Thursday 02 November, 2000
Understanding Cot Death
On average eight children die from cot death each week in the UK. Despite being given a name, as yet the causes of death remain unknown.
As researchers in Manchester reveal the possible link between cot deaths and a bacterium associated with heart disease and stomach ulcers, BBC Science examines the theories and asks are we any closer to establishing a cause for these unexplained infant fatalities?
What is SIDS?
The most terrifying situation that any parent can imagine must be the unexplained death of a child. In developed countries cot death, also known as sudden infant death syndrome (SIDS), is the most common cause of death in babies aged between one month and a year.
Whilst the name may imply that the death only happens in the cot, SIDS can occur anywhere. In prams, beds, cars or even in a parents arms babies can die without any warning and as yet there are no products or practices that are guaranteed to prevent death. However, whilst researchers probe for answers they throw up possible solutions.
| ‘Risks of cot death can be cut if babies are put to sleep on their backs’ | |
Links to SIDS
There have been many suggestions about what causes SIDS. Fungus on a baby's mattress, a build-up of carbon dioxide around the face, parents who smoke and babies lying on their stomachs have all been put forward as possible explanations.
Following a report released earlier this year, some parents have even become fearful of leaving a child with a carer. The study, carried out in the US, found that one in five sudden infant deaths occurred whilst babies were being cared for by their minders. The report suggested that many people who looked after infants during the day were failing to follow guidelines and despite the recognised risks, continued to place children on their fronts during their daytime naps.
Whilst doctors remain unable to provide definitive answers to the causes of SIDS, research has consistently shown that the risks of cot death can be cut if babies are put to sleep on their backs. Dr Rachel Moon, of the Children’s Medical Centre, in Washington DC explains the importance of this positioning:
‘Infants may be at increased risk because they have not yet developed the upper body muscle strength routinely seen in initially prone sleepers, which may be protective in lifting the head and clearing the airway when sleeping prone.’
Monitoring devices
In the desperate bid to avoid cot death, parents are also told of new technologies and mattresses that could prevent SIDS. In May 2000, one such device was presented when researchers at the University of Tokyo revealed their “smart cot”.
The cot contains 384 pressure sensors, which are placed under the mattress enabling the parent to monitor how the baby is lying and breathing. By analysing pressure distribution from these sensors, the researchers claim that parents could be given early warning signs if their baby is in difficulty.
On learning of the smart cot, The Foundation for the Study of Infant Deaths (FSID) expressed doubts about the development. Dr Sara Levene, FSID’s Medical Advisor, summed up the problems of such devices when she said:
‘There is no existing evidence that there are any early warning signs for SIDS that can be picked up by monitoring, so there is no particular reason to believe that this device will have any practical value for parents.’
Helicobacter pylori
Now, a new study suggests that babies who die for no apparent reason could be infected with a common bacterium. In a study of 32 babies who died of SIDS, doctors in Manchester have found that almost 90% were infected with the bacterium, Helicobacter pylori.
In a report in the journal Archives of Disease in Childhood, the researchers say that of eight babies that had died of other causes, only one was infected. Helicobacter pylori is often associated with stomach ulcers and heart disease, but many people carry the bacteria without any symptoms.
Dr Jonathan Kerr, who led the research team at Manchester's Royal Infirmary, warns that it can be spread through saliva. He advises parents not to lick or suck a baby's feeding bottle or dummy, to avoid unwittingly passing it on to the child.
It's not known what role Helicobacter might play in cot deaths, but Dr Kerr suggests it might lead to the production of ammonia in a baby's lungs. However, although the study is statistically significant, it is small. The researchers say more work is needed to confirm their results.
Although the number of unexplained infant deaths may be alarming, the fact is that cot death is still relatively rare and is decreasing – since 1991, the rate of SIDS in the UK has been reduced by 70%. Whilst research remains inconclusive, it does continue to help us understand more about SIDS and serves to highlight some of the small acts which could save a baby’s life.
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| FSID advice |
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The Foundation for the Study of Infant Death advise that parents and carers take the following six key steps to reduce the risk of cot death:
Place your baby on its back to sleep
Cut out smoking in pregnancy – fathers too
Do not let anyone smoke in the same room as your baby
Do not let your baby get too hot or too cold
Keep baby’s head uncovered – place your baby with their feet at the foot of the cot, to prevent wriggling down under the covers
If your baby is unwell seek medical advice promptly
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