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Doctor Cites Progress on SIDS Prevention
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Doctor Cites Progress on SIDS Prevention

Children's Health

Doctor Cites Progress on SIDS Prevention

Doctor Cites Progress on SIDS Prevention
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It's still not clear what causes Sudden Infant Death Syndrome, but medical researchers are having more success preventing it. Yale Medical School professor Dr. Sydney Spiesel, a Slate contributor, tells Madeleine Brand what they're learning.

MADELEINE BRAND, host:

This is DAY TO DAY. I'm Madeleine Brand.

And now our regular look at health news. Doctors have been studying sudden infant death syndrome, or SIDS, for decades but they still aren't sure what causes it. They're getting a better sense of how to prevent it, though. Joining us is Dr. Sydney Spiesel. He's a pediatrician and professor at the Yale Medical School and he writes a monthly health column for the online magazine Slate.

And welcome back to the program.

Dr. SYDNEY SPIESEL (Pediatrician): Oh, thank you. It's always nice to be here.

BRAND: OK, first of all, let's remind people what the best advice is for preventing SIDS and that is the back to sleep philosophy, putting infants on their backs when they go to sleep.

Dr. SPIESEL: We learned that in a number of different ways. One of the places in the world that had the highest incidence of SIDS was Australia and New Zealand. And there were so many cases compared to other places where it occurred in the world that it was possible to begin to look at the question in a scientific way. And the first thing that they found, which was, you know, if anything, they have an excess of sheep in New Zealand and sheepskins magnify--sheepskins increase the risk of SIDS.

BRAND: And is that because the sheepskin was suffocating the babies?

Dr. SPIESEL: Sheepskin, and even sleeping facedown in any kind of soft surface increases what's called rebreathing. You're breathing exhaled air over and over and over again. Now if you rebreathe exhaled air, you really can't ever extract enough oxygen. I think the only plausible thing is that it has to do with an increased amount of carbon dioxide, but that's just my opinion.

BRAND: And recently the American Academy of Pediatrics recommended that children be put to bed with pacifiers to prevent SIDS. And why is that?

Dr. SPIESEL: They took kids who had died with SIDS and then they found a comparable collection of other kids who were born approximately the same day, who had the same ethnicity and they asked those families where the kid hadn't died and asked questions to see what were the differences. One of the things they found was a more than 90 percent reduction in sudden infant death syndrome in kids were who using pacifiers. And we don't know if it's causative. We don't know if using the pacifier is the critical thing or maybe something else is, although you kind of suspect that it's the use of the pacifier. And nobody has any idea really what the mechanism is.

BRAND: So it's a complete mystery?

Dr. SPIESEL: We can start to identify some of the things that can contribute to it and we can identify some of the things that can help prevent it. For example, there was an amazing--around the world there was an amazing decrease in the incidence of SIDS once the pattern changed of putting kids on their back to sleep. So it seems like that really is causative, that sleeping face down increases the risk of SIDS. Sleeping face up, really, there's some probably causative relationship that helps decrease the rate of SIDS.

BRAND: Well, another recommendation from the American Academy of Pediatrics caused a furor a few months back and that was to tell parents not to share their bed with their infants. And a lot of mothers and fathers were outraged at that suggestion but the American Academy of Pediatrics said, well, that will reduce the number of SIDS.

Dr. SPIESEL: We don't know if it'll reduce the number of SIDS; although there does seem to be a connection. The connection is actually magnified in mothers who smoke. We don't know what that's about either. Some of the people who feel most strongly about this co-sleeping--first of all, they like the idea of the kind of warmth and bonding in relationship between the child and the parents in the sense that it promotes breast-feeding. It's so much easier to just kind of reach over and grab the kid rather than get out of bed and go over to the nearby crib or something like that. But there is a risk. I mean, it does somewhat increase the risk.

BRAND: Dr. Sydney Spiesel is a pediatrician at the Yale Medical School. He writes about medical news for the online magazine Slate. Thanks a lot.

Dr. SPIESEL: Thank you very much.

BRAND: DAY TO DAY returns in a moment. I'm Madeleine Brand.

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