Sudden Infant Death Syndrome
– The Simple Truth

The tragic phenomenon of crib death, Sudden Infant Death Syndrome (SIDS), occupies a large number of researchers all over the world.  They are trying to find the explanation for what used to be called unexplained infant death.  How can it be that perfectly healthy, well-developed babies suddenly stop breathing in their sleep and die?

One might be forgiven for suspecting that there is a touch of prestige involved in the quest.  Whoever solves the SIDS enigma has a bright future indeed.  The Nobel Prize for Medicine could well be on the cards!

Is that why the explanation is not permitted to be as simple as it actually is?

“A good friend of mine experienced this devastating trauma,” writes one mother.  “Her child died at the age of six months.  The baby had been put to bed in the crib on his back, and all medical instructions had been followed to the letter. She was never given an explanation as to why her child died.”

You don’t have to be a doctor or a researcher – or for that matter a mother of nine who will soon have devoted half a century to living and working, day and night, mainly with very young babies (my personal research project is based on a sample of 800 infants) – to state that all parents become extremely anxious the minute their newborns exhibit irregular breathing.  Babies sometimes gasp for breath, and sometimes lie completely motionless and seem not to breathe at all – which in fact they are not.  Newborns can stop breathing for as long as 40 seconds several times a day.  This is something that few adults can manage.  

Why does it happen?

The reason is that, at birth, breathing is no more automatic than, for example, the very complicated process of digesting food.  In rare cases, babies neglect to inhale again after these long, irregular episodes of not breathing.  The explanation for Sudden Infant Death Syndrome is that simple.

A newborn has never breathed air before.  Breathing can be described as a series of reflexive movements.  Babies take a deep breath for the very first time to get the air that will oxygenate the blood.  Newborn babies breathe because they have to breathe.  Similarly, newborn babies suck on everything that is given to them.  They suck because they have to, but naturally they have no idea what this sucking will lead to, namely continued survival.

All new parents know that their babies have to eat to survive.  All parents know that their babies must breathe to survive.  When their babies’ breathing is irregular, which it is at the beginning of life and for many months thereafter, this causes parents as much anxiety as their babies’ inability to eat would (and does).  There is no big mystery.  It’s all about instincts.  Human beings know instinctively.

The SIDS enigma isn’t really that enigmatic.  Breathing is not automatic from birth.  The babies who die “forget” to inhale.  In the same remarkable way, children as old as two or three “forget” to raise their heads out of a pool of water they have fallen into.  They just lie there and drown without so much as a hint of resistance.  They are perfectly capable of getting up and walking away, but they don’t.  Sometimes, the breathing reflex is rendered irrevocably inoperative.
 
 

Twelve years ago, one of my little grandchildren came to stay with me for a “sleep cure”.  I would give this five-month-old, sleep deprived little mite the sound sleep he so desperately needed.  Naturally, I didn’t sleep a wink.  Was he breathing?  Was he breathing properly?  I would constantly poke the palm of his hand to get a reflexive movement in response.  This was not my own child, so the responsibility was that much greater and that much more excruciating.  The next day I heard that so-called breathing alarms were available to ordinary mortals, not just to hospitals.  I was overjoyed and had one sent to me by courier.  The second night of the cure, I actually dared go to bed myself, since the alarm would stand guard for me.  A little green light blinked reassuringly, indicating that the baby was breathing continuously.

This same baby was sleeping peacefully in his baby carriage at a barbecue one summer evening.  His parents stood guard on each side of the carriage keeping an eye on him.  All was well with the world, or so everyone thought.  But the alarm went off.  The baby had stopped breathing.  If it hadn’t been for the alarm, no one would have noticed a thing.  As it was, the child’s parents could simply “remind” him to start breathing again.  By turning the baby over onto his back so that he surfaced briefly, the catastrophe that could have occurred was averted.  In all probability, the little lad would have started breathing again on his own.  The alarm was set to go off if he stopped breathing for more than twelve seconds.  But who knows?  Three minutes is all it takes.

I remember thinking that the breathing alarm was the greatest invention since the washing machine!  I recommended breathing alarms to everyone I knew, particularly to my own kids of course.  I was therefore utterly astonished to discover that the SIDS-establishment advised against the use of breathing alarms.  Imagine how we would all react if the fire department attempted to dissuade people from installing fire alarms or the police advised motorists not to buckle their seatbelts on the grounds that the use of such devices would either cause undue anxiety or instil a false sense of security!

This is where we reach that proverbial fork in the road.  To the best of my knowledge, there is not a single documented case anywhere in the world of a child dying of SIDS with a functional breathing alarm under the mattress.  Nevertheless, doctors and researchers advise against installing breathing alarms.  There is only one possible explanation, and it is so cynical that I hesitate to put it in writing.

The SIDS mystery is not a mystery at all.  The explanation for “inexplicable” crib deaths is all too simple.  If, however, it were generally accepted that children in rare cases simply “forget” to breathe, the generous research grants, the glittering prestige and the visions of Nobel Prizes that dance in the heads of the medical establishment would all evaporate.  Even something as tragic as Sudden Infant Death Syndrome can be turned into a cash cow and a career booster.   

My goal is to ensure that young children get the sound, undisturbed continuous sleep that they need.  The SIDS-establishment has chosen another path.  Through their fear-mongering propaganda, they have managed to deceive new parents into believing that they are putting their infants in mortal danger if they put them down to sleep on their stomachs – which, just like turtles, frogs and beetles, is what human infants are designed for.  This is not just about freedom of movement and optimal neurological development, but also about sound sleep, which is essential for life.  Infants that are put to sleep on their stomachs right from day one seldom, if ever, develop sleep problems.  Among babies who are put to sleep on their backs, sleep problems are the rule rather than the exception.  (And it is for these children that I have developed the Good Night’s Sleep Cure, which is the only sleep method that confers on infants a palpable sense of security.  And in an infant’s precarious, brittle world of vulnerable helplessness, this sense of security means survival.)

We all have to choose our own path.  I have chosen mine.  I want young children to sleep soundly.  They want and need to sleep well at night, just as we adults do.  The researchers have chosen their path – at the price of young babies’ right to sound sleep and to life itself.  It has been decreed that their lives shall not be protected by breathing alarms. The researchers have opted to look for the explanation for SIDS in a place where no explanation is to be found.  Thus, the research gravy train can go on forever.  The SIDS-statistics can be reduced through new “discoveries” until the only viable solution is that no one, parents or children, will sleep at all.  Most deaths occur in bed, so if everyone stands up, the statistics on dying in bed drop dramatically – just as the statistics on traffic accidents will drop if everyone quits driving.

The latest break-through informs parents that it was their fault that their infants died. They were neglectful, God only knows how (for now anyway).  But the truth in all its bitter simplicity is that it was the baby who neglected to inhale after one of those many, often extended, breathing pauses.  The devastated parents have to live the rest of their lives believing that they neglected their children.  “You slept fifteen minutes too long,” the doctors told a new mother, whose baby died beside her in bed at the hospital.  All efforts to resuscitate the child were in vain.  It died and the burden of guilt was placed squarely on the mother’s shoulders for her to carry with her to her grave.

If the SIDS-establishment’s zero tolerance policy were taken to its logical conclusion –  without breathing alarms please note – children would not be allowed to sleep at all.  That is a “solution” so idiotic that not even the most prominent researcher would dare suggest it.  They have done the next best thing however.  The mother has now been forbidden to sleep.  Nicotine, alcohol and prescription drug free, she shall sit ramrod-straight in her chair and breastfeed for six months, round the clock, wide awake and sharp as a tack.  If she falls asleep, she is endangering the life of her baby!  She is to function as a human breathing alarm and monitor her child’s breathing 24/7.

Among others, Peter Fleming, Professor of Paediatrics and Developmental Psychology at the University of Bristol, UK, has brought these new discoveries into the public domain.  He feels he has been misinterpreted by the media.  "My view is that the positive message of this study is that it says don't drink or take drugs and don't smoke, particularly for breastfeeding mothers. We did not find any increased risk from bedsharing. It is a very different message from the one the media picked up.” (Boseley 2009. )

He defends himself further. “You can say that half the deaths occurred while babies slept with their parents. You could also say that half the deaths occurred while babies were alone in their cots,” he says, but: "I don't see anybody saying, 'Don't put your baby in a cot.'"  (Boseley 2009)

He continues his somewhat alarmed line of reasoning (during which he neglects to mention how these babies were lying – in all probability on their backs – and just as probably without breathing alarms): "Any advice to discourage bedsharing may carry with it the danger of tired parents feeding their baby on a sofa, which carries a much greater risk than co-sleeping in the parents' bed. -- Anecdotally, two of the families of Sids SIDS infants who had co-slept on a sofa informed us that they had been advised against bringing the baby into bed but had not realised the risks from falling asleep on the sofa.” (Boseley 2009)

What is so dangerous about sleeping on a sofa?  Exactly what risk do little babies run when they are being breastfed by Mom or bottle fed by Dad?  Do these babies run the risk of dying of SIDS because whichever parent is on duty falls asleep?  Or is the real risk they run that of being smothered because the parent on duty – groggy for some reason (lack of sleep perhaps?) – lies on them?  Could this be the cause of SIDS?

No.  Then the fatality would be classified as death by asphyxiation.   

The autopsy records do not distinguish between asphyxiation and SIDS.  That does not however mean that asphyxiation and SIDS are synonymous.  Asphyxiation is due to external factors, while SIDS is due to internal factors.  SIDS is caused by nothing other than a short-circuiting of the breathing reflex.  Any one of those frequent breathing pauses, to which all infants are prone if they are sleeping deeply, can be one too pause many and one pause too long.

It was not the exhausted mother’s fault, no matter how woozy she was, that her baby never resumed inhaling.  Nor was it the fault of the barely conscious father, no matter how medicated he was.  The “fault” is a malfunction of the breathing reflex.

Fleming and his fellow researchers the world over are already feeling the heat.  And it will grow more intense I’m afraid.  The human protective instinct is not to be trifled with.  In the long run, no experts, however dazzling their qualifications, can frighten parents into going against their instincts.  The instinct to survive is the most powerful instinct we have, and it is not restricted to our own survival.  It is not egotistical.  If it were, we would not even be walking the earth, let alone ruling it.  We survived because we didn’t abandon each other, especially the smallest among us who would carry on the species.  Giving food to helpless young children, keeping them warm, protecting them from wild animals and other life-threatening dangers to the best of our ability are imperatives that are hardwired into us.  These exalted researchers who try to forbid new mothers from embracing their children, breastfeeding them, warming them and sleeping with them where they are lying, be it in a bed, on a sofa, on a mat on a dirt floor, or wherever these women happen to rest their heads, are throwing down a challenge not only to the protective instinct, but to the survival instinct as well – an instinct that encompasses the entire human species.  And that has a price tag.  This time they have gone too far. Nevertheless, children die.  They always have.  Mozart had seven children, of which two survived into adulthood.  In old Swedish census records from the 18th and 19th centuries, we can read entries about infants’ deaths, where “lain upon until dead” is often given as the cause of death.  SIDS or not?  It’s impossible to know.  Moreover, children died (and still do) of starvation, cold, life-threatening diseases – which are not always life-threatening (at least in our part of the world).
One thing is certain; SIDS will not be eradicated through universal sleep deprivation.

The key question is this:  shall we hypothesize about the catastrophe after it has occurred, or shall we prevent it from happening in the first place?

For me, it is hardly a difficult choice, given the fact that we live under far more secure circumstances than human beings did not that long ago (and still do in large parts of the world).

Thus, here is my list of factors that do not pose a risk:

    * Infants should sleep on their stomachs.  It is what they are designed for, which is obvious to anyone who cares to look.
    * Breathing alarms should be issued for every child from birth and should not be restricted to neo-natal units.  They should be standard equipment for the first 10-11 months of life.
    * Infants should sleep on a smooth under sheet in their own beds in a cool, dark room, lightly dressed with naked feet and legs.   Covers and bedding should provide warmth, and freedom of movement should not be curtailed.
    * Infants should never be allowed to cry themselves to sleep.  They should be calmed where they lie.  The Controlled Crying Method (The Cry-It-Out Method) is reprehensible.
    * Healthy children should never be medicated.

Stockholm, Sweden, November 2009

Anna Wahlgren, mother of nine, author of For the Love of Children and A Good Night’s Sleep.

References:Boseley, S 2009, ‘Cot death warning on shared bed with baby misinterpreted – expert’, The Guardian, 16 October.