The Sudden Infant Death Syndrome Alliance
1314 Bedford Avenue
Suite 210
Baltimore, Maryland 21208 # 410-653-8226
# 800-221-7437
E-Mail sidshq@charm.net
www.sidsalliance.org
MEDIA ADVISORY
TO: Affiliate Presidents and Executive Directors
FROM: Judith S. Jacobson, Executive Vice President
DATE: 4/2/01
RE: "Thermal Stress in Sudden Infant Death. Is There an Ambiguity With the
Rebreathing Hypothesis?" Pediatrics Vol. 107 No. 4, April
2001
____________________________________________________________________________
In the April 2001 issue of Pediatrics, Warren G. Guntheroth, MD and Philip
S. Spiers, PhD,
compare the risk factors for infant's overheating with those of rebreathing
and determine
that both share some common clinical markers and pose a risk for Sudden Infant
Death
Syndrome. They conclude that it is important that health care professionals
and others
who interact with new parents continue to focus on maintaining a comfortable
room
temperature for the baby and avoid overheating. The article, "Thermal Stress
in Sudden
Infant Death. Is There an Ambiguity With the Rebreathing Hypothesis?" states
that - in
addition to placing an infant to sleep on his or her back - SIDS could be
further reduced
by not wrapping an infant in excessive bedclothes or by covering its head
during sleep.
The authors chronicle a history of medical research on parents' practices
in creating a
sleep environment for their infants, reinforcing the importance of placing
babies on their
backs for sleep. An infant's ability to retain body heat is significantly
increased by stomach
sleeping; the main source of heat loss is the baby's head - particularly
the face. If that is
also covered, overheating is even more likely. Challenged by thermal stress,
an infant's
heart, lung and sweat glands must work harder to cool down. Guntheroth and
Spiers
suggest that SIDS risk as it relates to seasonality, infection, and the effects
of bedsharing
are consistent with the overheating hypothesis. In colder months, parents
may dress an
infant in more layers or with warmer blankets. An infant with a fever needs
less as opposed
to more insulation from clothing because his body temperature is already
elevated. Studies
have shown that an infant frequently has its head covered when bedsharing,
as well as the
heat source provided by the mother's body under shared blankets.
Since the launch of the Back to Sleep Campaign in 1994, the primary message
for parents
and other caregivers has been to place infants to sleep on the back to help
reduce the risk
of SIDS. Through multiple research studies from around the world, stomach
sleeping had
been indicated to create the greatest risk for SIDS. At the same time, further
risk reduction
recommendations have been provided, including the use of a firm, flat mattress;
elimination
of fluffy, loose bedding and soft objects from the infant's sleep environment;
maintenance
of a smoke-free zone around the baby; and the avoidance of infant overheating
due to
excessive bed clothes or room temperature.
Consistent with the Guntheroth and Spiers study, the SIDS Alliance brochure,
Facts About
Sudden Infant Death Syndrome & Reducing the Risk of SIDS cautions parents
to be careful
not to overheat their baby. "Research findings indicate that overheating
(too much clothing, too
heavy bedding, and too warm a room) may increase the risk of SIDS, particularly
if a baby
already has a fever. Other signs that your baby may be overheated include
sweating, damp hair,
heat rash, rapid breathing, and restlessness. Babies cannot regulate their
own body temperature
well, therefore, parents should set the thermometer to whatever temperature
you find most
comfortable and dress your baby in as much or as little as you would wear.
Remember to
remove your baby's hat and heavy outerwear when indoors, in cars, or stores
to keep your
baby from becoming overheated during the cold weather months, and limit layers
of clothes
and blankets in warmer weather."
While we acknowledge overheating as a risk factor and encourage parents to
avoid
overdressing their babies for sleep, it is important to note that studies
have also found an
increased SIDS risk among infants who were wearing too little clothing while
sleeping in a
cool environment.
Although we do not yet know exactly how or why SIDS happens, researchers
continue
to identify deficits, behaviors, and other factors that may put an infant
at higher risk. It is
important to remember that risk factors are not causes of SIDS, but are believed
to make
an infant more vulnerable and increase the possibility of death. SIDS, like
other medical
disorders, may eventually have more than one explanation and more than one
means of
prevention. Multiple and different risk factors may play a role in a particular
infant's death.
At the same time, many SIDS victims have no known risk factors; and most
babies with one
or more risk factors will survive. Research must continue if we are to discover
what causes
SIDS, and expand upon opportunities to reduce SIDS risk.
According to Bradley Thach, MD, Professor of Pediatrics at the Washington
University
School of Medicine in St. Louis and chairman of the SIDS Alliance Medical
and Scientific
Advisory Council, the Back to Sleep recommendations continue to provide parents
and
care givers with the latest medical evidence on reducing the risk of SIDS
in the hope of giving
every baby the best possible chance to thrive. Dr. Thach reminds parents
and other caregivers to:
· Place your baby on the back to sleep at night and naptime.
· Use a firm mattress in a safety-approved crib or bassinet.
· Eliminate fluffy, loose bedding from your baby's sleep area.
· Keep your baby's face clear of coverings.
· Be careful not to overheat your baby.
· Don't allow anyone to smoke around your baby.
· Educate babysitters, day care providers, grandparents and everyone
who cares for
your baby about SIDS risk.
· And don't forget to enjoy your new baby!
The SIDS Alliance is a national, not-for-profit, voluntary health organization
dedicated
to the support of SIDS families, public education, and medical research.
For the latest,
quality-assured information about Sudden Infant Death Syndrome and ways to
reduce
SIDS risk, call the SIDS Alliance toll-free at 1 (800) 221-SIDS (7437) or
visit the SIDS
Alliance Online at
www.sidsalliance.org.