$Unique_ID{BRK02085}
$Pretitle{}
$Title{Sudden Infant Death Syndrome and the Way a Baby Sleeps}
$Subject{SIDS sudden infant death syndrome infants baby sleeping position
vomiting cheesing regurgitation postnatal care gasping reflex arousal reflex
breathing suffocation}
$Volume{}
$Log{}

Copyright (c) 1993  Tribune Media Services, Inc.


Sudden Infant Death Syndrome and the Way a Baby Sleeps


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QUESTION:  Despite all I have read lately about SIDS (sudden infant death
syndrome) and the way a baby sleeps, I am still confused.  My mother always
cautioned us to keep a baby sleeping on its tummy, so that the drool wouldn't
stop up his lungs.  The articles in the paper seem to be saying just the
opposite.  Could you please explain why?  Thank you.

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ANSWER:  The recent flurry of news reports about sudden infant death syndrome
(SIDS) was inspired by a recent article in the Journal of the American Medical
Association (JAMA).  The authors reviewed all the medical literature dealing
with reports of infant deaths, and the relationship to the sleeping position
of the infant.  For many years, general medical advice was that the prone
position (sleeping on the tummy) was preferable, not only because of the
effect of the child's saliva (or "drool" as you put it) but more specifically
because of fear that vomiting or regurgitation (some parents call this
"cheesing") during sleep could lead to obstruction of the airway.
Theoretically, the baby's tongue falling back into the throat during sleep in
the supine position (on the back) could also cause obstruction.  There is
little in the medical literature that shows that this fear is legitimate.
Quite the contrary, when the cases of sudden death are analyzed, there is an
increased risk that occurs when the baby was sleeping face down.
     For some time, it was believed that a child, even a sleeping baby, would
move about if their airway became clogged by bedclothes.  If breathing is
prevented for many seconds, a gasping or arousal reflex occurs that changes
the position, and allows air to flow again.  However, in some children this
reflex may not be well developed, and they may be more liable to suffer
suffocation.  The exact mechanism by which the tummy position increases the
risk for SIDS is not clearly understood, but when parents are educated about
the possible dangers of this position, the number of SIDS deaths are
decreased.  Until more data can be developed, the present recommendation is to
avoid the face down position, unless some other medical condition prompts your
doctor to advise otherwise.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.