Sudden Infant Death Syndrome Sids and African Americans

State University

Sudden Infant Death Syndrome SIDS and African Americans

Sudden Infant Death Syndrome (SIDS) still baffles the mind of several people who seek to understand the underlying cause of this condition. SIDS is understood to be an unexplainable death that affects infants under the age of one. It is an unfathomable condition that’s quite frightening because it strikes without warning and affects the seemingly healthy infant. The time frame for this occurrence is at night and usually occurs without any notice. Usually it is while infants are asleep that this condition occurs, the reason for the name “crib death” because this condition usually occurs in the crib. However, it should be noted that that this event can occur anywhere from car seats to strollers, infants seats etc. What is peculiar about these deaths is that there is no sign of suffering and seems like this infants simply died in their sleeps.

There are a number of similarities that is common in SIDS death.

• It is the leading cause of death in infants 1 month to 12 months of age, and the highest deaths occurring between the ages of 2 months and 4 months
• Sudden and quiet death of an infant that seemed perfectly healthy.
• Death in unpredictable in nature without any insight into the cause and unpreventable.
• Death by sleep with no evident sign of suffering
• Autopsy helps shed light on causes of death, including assessment of the death scene along with and evaluation of the clinical history.
• Designated as a diagnosis of exclusion.
• It is noted as a medical disorder and is listed under the International Classification of Diseases, 9th Revision (ICD-9).
• Sudden infant death that creates more unanswered questions and grieving for parents and families.
  

It must be noted that there are many misconceptions about what causes SIDS which extensive research shows are myths. The following is not connected to SIDS

• caused by vomiting and choking, or minor illnesses such as colds or infections 
• caused by the diphtheria, tetanus (DPT) vaccines, or other immunizations 
• childhood diseases
• child abuse 
• the cause of every unexpected infant death 

When we experience a sudden, unexpected death, it is terrifying and one’s sense of safety and security comes under examination making us confront our mortality (Corr, 1991). The loss of an infant suddenly is not a normal occurrence, and places parents, families and friends in a traumatic state of mind. Having no possible explanation for the cause makes it difficult to accept the loss when it happens.

The term SIDS have been used throughout recorded medical history since it was adopted in 1969 by an international work group. SIDS was recognized as a significant public health issue after the National SIDS Act of 1974. Since the Act there has been funding through the government to help in research disseminating information and provide various counselling programs in all 50 states. There is a likelihood that infants susceptible to SIDS have developmental abnormalities in the heart and respiratory rate control. It has been hypothesized that environmental stresses encountered in early infancy could induce a “short-circuiting” of normal “defense” or arousal mechanisms resulting in sudden death. Nerve cell abnormalities both in structure and function have been identified in SIDS infants, and this could increase risk for sudden infant death. The delayed development of the brain stem and reduced myelination of specific brain regions has been key evidence uncovered by several studies. It is also been noted in infants with SIDS that there are neurotransmitter abnormalities, few receptors or structural deficiencies within the arcuate nucleus (which is a nerve cell complex integral to cardiorespiratory and arousal responses).

Cigarette smoke exposure is one of the most amendable risk factors associated with SIDS. The risk associated with SID increases 5 fold with infants exposed to cigarette smoke both post-natal and pre-natal.

In recent research, African Americans have three times greater risk of SIDS than Caucasians and six times the risk of Hispanics or Asians suggesting an important role for genetics (University of Chicago, 2006). Since the 1992 recommendation to place babies on their backs to sleep, the SIDS mortality rate has decreased almost 50 percent in both African-Americans and Caucasian. Researchers note that pre-natal and post-natal behaviors of mothers is not a reliable predictor of the occurrence of SIDS (NCHS, 1990).
According to a Mayo Clinic study a cardiac gene has been linked to sudden death syndrome (SIDS) and is the first molecular evidence to possibly unlock the mystery behind SIDS. “A team of investigators led by Michael J. Ackerman, M.D., Ph.D., from Mayo Clinic, the Arkansas State Crime Laboratory, Baylor College of Medicine and the University of Wisconsin, Madison, examined 93 cases of SIDS or possible SIDS deaths. They collected body tissue from the infants and examined them for a specific defect in a gene located in the heart (the SCN5A gene). This gene acts as an electrical tunnel and controls the heart’s rhythm. This finding may represent a key to preventing infant deaths in the future by considering lethal heart rhythm disturbances as a possible cause for some cases. Future research will build upon this finding to examine other potential causes of SIDS” (Mayo Clinic).
According to researchers education plays a key role in how parents put their infants to sleep. African-American parents are more than twice as likely as Caucasian parent to place infants on their stomachs. Other information suggests that these myths are generated from false beliefs that babies sleep better on their stomach. “In fact, a 2000 national survey conducted by the U.S. Consumer Product Safety Commission (CPSC) and Gerber Products Company found that while about half whites say that get information about sleep position from their physician or a nurse. African-Americans tend to get information more from a family member such as a grandmother.” (Goyco, 1990). Thirty-one percent of African –American parents have placed the infants on their backs as recommended by CPSC. There are certain risk factors that peculiar to SIDS death. These are:
• Smoking, drinking or drug usage during pregnancy
• Poor prenatal care
• Premature or low birth weight
• Mothers younger that 20
• Continuous exposure to cigarette smoke following birth
• Overheating from excessive sleepwear and bedding
• Sleeping on stomach
(Willinger, 1991)

It should be noted that research shows that SIDS is not passed down from parent, neither is it something that is contagious. Also the disparity between African Americans and Caucasians is not based on sleep position, but more on bed sharing and very low bed usage. The research indicates that bed sharing deaths are twice as common with African American and in non-African Americans.