
the actual risk of SIDS for an infant placed on its stomach is still extremely low.
Therefore, we must ask, why is the rate of SIDS so much lower in the U.S. where the
prevalence of prone sleeping is so high, and to what degree would a change in sleep
position affect our rate of SIDS? Only carefully conducted studies in the U.S. will
provide us with the facts we need. |
||A study released in the May issue of Pediatric Pathology links nephron
deficiency, a kidney disorder, to a number of infants who "died of no known
cause." Attention to the researcher's work in England stimulated premature coverage
by the U.S. media. Findings from this study will be evaluated by our Medical and
Scientific Advisory Council (MSAC) once the paper is published. Given the circumstances,
we can only maintain an open mind about the significance of this work. |
||A study conducted by the National Center for Health Statistics has
demonstrated that infants are three times more likely to die of SIDS if their mothers
smoked both during and after pregnancy, implicating passive smoke exposure as a risk for
SIDS as well as respiratory disease and other ailments. SIDS Alliance medical advisors
support wholeheartedly the authors' call for "smoking cessation among pregnant woman
and families with children," but caution against confusing a risk factor as a cause
for the syndrome. Smoking, in and of itself, is not the cause of SIDS. The cause of SIDS
remains unknown. |
||Television reports on Munchausen Syndrome-by-proxy, including
off-the-cuff comments back in April by an anchor on 20/20, suggest that many babies who
die of SIDS may be victims of Munchausen Syndrome-by-proxy. (To 20/20's credit, a recent
re-broadcast of this piece corrected this misinformation.) This is a disorder of parenting
and a form of child abuse, in which a parent creates a fictitious illness in his/her child
to gain the attention of doctors and nurses. Munchausen Syndrome-by-proxy may involve
physical injury to the child or suffocation mimicking "apneic spells," sometimes
causing the child to die. SIDS and infant apnea are naturally occurring events; they are
not a form of child abuse. Relatively few deaths attributed to SIDS are later discovered
to be due to intentional trauma. It is much more common for SIDS parents to be unfairly
suspected of abuse and neglect, compounding the tragedy they have already experienced. |
When it comes to media coverage of SIDS, we often feel a sense
of frustration in being confronted with misleading headlines, announcements of so-called
breakthroughs and statements taken out of context. The Medical and Scientific Advisory
Council of the SIDS Alliance is sensitive to stress caused by these reports, and responds
in a professional and timely manner with organizational positional statements aimed at
clarifying key points and putting them into perspective.
"Longing as we all are for news of a major breakthrough in the realm of SIDS
research, we must proceed with high hope tempered by caution. We must continue to support
scientists seeking solutions through the NICHD's Five Year SIDS Research Plan and programs
funded privately through the SIDS alliance if we are to find real answers to the many
mysteries of Sudden Infant Death Syndrome," concludes Moran.
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