The research community has identified a number of infant groups that are at increased risk for
SIDS. These include infants born less than 3-1/2 pounds, those who had a life-threatening event
or those whose sibling suffered a SIDS death. When infants are in any of these risk groups, the
Institute recommends that the infant be tested under controlled conditions with a polysomnogram
and feeding study which can be used to estimate an infant's risk for prolonged or pathologic
apnea. As these studies have become more sophisticated and their results have been statistically
analyzed, the predictability factor has improved. The scientific basis for this conclusion is being
prepared for publication.
Once an infant who is at an increased risk for SIDS and whose test results are abnormal the
Institute recommends close observation in an attempt to prevent SIDS. The most effective tool
for such observation yet identified is the infant monitor which can be applied either in the hospital
setting or at home. The underlying theory to the use of home monitoring is that the terminal
event is either a cessation of breathing (prolonged apnea) or reduced heart function. Therefore,
the use of an infant monitor which sounds an alarm for apnea or reduced heart function and
records these events will alert caregivers to the need for intervention, and provides a permanent
record of the infant's condition during the monitoring period. The research on high risk infant
groups indicates that the SIDS death rate has been reduced between 60 and 70% below that
which would have applied to this population had monitoring not been in effect.
Because responsible clinicians have prescribed infant monitors, either in the hospital or at home,
for most infants who appear to be at high risk of SIDS, there has been criticism in some quarters
that more monitors are being used than is clinically indicated. The American SIDS Institute
recently developed a central apnea risk evaluation program which is currently the subject of a
patent application before the U. S. Patent Office. The Institute believes that this evaluation will
more accurately predict those infants who are more likely to experience prolonged apnea and a
SIDS death. The Institute also believes that this will significantly reduce the need to monitor the
large number of babies currently being monitored and, more importantly, it will encourage
clinicians to monitor more carefully those babies at higher risk of SIDS.
As part of its ongoing research, the Institute is also seeking to develop a simple inexpensive blood
test, perhaps one that is done in connection with the standard PKU test performed on most
newborns today, that could predict the likelihood of prolonged apnea or SIDS. Meanwhile, the
Institute believes that the central apnea risk evaluation performed on high risk infants followed by
monitoring if indicated is a cost-effective technique for preventing SIDS. Other studies are being
conducted by the Institute and elsewhere which could lead to more advanced techniques.
The recent publication of the book, Death of Innocents and its public relations campaign suggests
that a large number of deaths attributed to SIDS may have resulted from caregiver abuse. Serious
investigations of child abuse reveal that up to 98% of all SIDS deaths are not related to child
abuse.
It has always been the American SIDS Institute's position that any sudden infant death should be
carefully investigated by proper authorities. However, it is extremely important that such
investigations be conducted with understanding and sympathy for the bereaved parents. To create
false suspicions in these cases could be devastating for the mother and the father of the deceased
child. Also, improper investigations concerning babies who are reported to have breathing
problems would discourage parents from seeking medical treatment in the future, which could
then lead to increased SIDS deaths.
For further information contact James Piper at the American SIDS Institute.
Telephone: (404) 843-1030, fax: (404) 843-0577