Dr. Jeremy F. Shapiro
Pediatrician
Dr Shapiro completed his undergraduate education at UC San Diego earning a B S in Biochemistry and Cell Biology and a B A in Political Science He furthered his education at UCLA where he earned a Masters Degree in Public…
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LOCATION: Los Angeles, CA, USA
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  • Attending Physician, Providence Tarzana Regional Medical Center
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SIDS and Serotonin
15
Posted in Adoption by Dr. Jeremy F. Shapiro on Jul 09, 2008

Undoubtedly, some of the most heart-breaking messages I receive here on Daily Strength are from parents and caregivers who have lost a child from Sudden Infant Death Syndrome (SIDS).  While the grief and anguish that is expressed always rips through my soul, I also feel useless when posed with the question of "why did this happen?" as no clear etiology is yet known.  But there is hope this will one day change as new research may implicate a brain neurotransmitter with SIDS.



So what is SIDS? SIDS is defined as the sudden death of an infant less than one year of age which cannot be explained after performing a thorough examination of the death.  It is the leading cause of death of infants (1 month to 1 year) with approximately 2,500 each year in just the United States. The peak incidence appears to be between 2 and 4 months of age with a higher frequency in boys than girls. Associations have also been found with mothers who are younger (less than 20), smoke, drink, and/or use drugs during the pregnancy, and receive poor prenatal care. There is also an association with premature and/or low birth-weight babies and following delivery, other risk factors include: smoking in the household, stomach sleepers (hence the Back to Sleep Campaign in the mid 1990s which has reduced SIDS cases by about 50%), and an overheated infant.


And what about this new research? In the most recent publication of the journal Science, researchers have shown that mice who are genetically manipulated to overproduce serotonin (a neurotransmitter involved with the body's temperature regulation, cardiovascular function, muscle contraction, and endocrine system as well as an individual's sleep, mood/depression and overall behavior) died at a young age in a manner similar to those who succumb to SIDS.  Specifically, it appears the mice were unable to control their heart rate and body temperature.  And although this does not provide us a definitive answer as to why SIDS occurs, it certainly opens up avenues that deserve closer inspection.


So my heart extends to all those who have unfortunately and unfairly been touched by SIDS and I leave you all with things that can be done to hopefully reduce its occurrence:



  • Good prenatal care: Having good prenatal care helps reduce the risk of a premature birth which is known as a risk factor for SIDS. Along these lines, no smoking, no alcohol and no drugs during pregnancy.

  • Back to Sleep: We all know of the campaign and its success. And for clarification, this includes both napping and nighttime sleeping.

  • Smoke-free zone: Not only does your child have an increased risk of having more colds and illnesses, there is a known association with SIDS.

  • Temperature: This can sometimes be confusing but I tell parents to keep the temperature in the infant's room comfortable, or at least what they think is comfortable--not too warm.

  • Bedding: The baby needs to sleep on a firm mattress. No big blankets or comforters and no sleeping on pillows or other soft materials. Furthermore, no need for any stuffed animals in an infant's bed.

  • Following up with your physician: Any illness issues with a young infant should be discussed (and possibly seen) with the physician as to appropriate care and precautions.

  • Breastfeeding: There is evidence that breastfed babies have a lower risk of SIDS than formula fed babies.

  • Consider a pacifier: In recent years, there has been some research showing a decreased risk of SIDS in infants who use a pacifier.


 


Dr. Jeremy


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Displaying comments 15-1 of 15
15
This is frustrating to me. I did everything I was suppose to. I never smoked, drank, or did drugs during my pregnancy. I had very good prenatal care. Aiden was not premature, but 11 days late. He was a good weight 8 lbs 1 oz when born. I gained over 50 lbs during my prenancy and never ate anything that was on the no list. I breastfed him for 3 1/2 months, the only reason I stopped is because he was a little piggy and I just wasn't making enough milk for him even though I drank about a gal. or more of water a day like I was suppose to. I always but him on his back to sleep in his bed, but Aiden was 5 days short of being 6 months old and was rolling over and just getting ready to crawl. I got nervous the first time I checked on him and found he had rolled over onto his stomach that I grabbed him and woke him up. I called the doctor right away and he told me it was normal for babies to do that as they get older. I never let anyone smoke around him!! If any of my smoker friends came to see him, I made the wash and sanitize their hands before comming anywhere near Aiden. I always kept the temp at a minimum of 70 F and I had fans running in every room all the time never shut off. He never had any blankets, stuffed animals, or soft stuff in his bed while he was sleeping I thought that was why I registered for a ton of the sleep sacks that are blankets for the babies because no blankets in the crib till much older. He was never sick in the short few months he was here except for a runny nose and a little cough in which I brought him into the doctors office and they told me to give him some baby tylenol it was also dec., jan., and feb during this time which is normal. The only thig is the pacifer..we tried to get Aiden to take it, but he never wanted it. So, please tell me where did I go wrong?! Aiden was a healthy strong little boy with nothing wrong with him. The autopsy showed nothing wrong, all the tests they did came back negative, and it took 8 months, but it was finally declaired SIDS in the middle of October..Aiden passed in Feb. which is what we knew all along because there was no other explanation and thats what the detectives said it was back in Feb. Also, I didn't take him out of the house except to the docs office until he got his first shots, and I wouldn't let any children around him either. So, please tell me then why did my son died of SIDS?! The stats are WRONG!
By AngelAidensMaMa  Nov 30, 2008
14
I agree with Jakob's mommy on this the numbers are badly misrepresented. To this day, my son's cause of death is listed as pnuemonia, however I have yet to get any questions answered at to even wht kind of pnuemonia he even had. I find this disturbing because the investigator who came to my house was bound and determined it was SIDS...none the less he is still gone. There are many who did follow the "Back to Sleep" crap (like me) and are kids are still gone. What I hate is that no where in these prevention reccomendations does it say, even if you do things correctly, your baby can still randomly die. In my county my Nicholas was the 68th (not a typo 68th) baby to ramdomly die in 2007 but yet this gets no attention because of here in my county everyone is worried about the crooked city mayor's extra curricular activity with his chief of staff!!!!! It is angering for sure!
By NickNicksmommykitkat  Aug 28, 2008
13
ok, so I have a few things to say about this. From the research I have done, and what I have heard being involved in the SIDS community since I lost my boy in a similar circumstance (the way the day went when we found him)... I have seen just as many if not more parents who lost their children to SIDS who did not do anything they were not supposed to do, and did everything they were. I have also heard and read many times from many different sources that the medical examiners are not writint SIDS as the cause of death as often as they should. They are putting things like undetermined death. Or Undetermined cause..ect. So the numbers have not gone down as much as everyone thinks, they are missrepresenting the numbers...These are things that I have found. I am in no way saying not to continue to do these things, I am simply saying I am not so sure about the statistics they are giving out...
By Jakobsmommyalways  Aug 21, 2008
12
Every single thing you listed I did not do and my baby still passed. to SUID- Sudden Unexplianed Infant Death- basically same differece. I (of course) didnt smoke drink or use drugs during pergnany. I was extra cautios and had great prenatal care, he was in only a daiper (so not overheated) when he passed, I am older than 20 yrs, he NEVER slept on his stomach, ever. He was breastfed and took a pacifier.

Now that we've cleared that up,... I did take an SSRI during pregnancy for anxiety. If seratonin is linked shouldnt mothers on SSRI"S be thouropugly thourough;y studied. I mean they take seratonin in slective serotonin uptake inhibuters and then there baby overproduces serotin b/c that is what they are used to in the womb so their brain does it once born. please please look at this. Iy seems so obvoius. Seratonin, SSRI's. please.
By ChristieZ  Jul 26, 2008
11
@Aremark
Nick was never around any of this stuff either as many of our baby angels weren't but since they don't know what causes SIDS for sure, the things listed are preventitives and really should be no-brainers anyway.
These are things that are listed to reduce risk they aren't accusations.
Not many of us lost sick babies, Nick was totally healthy and just took an afternoon nap. What I like about this writing by Dr. Jeremy which is that he isn't throwing all back on us like we did or didn't do something to cause this. Alot of this research Dr. Jeremy cited are based on things that they do know and have found, many things may or may not apply to everyone. Based on the things above, many of us did those things and more, my son was not only sleeping on his back with a pacifier but in a SIDS sleep sack, yet he still died. There are many things that aren't known. I do think that SIDS needs more attention for sure!
By NickNicksmommykitkat  Jul 12, 2008
10
Solace and refuge - God is the answer, God is the key, he gave His son for you and me. If you believe, He sees you through no matter what you are going through. Christ the King of Kings. Oh Glory be to the One who gives and takes life. Ponder on the King and he will give you Peace, and understanding that surpasses all Human understanding. All knowing, all powerful. The little children are with their Father in Heaven. May His Peace Be With You Always - Believe in Christ and you will go where your loved ones are.
By torigrace  Jul 12, 2008
9
I don't agree with some of the things you are saying.I am a SIDS mom.My daughter died last year to SIDS.She was away from smoke and i never drink or smoke while pregnant with her.She wasn't premature baby.And i did all i can to protect her and did what people been telling me.And i had good Prenatal care during my pregnancy.She was healthy baby when she died.They couldn't find nothing wrong during the autopsy.This happen all of sudden and i don't think you know quite yet what cause this.Needs more research.And our baby ain't statics they are our angels.
By aremark  Jul 12, 2008
8
Understood.
It just popped in my mind and I had to ask it. I read the link to the article and it seems that they are hopeful that this might be the key in finding the causes (or perhaps at least one) of SIDS. Does the medical community make a distinction between SIDS (when all precautions are taken as stated above) and the and when asphyxiation occurs because of belly-sleeping or bedding?
All of it--terrible.
By DLR77  Jul 11, 2008
7
DLR77-Very interesting question but to make a leap to what you are asking would be difficult following good research techniques.
By DrJeremy  Jul 11, 2008
6
SIDS breaks my heart. Something like this shouldn't even be in existence. if I were ruler of the world, this would no longer be SIDS. Now, if I could just find that magic wand.

Do you think that this new research might to point to the supposed safe usage of certain SSRIs during pregnancy?
By DLR77  Jul 10, 2008
5
thank you for posting this. i lost my baby girl, Claire, to sids in September of last year. just getting sids talked about is a start. most people think "it can't happen to us" but it does. sids needs to be taked about more often, so that a prevention or cure may arise.
danielle
By toosoon  Jul 10, 2008
4
do not use sleep postioners either!
By NickNicksmommykitkat  Jul 09, 2008
3
Thanks for the link Jamiesmommy and thanks for the tip, Leosmommy...very good point.
By DrJeremy  Jul 09, 2008
2
http://news.yahoo.com/s/ap/2008070...
By jamiesmommy  Jul 09, 2008
1
Very well written. I would perhaps also advise parents to remove the bumper pads in the crib & consider not co-sleeping either at night time or during naps.
By Leosmommy  Jul 09, 2008
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