Conference moira::parenting

    
     I read a leaflet about it and it gave the 4 points you said,it allso
    stated that in China where babys sleep with there parents that cot
    death is unknown.
    
                     SCott

    
    The following is taken from a Department of Health (UK) leaflet
    entitled "Reducing the Risk of Cot Death".  It is reproduced here 
    without permission.  Text within < > are my comments.
    
    The suggestion about breastfeeding is notable by its absence
    from this leaflet.  That is probably because it is a controversial
    point and the government did not want to come down on one side of
    the fence of the other.
    
    =====================================================================
    
    	Cot Death, also known as Sudden Infant Death Syndrome, usually
    	affects babies between one and five months.  It happens while
    	they're asleep and is always sudden and unexpected.  Thankfully
    	it is comparatively rare.
    
    	Because no one yet knows why Cot Death happens, there's no sure 
    	way to prevent it.  Studies have shown that by taking a few 
    	simple precautions, you can reduce the risk.
    
    	The information in this leaflet is for everyone who looks after 
    	a baby...not just parents but other members of the family and other
    	carers such as childminders and babysitters.
    
    	Why not keep this leaflet next to where your baby sleeps so
    	everyone knows what to do.
    
    
    	O  Sleeping Position
    
    	   Recent research shows that Cot Death is more common in babies
    	   who go to sleep on their tummies.  By making sure your baby goes
    	   to sleep in the right position you can reduce the risk of Cot
    	   Death.
    
    	   Babies should be laid down to sleep:
    
    		A) on their backs   <photo of infant on back>
    
    		or
    
    		B) on their sides, with the lower arm forward to stop
    		   them rolling over.  <photos of infant on right and left
    		   sides.
    
    	   Don't be worried that babies might be sick and choke of laid
    	   on their backs.  There is no evidence that this happens.
    	   <If you *are* worried, a rolled up blanket against the baby's 
    	    back with the tail end of the roll tucked under the baby will
    	    keep her from rolling onto her back.>
    
    	   Some babies who require special care or who have particular 
    	   medical problems need to be nursed on their tummies.  Your 
    	   doctor, nurse or midwife will explain why.  If in doubt, talk
    	   it over with them.  <For example, it is known that premature
    	   babies do better when placed on their tummies.>
    
    	   For babies who have been sleeping on their tummies, try them on
    	   their backs or sides.  But they may not like the change and find
    	   it difficult to settle.  If this happens then it is probably 
    	   wise not to upset them by insisting on the new position.  If you
    	   are at all worried then speak to your health visitor or doctor.
    
    	   The right sleeping position is only important until babies are
    	   able to roll themselves over in their sleep.  Once they can do
    	   this it is safe to let them take whichever position they prefer.
    
    
    	O  Temperature
    
    	   Babies should be kept warm, but they must not be allowed to get
    	   too warm.  Keep the temperature in your baby's room so that you
    	   feel comfortable in it.
    
    	   Use lightweight blankets which you can add to or take away 
    	   according to the room temperature.  Do not use a duvet
           <comforter> or baby nest <one piece quilted pouch> which can be 
    	   too warm and can easily cover a baby's head.
    
    
    	O  Smoke-free
    
    	   Create a smoke-free zone for your baby.  Do not smoke anywhere 
    	   near the baby.  Better still, do not smoke at all.
    
    
    
    OOO If your baby seems unwell seek medical advice early and quickly.
    
        Research continues into the causes of Cot Death.  Remember it is 
    	comparatively rare, so do not let the fear of cot Death spoil 
        the first months with your baby.
    
    
    
       Further copies of this leaflet are available by writing to:
    
    		Reducing the Risk of Cot Death
    		Health Publications Unit
    		No. 2 Site
    		Heywood Stores
    		Manchester Road
    	  	Heywood
    	        Lancashire  OL10  2PZ
                   <UK>
    
    =====================================================================
    
    		   

    I am so glad this note was started!  I was surprised this hadn't been
    touched on already.  I have heard a few other ways to help prevent
    this.  I do not know how accurate this info is, as most of it was
    heard word of mouth, mother to mother talk, etc.  Most everything
    I have heard relates to their ability/inability to breath, although
    when autopsies are done on children who have died of SIDS, I don't 
    know if suffocation is detected.
    
     - Don't use baby powder on baby anywhere.  The dust from the powder
       gets in their nose and long-term affects their ability to breath.
    
    -  Don't put anything against their heads that could cause them to
       not breath, or breath back in too much of their carbon monoxide(?).
       This means no pillows or stuffed animals in crib, no blankets pulled
       up to their necks, and watch their arm positions, don't let them
       pull their arm up to shield their face.
    
    -  Check the firmness of your crib mattress, especially if you are
       using a used one, the baby could sink too low, and obstruct
       breathing.
    
    From what I have heard, once they can shift their head from side to
    side, they can reposition themselves if they have difficulty breathing.
    
    The breastfeeding point makes sense, in that the babies have to suck
    harder to nurse, and this would strengthen their lungs/upper body,
    you know what I mean. (MHO)
    
    Sad story:
    
    My sister-in-law's neighbor's neice's baby (got that?) died of SIDS.
    The couple had gone on vacation, leaving the baby with grandma, Mon-
    Thurs.  The grandma had plans for Friday, so they had arranged for
    the baby to go to the regular sitter's, where the couple would 
    pick up the child on Friday.  When the couple arrived back in town,
    they went on home to unload their stuff, then the dad went to pick
    up the child while the mom got organized.  This was around 3:30, and
    the baby was taking a nap, at the sitter's, as this was it's normal
    nap time.  When they went to get the baby, it had died of SIDS.
    They are still struggling with the guilt, grief, etc.
    
    Angie
                                                                      

I don't really have any advice or suggestions, but will just pass on what
I have heard.  My sister died of SIDS in 1959, at age 3 1/2 months.
Back then, it was considered an "act of God" or otherwise medically
unexplainable.  In subsequent years, I learned that the mother smoking
during pregnancy would increase the risks of SIDS.  My mother was a heavy 
smoker in those days.

Like the child in the previous note, my sister died during an afternoon
nap.......I seem to recall reading somewhere that SIDS more often occurs
during daytime naps than at nite.  The heat factor mentioned earlier
may be a part of that.  My sister died in July; our house had no 
airconditioning.  I don't know if it was especially hot that day or not.
I'll ask my Mom if she remembers.

When we had our first child, we asked the pedi if there was an increased
risk of SIDS due to the fact that it had been in my family.  He said he
was not aware of any medical evidence that SIDS runs in families.  Obviously,
it cannot be directly hereditary.

Frank

    We have friends who lost an infant to SIDS about 12-15 years ago. Both
    their subsequent children had episodes of "sleep apnea" where they
    would stop breathing momentarily. Both wore monitors to check on this
    for 1 year. Both set those things off *all the time*, but always
    started breathing on their own again. To be fair, though, the mom says
    she usually hightailed it into their rooms making no effort to be
    quiet, and the noise might have startled them into breathing. They are
    both perfectly normal girls now, one 14 years, and the other 5.5 years.
    
    As a side line.... normal infants (those born full-term and with no
    obvious physical problems, such as Cerebral Palsy), can turn their
    heads from side to side *at birth*. The danger is if they still could
    not clear their airway even after doing this (such as if they were
    lying on a waterbed, a soft pillow, and folded up blanket, etc.). But
    they definitely *can* turn their heads. It is not graceful, and more or
    less involves the baby smearing its face across the mattress/floor,
    rather than actually raising it's head. But it works, however they do
    it.
    
    --dave--

    	Be careful how you clump "normal kids" into one group. Spencer was
    very normal at birth but because of his body and head size he just did
    not have the physical strength to move his head from side to side at
    birth. We had to initially be very careful with him (with regards to
    spitting up and congestion).

    	It's that old generalization red light that went on when I read
    your note, wouldn't want anyone to make assumptions and maybe leave a
    larger baby alone.

    			Wendy
                                                  
    				Wendy

See Parenting_V1 (see note 9.9 for access information), topic 167.

Wait till you have some time; note 167.0 is quite long, and very, very moving.

Clay

    I am not a parent (yet...), but would like to give you parents some
    information, which may not be common knowledge:
    
    A new device is being sold here in Israel (mainly to hospitals, but
    also to private people). The device is supposed to monitor the baby's
    breathing without strings and needles attached to the baby, but rather
    to the crib. It has been declared by doctors to have an amazingly low
    false-alarm rate. It is highly recommeded for high-risk groups of
    infants (such as premature babies).
    
    I don't know if other such devices are sold elsewhere, or if this
    device is being sold overseas, nor do I remember the exact price-tag
    (could it be about $100 ???). I would be glad to find out more info
    if anyone shows an interest.
    
    Shlomo Urbach (with DEC @ Tel-Aviv)

    We had an apnea monitor for 6 months after we brought Shannon home from 
    the hospital.  Since she was premature, the insurance covered a portion
    of the cost.  I really think it is a great device for parents as it
    enables one to sleep without fear!  Many people (family) wished they
    had had such a thing when their kids were infants.  How many times does
    the average parent check on their infant during the night? Granted, the
    false alarms caused my heart to beat out of my chest!  But they were
    few and far between.
    
    

    I must admit I have a secret fear of this - since she was three weeks
    old Charlotte has decided that she will not sleep unless she is on
    her tummy. This concerns me (and I am thinking of weening her!) but
    my husband likes to point out several things to me:
    - she's a big and strong baby (can keep her head up, is starting to 
      move around in the crib)
    - she's been breathing since the womb (our last ultrasounds had her
      practicing breathing ALL the time - Alan says that Apnea is NOT her
      problem).
    
    Alas, after loosing Daniel in stillbirth last year I am still quite 
    scared - and probably will be for a long long time. 
    
    Monica

SIDS is not just confined to infants.  In Ottawa a few years back a toddler
at around 2 died of SIDS during an afternoon nap at a day care.  Generally
the risk does decrease with age ... but it  still happens.

Stuart

    
     There was a case last year in England when a girl of 14 died and it was 
    put down to SIDS.
    
                     SCott

    According to the most recent info my pedi had, US surveys have not
    confirmed any of the associations mentioned in earlier notes --
    especially any connection with heat and with sleeping on the
    stomach.  I was worried about it because I had heard the same
    thing and David was definitely a tummy-sleeper.  
    
    Many of the steps listed (making sure the mattress fits the crib,
    etc.) are good for reducing the likelihood of accidental
    suffocation, but suffocation is not the same as SIDS.  
    
    It is not true that SIDS is uncommon in cultures where the child
    sleeps with the parents.  Many is the mother who has woken up to
    find her child dead beside her -- my mother's mother was one of
    them.  
    
    --bonnie

    
    FWIW
    
    A good friend of mine is a neonatologist (newborn specialist) at a
    major hospital in Philadelphia.  He was recently telling me how
    disgusted he was that the US has recently mandated that all
    pediatricians must warn new parents that infants sleeping on their
    tummies may cause SIDS.  He says there is no medical connection, only
    the fact that a lot  of the babies that died were on their
    stomachs when it happened.  He said that most newborns, given the
    choice, will prefer to sleep on their bellies, thus it would make sense
    that a lot of the victims were on their bellies when the death
    occurred.
    
    He felt that making this announcement, without medical proof, would
    simply add a lot of guilt to parents who allowed their babies to sleep
    on their stomachs.  We disagreed on this, since I feel that if there is
    any chance that it may save some lives, then it should be well known. 
    But then...he knows babies and I know computers....

    
    I think the real problem here may be a matter of ordering some
    facts here and drawing the right logical conclusions ... I'm not
    saying your neo-natologist friend is wrong ... but I do have this
    feeling he is looking at the picture the wrong way around.
    
    The statistical incidence of SIDS deaths amongst tummy sleepers
    is higher than back or side sleepers.  Note this is a statistical
    incidence ... so it takes into account that more babies sleep on
    their tummies.
    
    SIDS is believed to be a latent tendency ... thus SIDS is not *caused*
    by sleeping on the tummy or on the back.  What the study found was
    that the tendency to SIDS *deaths* is *reduced* amongst back sleepers.
    
    I remember hearing of another study ... sorry I do not have the
    details, it was a long time ago and we were blessed with not having
    to worry about this ...  They looked at children who have had a SIDS
    incident ... i.e. not a death but a stoppage of heart / breathing.
    Usually SIDS incidents are not unique ... i.e. children tend to have
    more than one incident.  Amonst these children, they found that after
    the first incident, those that slept other than on the tummy did not
    have as many incidents as those who did.
    
    This tends to confirm the not sleep on the tummy theory.  But remember
    the hitch with all this is that we are dealing with an incredibly
    small statistical population.  Thus all the statistical differences
    are close to, if not within, the statistical equivalent of experimental
    error.
    
    On the other hand, if your child will sleep other than on it's tummy,
    then why not ?  My kids never liked sleeping on their tummy (like
    their parents!).
    
    Stuart

                                       
    I just got my August issue of "Parenting" (a friend gave it as a new
    baby gift and it arrives in the UK before the month it is for!).
    
    There is an item in the Medical News section on SIDS.  It is reproduced
    here without permission. Emphasis using "*" is italics in the article.
    My comment is in "<>".
    
    --------------------------------------------------------------
    ALERT:  SIDS Controversy
    
    After evaluating studies from other countries associating sudden infant
    death syndrome (SIDS) with babies' sleeping positions, the American
    Academy of Pediatrics now recommends that babies be put in their crib
    on their side or back, *not* on their stomach (the most common position
    in this nation). <USA>
    
    The recommendation--which does not apply to preemies or babies with
    respioratory problems--has prompted controversy; some pediatricians
    express reservations about having even healthy babies sleep on their
    back.  Until more information is available, you may want to put your
    baby down to sleep on his side, propped up from behind by a rolled-up
    towel or blanket (not a pillow), and see whether he stays in this
    position.  Before making any change in your child's sleeping position,
    be sure to discuss the issue with your doctor.   
    
    				    end
    -----------------------------------------------------------------
    
    I am still searching for the SIDS research done in New Zealand.
    
    LaDonna
    
    
    

    
    I have finally received the research information on the SIDS study done
    in New Zealand.  Thanks to Dianne Archey in Auckland for contacting 
    Dr. Shirley Tonkin and sending the information to me.
    
    There are 4 main articles and they are fairly lengthy.  I am in the
    process of entering them into my system.  As I get them typed in I will 
    make them available in:
    
    		ROCKS::DISK$USER01:[LMCDONALD.PUBLIC.SIDS]
    
    To see what is in this directory type:
    
    $ DIR ROCKS::DISK$USER01:[LMCDONALD.PUBLIC.SIDS]
    
    You should be able to copy the FILES to your own account by typing:
    
    $ COPY ROCKS::DISK$USER01:[LMCDONALD.PUBLIC.SIDS]filename.txt *
    
    
    I hope you find them interesting. I know I did.
    
    LaDonna
    

    
    My apologies. I forgot to check the world protection on my top level 
    directory.  You should be able to get at the files now.  Nudge me again
    if you still have problems.
    
    LaDonna

                       -< MEDICAL questions and answers >-
 
    
    No one knows for sure, however the first question the doctor asks is: 
    "Is there any cats in your house?"  I think there is something to that!  
    Especially if you live in a basement apartment (poor circulation.)
    
    It makes sense if you think about it.  Brand new life.... the fresher
    and clearer the air the better the lungs can adjust.  Make sense?
    
    Sorry kitty lovers!
    Pam
    

    Ahhhh.... cats causing/affects SIDs? Bad air in houses because
    of cats? I'd like to see/hear some facts on this one!
    
    (although I must admit sometimes that kitty litter does get a bit
    ripe..! :-))
    
    Cyn_a_bit_skeptical_meow
    
    
    
    

    
    
    re -1
    
    	Cat urine is supposed to be quite toxic for unborn children and
    most pregnant mothers are warned as such...
    
    
    
    	whether it can cause SIDs, I don't know...
    
    
    			jim s.

    
    Personally,  I think most doctors just don't like cats.  I have never
    heard of cat urine being toxic.  However, it is possible to catch other
    nasties from cat feces.  This subject is discussed elsewhere in this
    notes file I am sure.
    
    To avoid ratholing this note further, noters might want to check out the 
    Feline notes file where this topic is discussed in the current version 
    and at length in the previous version.  You can find it at MUTTON::FELINE 
    or press the 'select' key or keypad '7' to add it to your notebook. 
    Use the command "dir/keyword=toxo" (or toxoplasmosis I can't remember
    which) to find the relavent notes.
    
    LaDonna

	

	I am pleased to say that I have finally finished the articles on 
	SIDS.  They are entitled 

		COT_DEATH_SUPPLEMENT.TXT
		COT_DEATH_UNFINISHED_BUSINESS.TXT

	The first is the publication of the first years results of the 3 year
	New Zealand cot death study.  The second article is for the more 
	popular press and sumarizes the three year study.

	Both of these articles are in the same directory as the other articles
	(see note 222.17)

	The report of the first years results are a bit heavy going but there
	is some startlingly significant information in there.  I will post 
	the abstract and some extracts from the Discussion section of the 
	article in another note.

	It should be noted that in the UK since the advice in this study has
	become the encouraged practice (about 14-18 months), the cot death
	rate for the UK has gone from  2/1000 live births to 0.7/1000 live
	births. Or, put another way (I have trouble visualising .7 of a child)
	the rate has gone from 1/500 to 1/2800!!

	It was also reported in the UK this week that almost half of all the
	babies and small children in this country are subjected to passive
	smoking. (a significant risk factor in cot death according to the
	New Zealand study)  I can't help but think how much more the cot death 
	rate could go down if we could stop people smoking around babies.

                        
	LaDonna

    
    
	COT DEATH SUPPLEMENT
	
	Results from the first year of the New Zealand cot death study.

	Abstract

	New Zealand's high mortality rate from the sudden infant death syndrome
	(SIDS) prompted the development of the New Zealand cot death study.
	This report of the preliminary analysis of the first year of the data
	gives the major identified risk factors.  One hundred and sixty-two
	infants who died from SIDS were compared with 589 control infants,
	who were a representative sample of all hospital births in the study
	region.  Obstetric records were examined and parental interviews were
	completed in 96% and 89% of subjects respectively.  Data were available
	for all the variables in this study in 95% of those interviewed, thus
	128 cases and 503 controls make up the subjects of this report.

	As expected we confirmed many risk factors for SIDS including: lower
	socioeconomic status, unmarried mother, young mother, younger school
	leaving age of mother, younger age of mother at first pregnancy, late
	attendance at antenatal clinic, nonattendant at antenatal classes,
	Maori, greater number of previous pregnancies, lower birth weight, 
	shorter gestation, male infant, admission to neonatal intensive
	care unit.  In addition, however, we identified three risk factors
	which are potentially amenable to modification.  These were the prone
	sleeping position of baby (odds ratio = 3.53, 95% confidence interval
	2.26, 5.54), maternal smoking (1-9 cigarettes/day, OR=1.87, 95% 
	CI=0.98, 3.54; 10-19/day OR=2.64 95% CI= 1.47, 4.74; 20+/day OR=5.06,
	95% CI=2.86, 8.95) and breast feeding (OR=2.93, 95% CI=1.84,4.67).
	After controlling for all the above variables, the relative risks 
	associated with prone sleeping position (OR=5.74), not breast feeding
	(OR=2.45) and maternal smoking (OR=1.83) were still statistically 
	significant.  These variables appear independent of each other in 
	their association with SIDS.  Population attributable risk was 
	calculated for these three variables.  In total these three risk
	factors may account for 79% of deaths from SIDS.

	If all parents stop putting their infants down to sleep in the prone
	position, do not smoke and breast feed their infants, the SIDS mortality
	rate may fall from 4.0/1000 live births to less than 1/1000.

-------------------------------end-abstract---------------------------------

	[The following are selected exerpts from the Discussion]

	...
	"In Sweden, a low risk region for SIDS (a rate of only 0.7 per 1000)
	smoking was shown to double the risk for SIDS with a clear dose 
	response curve evident [7].  The risk was even higher in the deaths
	in the first 10 weeks where heavy smoking (more than 10 per day) had a 
	relative risk of 3.6 compared to nonsmokers.  Another record linked 
	study in Missouri had very similar results [6].  In both studies, 
	very little of these excess deaths could be attributed to reduced 
	birth weight in infants of smokers, suggesting that passive smoking 
	might be a direct precipitating factor of SIDS.  Although smoking data
	was collected at the first antenatal visit it is unlikely that there 
	would be much change in smoking patterns following the birth.  Both
	studies concluded that the stopping of maternal smoking might  be the 
	single most important preventable risk factor for SIDS.  Stopping 
	maternal smoking was found to be the second most important preventable
	risk factor in our study."

	...

	"We believe that in a country where the risk of dying from SIDS is 
	four in every 1000 live births (and up to seven per 1000 in southern
	New Zealand) that all infants without other medical reason (such as 
	clinically significant gastrooesophageal reflux or Pierre Robin 
	syndrome) should routinely be placed to sleep on their backs or sides.
	This is in fact the practice originally recommended by the founder
	of the Plunket Society, Sir Truby King, in 1937 [30]."



                                             

    
    Since after today I will no longer be with Digital, I do not know what
    will happen to my account.  I have moved all of the research documents 
    to another user's account (my hubby) and they can be accessed on:
    
    
    	OPG::DISK$USER1:[ANGUS.PUBLIC.SIDS]COT_DEATH_SUPPLEMENT.TXT
    					   COT_DEATH_UNFINISHED_BUSINESS.TXT
				   	   LETTER_TO_ED.TXT
    					   STUDY_UPDATE.TXT
    
    
    If you have any trouble accessing these files, send mail to 
    
    	Angus McDonald @REO  or  SUBURB::MCDONALDA
    
    
    Good Luck and Best Wishes,
    
    LaDonna
    

    In the euphoria of leaving, LaDonna slightly mistyped the device spec.
    The location of the documents is
    
    OPG::DISK$SPG_USER1:[ANGUS.PUBLIC.SIDS]COT_DEATH_SUPPLEMENT.TXT
      		       	      		   COT_DEATH_UNFINISHED_BUSINESS.TXT
				   	   LETTER_TO_ED.TXT
    					   STUDY_UPDATE.TXT
    
    Angus

    Give my regards, and best wishes to LaDonna.
    
    I heard something last week that is now linking SIDS to the infant's
    kidneys.  I really didn't understand what it was saying except it
    sounded like either the kidney was not normal, or wasn't manufacturing
    some chemical, and this was causing SIDS.  Something was said about the
    possibilities of testing newborns for this kidney defect at birth.
    
    Can anyone else fill in the gaps?
    
    Lyn
    

    
    
    the Colorado Springs folks also say keep babies on their backs. Nobody
    told the babies though, our two roll over to their tummies as soon as
    the lights out!
    
    The thing about the kidneys that I read was something to do with the
    density of the lining, somebody in Liverpool England had figured many
    SIDS babies had very little of this lining.
    
    Simon

    My doctor at the CS Medical Center told us to lie Jaime on her
    side, with two blankets, one on each side to keep her from rolling
    away.  Worked great.  We weren't worried about her being on her
    back and spitting up and choking, but keeping her off her belly to
    reduce the risk of SIDS.
    
    

    
    In the papers this week - a 60% reduction in the number of cot deaths
    for the early months of 1992.
    
    The "Back to sleep" idea started in Nov '91 is working. Now we have to
    find out why any babies are dying of SIDS.
    
          Celia
    

    Yes, I saw a piece in the Boston Globe about it too. This is 
    very striking -- such a dramatic reduction in deaths in such a
    short time, seemingly due to a simple change of practices.
    
    I plan to discuss it with my pediatrician, who pooh-poohed the
    idea a year or so ago for lack of data...
    
    Lucy   

    My niece has a son who's almost 8 months old.  When he was about
    6 weeks old he stopped breathing.  They've been involved with the
    hospital here in Houston (the SIDS unit).  He's been hooked up to a 
    monitor and has had alot of alarms.  The doctors said he should be on
    this alarm system until he goes two months without a major alarm.  I've
    noticed that Justin (her son) seems to be slow in developing, i.e.
    making sounds or words, crawling (he still doesn't), sitting up (just
    started), doesn't try to move his feet to walk, pulling up, etc., you
    get the picture.  Since a SIDS child stops breathing doesn't it seem
    possible that each time a child has an alarm that it does a little bit
    of brain damage.  I guess I'm trying to rationalize him being slow in
    developing.  Is it normal for SIDS babies to develop slow?  Have there
    been any studies done on this?  If so, can someone direct me there?
    
    Thanks!
    
    Jane

re: .34

   Excuse what may sound like an insensitive question, but aren't you
   talking about a different condition?  I thought that SIDS was fatal?
   Aren't you talking about some form of apnea (or something else
   entirely) instead?
   
   Just wondering,
   
   - Tom

Yes, SIDS is fatal, but it is often possible to revive a SIDS victim if
it is done quickly enough.  The usual cause of death for a SIDS baby is
failure to breathe ... the nervous system simply seems to stop the breathing 
reflex.  Thus the child can often be revived by manual intervention.  So,
it is common for children who have had a detected failure to breathe or
who for other reasons are considered "high risk" (such as previous SIDS
death in a family) to be fitted with monitors that detecct failure to breathe
and sound an alarm.


I believe that it normally takes more than 20 seconds of lack of oxygen to
cause brain damage ...  The developmental spread of babies is so broad that
it really is hard to tell whether there is something wrong or not.  Some
children are naturally very late ...  Also, I have seen some children who
have had medical problems at birth, have their parents do so much for them
that they fail to make normal progress.  Across the street from us is a
6 year old lad who really wasn't able to speak properly until 2 years ago.
There was absolutely nothing wrong with him ... he's fine now ... but his
parents doted to his every need ... all he needed to do was grunt!  

I wouldn't worry too much ... 

Stuart

    
    I just described my 7 1/2 month old climbing, the other 7 1/2 month old
    twin still cannot sit herself up! So I wouldn't worry about being
    behind the development curve, even in identical twins its different!
    
    Simon

    Jane,
    
    I echo what Stuart said. Since this child is not yet 8 months old,
    I suggest you try to set aside your fears and wait a while (like
    a year or more). I went through this with a friend's child and I
    was way off-base in my concerns. I hope this turns out to be true
    for you too!
    
    Lucy

    The hospital classified Justin as a SIDS baby because he did stop
    breathing initially.  The monitor they have on him is set to go off at
    15 seconds if he doesn't breath.  That's considered a major alarm.  He
    does seem to have these alot.
    
    In a previous note it was suggested that parents don't do much to help
    the child's development, thus they develop slower.  This has also been
    discussed with members of my family because "I" don't think his parents
    spend enough quality time with him.  They both work (the dad works
    rotating shift work) and neither one of them have ever been around
    kids.  They seem to come home, feed him and put him to bed.  
    
    Since I know none of my family work at DEC and will never read this 
    note, I've had concerns about Justin since he was first born.  
    He reminds me of my aunt's baby that had cerebal palsy.  
    
    Maybe I'm just looking for things that aren't there.  I'll just wait it
    out and see what happens.
    
    Thanks for the responses!
    
    Jane

Jane,

Your last note really got to me.  It seems to me that you don't agree with
both your niece and her husband working, or with their parenting style.  But
from what you've described, it sounds like a similar situation to mine right
down to dealing with a monitor.  

I don't believe that the incidents you have described cause any brain damage
or slower development.  But you also haven't described development that is
out of line with the child's age.  Talking skills usually come around 12-15
months.  Crawling can be in the 9-12 month range and may not happen at all,
or may happen for a week and then the child is walking.  Some babies don't
like to sit up.  Premature babies like mine tend to do things backwards, so
my kids crawled well before they sat up with  Brad almost walking before he
would sit on his own and that was at 14 months (11 months adjusted) but was
within the appropriate age guidelines.

It has been proven that a nurturing, loving environment can contribute to a
child's development and progress, but babies still do things on their
own schedule.

It seems to me that you are condemning your niece for working and not spending
more 'quality' time with her son, but are you really in the position to decide
that her time with him is not 'quality' time.  Do they live with you such
that you can see how things work in their family?  If they do, perhaps you
can do things with the baby to help him develop.

And do you know if the frequency of alarms is really due to the baby having
incidents?  It is possible that there are other things causing the alarm
to go off such as loose leads, bad leads, bad monitor, baby moves wrong
and dislocates the leads etc.  I know when Brad had one of those monitors that
it went off every 5-10 minutes one day.  Turned out to be bad leads, but you
don't know that at the time and I was a basket case by the time we got to
the doctor's office.

I guess I found your description of your niece's lifestyle to be similar to
mine, and I don't think I'm a bad parent because these are my first children
and I happen to work full-time.  I suppose if they didn't eat so much and need
a roof over their heads I could stay home, but things didn't work out that way.
And I don't find it odd that your niece gets home from work, feeds the baby
dinner and then he goes to be shortly.  Babies need their rest and shouldn't
be kept up all hours to fit the parents' schedule.  My kids will be 2 the end
of this month, and they can't seem to stay up later than 7:00, although we
did manage to get them to 7:20 last night before Jessica grabbed a blanket,
found a spot on the floor, and settled in with her thumb to give us a hint
that she was ready for bed.

I guess you really hit a raw nerve with me.  But I do think the baby is 
developing OK.  And if you still have concerns in a little while, perhaps
you could suggest a developmental evaluation for the baby.  In MA, the program
is state-run and is called Early Intervention Program.  I'm sure the hospital
will be able to point you to a similar program near you.

Cathy

    Cathy:
    
    I'm not condemning my niece for working.  Quite the contrary.  It's
    very admirable to work when you have small children and still manage to
    do all the other things mothers have to do.  I have two kids who are
    pretty much grown now and I don't know how I made it.  You have to have
    two incomes these days to make ends meet.
    
    My niece does live close and I see her quite frequently.  Her husband
    takes care of the house and cooking and cleaning (must be wonderful) so
    she doesn't have to worry about those things.  She's very hard headed
    too and it's difficult to talk to her about some things.  Part of it
    may be attributed to the fact that she's never been around kids so she
    doesn't know what to do.  Michelle has just started this week working
    an 8 to 5 job.  Before she set her own hours, usually 11 to 3. 
    
    Regarding the alarms, I don't consider the leads being loose, etc. a 
    "major" alarm.  The ones that really concern me are the 15 second ones
    when he quits breathing.  He does have alot of those.  
    
    The part that bothers me about the "quality" time (not quantity) is
    that in my observation she sticks him in the walker, rarely talks to
    him, doesn't read to him, when he doesn't open his mouth to take his
    next bite she pops him on the head, etc..  Granted, we all get fed up and
    tired, but we still have to take care of someone who depends totally on
    us.  It's a fact of life.  
    
    I'm not knocking working mothers!  I was one, still am one, and will
    continue to be one, I guess forever.  I'm just saying in my niece's
    case "I" don't feel that the time she has to spend with Justin is what
    it should be.  Maybe it will with time.
    
    Jane

Jane,

Who takes care of Justin while your niece is working?  Even though your 
niece may not be doing all those activities, perhaps the daily caretaker
is doing it. And you could maybe encourage some of these activities by
bringing over some toys or books that are educational.  Maybe even some
of those Dr. Seuss tapes where they read the Dr. Seuss books to the child.
My son just loves "Mr. Brown Can Moo" and can sit there all day listening
to that, so he loves the tape.  I know that my sitter does all those
developmental-type things with my kids as that's the bulk of their day,
and it's when they need to be doing these things.

Also, check on the Early Intervention type program in your area.  They may
have literature and such that could suggest activities for the baby that you
could either give to your niece or perhaps make the suggestions that you
read in there.

I'm still not sure how you know when the alarms are real vs. something else.
I know the machine lights up to tell you, but I also know they are not 
always accurate.  And the fact that he does have so many alarms is why
he's got the monitor, so I wouldn't worry that having them is causing him
any harm.  I'd be looking for progress on the frequency decreasing.  One
other thing -- does he self-correct or does he require intervention to 
start breathing again?  Self-correction is progress even if he corrects
after he hears the alarm which is very common.  That's better than someone
having to pick him up and do something to get him to breathe again.

And they do grow out of that, but some babies take longer than others. My
daughter had a low aminopholin (sp?) level, so she kept forgetting to
breathe and required supplemental aminopholin to stop the apnea, but she
outgrew it quickly and came home at 10 weeks with no equipment.  My son,
on the other hand, had a different problem where he would spit up, choke,
panic, stop breathing and drop his heart rate, so he came home with a monitor
the first time he came home which was at 17 weeks (he stayed home less
than 2 weeks before going back to the hospital).  I know of babies having
monitors for a year to 18 months, so it would appear that this time-frame
is normal for babies who require monitors.

Cathy

    We lost our six month-old daughter Harriet in 1980 through SIDS. Our
    next two children were perfectly healthy and showed no signs of any
    similar problems. Our last daughter, Alice, now 6 (today) was also
    quite "normal". That is, with one very alarming exception. When under
    very severe stress, such as after a fall, or a bang somewhere, or when
    severely upset, she would cry and cry until she simply stopped
    breathing in mid-yell.
    
    We'd been paranoid enough about them after our experience with Harriet,
    and this took some getting used to. In fact, we took advice. She's been 
    grown out of the thankfully rare habit for some time, and despite
    "stopping" breathing for quite long periods (10-15 seconds), she is not
    only perfectly normal, but extremely bright. Her stature is very
    diminutive, but her mental development is advanced if anything.
    
    To allay your fears, there is a monitor you can have at home. A friend
    of ours, whom we met through our local SIDS support group had all three
    of her (post-SIDS) children on a monitor which was "permanently"
    attached to them until a year-old or so. We didn't want one, it somehow
    seemed to cause more worry and anguish than it fixed, but our friends
    felt it was worth it. Ask your doctor; I believe it was an Apnea
    Monitor or somesuch.
    
    In the end, you can watch them for 23hours 59 minutes a day, and the
    second you look away, it can happen... If you're really that worried,
    get a monitor.
    
    Laurie.

    There was some news on the radio this morning which I only half heard
    (clock radio - just woken up). It was the results of a study that
    connected SIDS to the body temperature of the baby at birth. If it was
    low (I don't know how low), the baby was at greater risk. Does anybody
    have any more info. on this news, as SIDS is the one thing about our
    forthcoming baby that really terrifies me.
    
    Andy 

    
    The item on BBC Radio 4 talked about the maturity and condition at
    birth I think (I was fighting the traffic on the M4). Babies born at
    full term in good condition were at less risk. I'll check the paper
    this evening for more information.
    
    SIDS frightens all parents, but by following the Back to Sleep
    programme introduced 18 months ago and with better public awareness of
    not smoking near babies or keeping them too warm, the SIDS rate for the 
    UK has dropped by 50%. 
    
                Celia
    

    Andy,
    
    Celia is correct. The SIDS rate in the UK has fallen by half, they
    feel, due to the "Back to Sleep" campaign. They hope, that as more
    parents become aware of it, that the rate will fall still further.
    There are three main things that, statistically, appear to contribute
    to the incidence of SIDS:
    
    1) Parental smoking. this is before, during or after pregnancy, is the
       prime constituent.
    2) Babies sleeping on the stomach.
    3) Babies becoming too hot, especially when unwell.
    
    Cheers, Laurie.

    We have a thermometer for the cot, which give 'too hot', 'too cold' &
    'just right'. With all the heating off, its generally 'too cold' or
    'just right' but with anybody in the room (with the windows closed but
    door open) its seems to rise to 'too hot' (about 70). As the windows
    are the old wooden sash its difficult to leave/keep them open. 
    
    Does anyone have any ideas on keeping the room cool?
    
    (As I live with the UK climate an air conditioner can't be justified) 
    
    Andy
    

     I heard yesterday(can't remember where as the mo)in nearly 4 out of 5 cot
    deaths that the parents smoked or the mother had smoked during
    pregnancy.Anyone else heard this???

    SCott

    
    re .46
    
    Open a window and door in a room next to the babies room or on the
    landing. We kept Rebecca's room just right in the heat wave last summer
    by having windows open (and doors) in the rooms either side of hers.
    This created a through draft. The window in her room is fine to leave
    open on warm nights now she is older. When she was tiny I was worried
    about a direct draft on her and insects flying in when the light was on
    during feeding and change times.
    
    If you cannot do the through draft idea due to the design of the house,
    move the baby's cot into a better ventilated area (your room or the
    landing?) during hot weather.
    
    On a general note, once a baby can kick its covers off, do not recover
    unless the baby is cold - test the body temp by touching the base of the
    neck or the tummy. The feet and hands may feel cold, but this does not
    mean the baby is cold.
    
    Babies soon learn to keep themselves cool if they get too hot in bed. 
    Your health visitor will be able to give you the tog values of
    everything the baby is likely to wear from a nappy to quilts and
    blankets and will recommend a max value. I think it is 8 which is not a
    lot as a nappy and vest together are about 3.
    
                 Celia
    

    I'd forgotten the health vistor would be calling. She's bound to have
    experience of all sorts of houses around my area, so I can have a chat
    to her.
    
    Thanks for peoples contributions
    
    Andy
    

    RE: .48
    
    Yes, that's true, which is why smoking before, during or after
    pregnancy is a no-no. Note, however, that not smoking is by no means a
    guarantee that you will not fall victim to SIDS. You need to bear in
    mind *all* the advice.
    
    In Suffolk (England) last year, we had *NO* cot deaths. Since we became
    involved in the Cot Death Support Group and FSID (Foundation for the
    Study of Infant Death) 13 years ago, it's the first time I can remember
    that. We all believe it's to do with the "Back to Sleep" campaign.
    
    Laurie.

Dave mentioned last night that he'd read recently about cot deaths and dreaming.

The article was about someone who had done dream research. We think it was in 
the Financial Times either one day last week, or on Monday of this if anyone
wants to chase the reference. We don't have the article to hand.

If an adult dreams they are swimming under water, they stop breathing for a 
short time. An auto reflex starts the breathing up after a few seconds. People
dream more about swimming if they are lying on their stomachs. 

If a baby is put on its tummy to sleep, it may well dream about swimming in the 
womb and it may well stop breathing. The auto reflex has not matured, so the 
baby does not start to breath again. If the baby thinks it is in the womb, it 
will not use its lungs.

This may be a stupid idea, but it may explain the deaths of babies that were not
too hot, lived with non-smokers, mature and fit at birth etc. As babies dream 
before they are born, there may be a bit of truth in this.

      Celia 

The problem I have with that theory is that
babies *do* breathe in the womb.  They breathe
amniotic fluid.


Pat

    Crib death was and still is my biggest,darkest nightmare.we used to
    sleep with one eye open,check on Yahli every 5 minutes and so on.I
    don't have an answer to the problem,but we DO have something that
    helps.It is called "BABY SENSE",it is an Israeli invention,and it is
    b far the best thing in the market.It is basically a board (2) that you
    put under the materss (sp),and it senses the baby's breath.If for some
    reason the baby stops breathing,the alarm goes off-loud enough to wake
    the whole town up.Then you have time to give the baby first aid.It
    happened to us when Shachar was 3 weeks old.2am we heard the
    alarm,jumped out of bed and followed the first aid instructions,until
    he started breathing again.The whole thing must have taken not longer
    than 10 seconds-but to us it was the longest 10 seconds in life.
    Anyways,"BABY SENSE" it is.Try checking at the large dpt. stores or
    places that deal with baby stuff (I know they export it to the states
    and my cousin in NY has one.) It is not cheap (around $120) here in
    Israel),but my baby's life worth alot more!
    If you need more info. send me mail,I will call the people who make it
    here.
    Rivka
    

    I haven't had time to read all the replies in this topic so if this
    is a repeat, just ignore me. :)
    
    I've read and heard that a baby is at a greater risk if he/she sleeps
    on her stomach, sleeps on anything too soft or on blankets, pillows
    etc.  Full-term babies that don't have respitory problems should
    sleep either on their backs or sides and this should help reduce
    the risk of SIDS.  In the hospital where I had the baby, they put
    all babies on their sides so if they spit up mucus they don't choke
    on it.