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- MEDICINE, Page 48Beware of the Pillow
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- Researchers uncover a new culprit in the mystery of sudden infant
- death syndrome
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- Each year in the U.S. about 7,000 infants die in their cribs
- for no apparent reason. Because doctors cannot find anything
- physically wrong with them, these babies are listed as victims
- of sudden infant death syndrome, a mysterious disorder that
- seems to occur when infants somehow forget to breathe. But new
- evidence from a pair of pediatricians at the Washington
- University School of Medicine in St. Louis suggests that a
- subtle form of suffocation may be the true culprit in
- one-quarter to one-half of all suspected SIDS cases. Their
- conclusion, published in last week's New England Journal of
- Medicine, reflects a growing suspicion among doctors that the
- position in which these babies slept, face down, may have played
- a major role in their death.
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- With the help of the Consumer Product Safety Commission,
- Dr. James Kemp and Dr. Bradley Thach obtained information about
- 25 infants who died face down. All of the babies had been
- sleeping on soft cushions, filled with polystyrene beads,
- intended for infants. The two colleagues began their
- investigation with a simple test. Each held one of the suspect
- pillows to his own face and tried to breathe through it. "If you
- breathe into it for a minute or two, you're O.K.," says Kemp,
- an expert in the physiology of infant airways. "But after that
- you really feel out of breath and uncomfortable."
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- Even though the cushion had not prevented them from
- breathing, the air they exhaled had become trapped in the beads.
- So when they inhaled, they drew in stale air that was low in
- oxygen. "You end up breathing back in what you've just breathed
- out," Thach explains. "All the oxygen gets used up." Adults have
- enough lung power to suck in sufficient oxygen through the
- pillow, but Kemp and Thach determined that babies could not. By
- testing rabbits that had the same lung size as infants, the
- pediatricians proved that rebreathing into the bead-filled
- cushions was fatal for babies. The two investigators also
- determined that any movement by the children to free themselves
- only buried their faces deeper into the pillows.
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- Although the Consumer Product Safety Commission announced
- a voluntary recall of the cushions last year, the pillows are
- still readily available in people's closets and at garage
- sales. Investigators are now trying to determine if other
- products, like bedclothes or stuffed animals, could also cause
- fatal rebreathing. In addition, the Missouri doctors' findings
- are sure to fuel the controversy surrounding a question that
- should have been answered long ago: What is the safest position
- in which to put a newborn down to sleep? Pediatricians in some
- European countries recommend placing infants on their side,
- while most American doctors still opt for the abdomen. Kemp's
- advice to parents: "Don't put your baby in a position where
- something soft can cover its face."
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- By Christine Gorman
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