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posted by janrinok on Tuesday May 10 2022, @05:43PM   Printer-friendly

A marker that could help identify babies at a higher risk of sudden infant death syndrome (SIDS) has been discovered by Sydney researchers.

The study conducted by The Children's Hospital Westmead confirmed what had long been suspected — that SIDS victims were unable to wake themselves up — but it went one step further by providing the why.

The enzyme butyrylcholinesterase (BChE) plays a major role in the "brain's arousal pathway" and was found at "significantly lower" levels in babies who die of SIDS.

[...] "Usually, if a baby is confronted with a life-threatening situation, such as difficulty breathing during sleep because they're on their tummies, they will arouse and cry out.

"What this research shows is that some babies don't have this same robust arousal response.


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  • (Score: 4, Insightful) by JoeMerchant on Tuesday May 10 2022, @07:14PM (23 children)

    by JoeMerchant (3937) on Tuesday May 10 2022, @07:14PM (#1243897)

    SIDS survivors (all of us above one year of age) are not "superior" in any way to SIDS victims, except perhaps those SIDS victims whose parents exhibit Munchausen syndrome by proxy - probably better to not let their psychology imprint on young developing minds.

    There are literally millions of ways to allow a human baby to die of neglect, and we are learning more all the time. A common measure of societal development is the infant mortality rate. This particular trick: keeping your baby breathing until age one mostly by putting them on their back to sleep... that's just one more way, of millions, that civilized humans care for their young.

    The mechanism of (primary) SIDS is an inability of the infant to respond to CO2 buildup in the bloodstream. Common thinking is that sleeping face down causes an accumulation of CO2 that the developing brain doesn't adequately respond to, but it's more complex than that. As most parents know, infants have overly flexible necks, something most don't know is that the face down posture is often accompanied by a chin-up pose which puts a pinch on the blood supply to the back of the brain - where the CO2 receptors are. Put all these factors together, along with the new research on low BChE, and you have a good mechanism to trigger advanced education in SIDS causes and prevention for the infants whose parents need it the most.

    But, hey, if you want to pop out some kids and leave them by a riverbank while you go forage for berries, I'm sure after a few thousand generations you'll breed up more robust infants. Probably dumber adults, too, since they don't have to be smart enough to care for their young.

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  • (Score: 2) by HiThere on Tuesday May 10 2022, @07:28PM (16 children)

    by HiThere (866) Subscriber Badge on Tuesday May 10 2022, @07:28PM (#1243900) Journal

    You are making assumptions that may or may not be true. But they are assumptions. We don't KNOW that SIDS involves neglect, that's just a common assertion. This marker suggests that the assertion may be incorrect, but it isn't proof.

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    • (Score: 4, Interesting) by JoeMerchant on Tuesday May 10 2022, @07:39PM (6 children)

      by JoeMerchant (3937) on Tuesday May 10 2022, @07:39PM (#1243902)

      We don't KNOW that SIDS involves neglect, that's just a common assertion.

      I'll tell you what we do know: a 1994 study of infants identified as high risk for SIDS, including younger siblings of SIDS victims, discovered a significant occurrence of Munchausen syndrome by proxy IN THE STUDY SUBJECTS. With the NICHD looking over their shoulders with regular home visits and in-home electronic monitoring, multiple sets of parents STILL intentionally smothered their infants to death. That's not neglect, that's abuse and murder, and it happens - though it is thankfully rare in the broader population.

      What is neglect? Up until 1993 or so, putting your infant on their back to sleep might have been considered - in some circles - as neglect. Thinking at the time was: babies throw up - on their backs they are at greater risk of aspiration of vomit and that might cause them to die of choking. Research at the time debunked that little tidbit of "common knowledge" and the "back to sleep" result of that research is still holding today as the best recommendation to prevent SIDS. With this BChE enzyme knowledge, at some point in the future parents who have been educated in the elevated risks facing their newborn but still fail to take actions to mitigate them might be considered as neglectful of their infant's needs.

      There's a huge gap between what is legally actionable neglect/abuse and what is commonly considered neglect, but the more we know, the more things will enter the realm of "should have known better, that regrettable result was avoidable, the parents were neglectful."

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      • (Score: 1, Interesting) by Anonymous Coward on Tuesday May 10 2022, @07:54PM (2 children)

        by Anonymous Coward on Tuesday May 10 2022, @07:54PM (#1243908)

        The "back to sleep" movement had one harmful effect: an explosion in the number of cases of plagiocephaly.

        https://en.m.wikipedia.org/wiki/Plagiocephaly [wikipedia.org]

        In typical fashion, medicine creates a problem, denies the problem, and eventually someone comes up with a treatment for the problem medicine created:

        https://www.uofmhealth.org/conditions-treatments/rehabilitation/plagiocephaly-helmets [uofmhealth.org]

        Image:
        https://i.pinimg.com/736x/33/fb/f8/33fbf8734e2064c69ba15a4f5c582a2a.jpg [pinimg.com]

        This happened to my firstborn children who were twins.

        • (Score: 3, Insightful) by JoeMerchant on Wednesday May 11 2022, @11:05AM (1 child)

          by JoeMerchant (3937) on Wednesday May 11 2022, @11:05AM (#1244016)

          Every medical intervention, no matter how benign, carries risks of significant side effects. Even (perhaps especially) vaccines. They are all risk vs benefit decisions, and decisions are usually better based on past observations than projections of what people think will happen in the future.

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          • (Score: 0) by Anonymous Coward on Thursday May 12 2022, @12:40AM

            by Anonymous Coward on Thursday May 12 2022, @12:40AM (#1244223)

            I just wanted to clarify that my first two kids got helmets because I knew their doc was full of it when he didn't bring up their misshapen heads and when I did, insisted that the problem would go away on its own, or maybe with just rotating their resting head position (while still on their backs). He could not admit that "back to sleep" was at fault. Independent research (thanks, Internet!) turned up the (at the time) new solution of helmets. They look fine now, but one has a slightly off skull shape (a bit more triangular than oval when viewed from the top, but symmetrical) that is not immediately evident until you try to find a bike helmet that fits.

            Never let a doctor try to buffalo you out of what you see and your common sense. They can push a "company line" with the best of them. Remember, "best medical practice" goes in fads, unfortunately.

      • (Score: 2) by sjames on Wednesday May 11 2022, @01:50AM (2 children)

        by sjames (2882) on Wednesday May 11 2022, @01:50AM (#1243981) Journal

        I wonder if the Munchausen by proxy finding was due to self selection? Commonly, Munchausen by proxy is seen in connection with a desire for attention from medical staff (among other things). Joining a study would be a fairly benign way to accomplish that. Apparently, for some it wasn't enough.

        Some parents of SIDS victims may be negligent, others conscientious but tragically mis-informed (bad advice dies hard).

        • (Score: 2) by JoeMerchant on Wednesday May 11 2022, @02:34AM (1 child)

          by JoeMerchant (3937) on Wednesday May 11 2022, @02:34AM (#1243987)

          I believe there were on the order of 500 enrollees and two deaths, one clearly attributable to Munchausen syndrome, and the other likely. The electronic monitor was effective, alarmed several times that might otherwise have been a significant event. The deaths were all off monitor. Both the effectiveness of the monitor and the MBPS deaths were politically ticklish topics that the official CHIME study reports avoided.

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          • (Score: 0) by Anonymous Coward on Wednesday May 11 2022, @10:41PM

            by Anonymous Coward on Wednesday May 11 2022, @10:41PM (#1244191)

            You believe? Both of those statements about enrollees and deaths are wrong. As is your conclusions. At least you can almost admit you are just making shit up to fit your opinion.

    • (Score: 3, Interesting) by JoeMerchant on Tuesday May 10 2022, @07:47PM (8 children)

      by JoeMerchant (3937) on Tuesday May 10 2022, @07:47PM (#1243907)

      There are literally millions of ways to allow a human baby to die of neglect

      We don't KNOW that SIDS involves neglect, that's just a common assertion.

      In the above, I'm not being specific about SIDS. Your baby can die of neglect in the following ways:

      • being left out in the sun too long
      • being forgotten in a child seat in the back of a car parked in a hot (or cold) parking lot
      • being set down on the ground in copperhead snake country
      • being allowed to toddle off the balcony of a high rise
      • being ignored too long when crying of thirst
      • being left to play with sharp metal toys near live electrical outlets
      • being allowed to play near old-school windowshade cords
      • ...

      There are literally millions of ways to "just have a short lapse of attention" and end up with a dead baby. There may not be criminal intent, there may not be malice, there may or may not be ignorance involved, but nothing changes the fact that we're fragile beings very dependent on our caregivers for several years after birth.

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      • (Score: 0) by Anonymous Coward on Tuesday May 10 2022, @08:12PM

        by Anonymous Coward on Tuesday May 10 2022, @08:12PM (#1243916)

        Yes, around here the building code specifies a maximum opening to prevent much of that. But anything predating the change of not permitted could still carry that risk. Then there's all the used baby gear that might have been recalled, but not sent back for repair it replacement.

      • (Score: 0) by Anonymous Coward on Tuesday May 10 2022, @08:24PM (2 children)

        by Anonymous Coward on Tuesday May 10 2022, @08:24PM (#1243917)

        >> nothing changes the fact that we're fragile beings very dependent on our caregivers for several years after birth.

        Darwin survived childhood and went on to become a very productive adult and had many children, none of whom died of SIDS. He was just doing his part to improve the gene pool.

        • (Score: 0) by Anonymous Coward on Tuesday May 10 2022, @11:22PM (1 child)

          by Anonymous Coward on Tuesday May 10 2022, @11:22PM (#1243960)

          Two of his children died in infancy.

          • (Score: 2) by sjames on Wednesday May 11 2022, @01:55AM

            by sjames (2882) on Wednesday May 11 2022, @01:55AM (#1243982) Journal

            As did many others. 19th century medicine and public health weren't nearly what they are today.

            Of course, the U.S. seems determined to return to that era.

      • (Score: 3, Interesting) by Kell on Tuesday May 10 2022, @11:07PM (1 child)

        by Kell (292) on Tuesday May 10 2022, @11:07PM (#1243953)

        For a long time I too had considered SIDS to truly mean "Socially Inconvenient Death Syndrome", and that it was a neat reporting name for incompetent parents or attention-seekers who had accidentally or purposefully brought about their child's death (see also, "fan death" in South Korea). However, this result that there is actually a meaningful biomarker strongly suggests that there might actually be an additional mechanism at play in addition to the mechanisms you've already identified. It can be both: there legit can be parents whose infant unexpectedly dies and which is heartbreaking, and there can be useless or malevolent parents who use SIDS as a cover for their behaviour. This result helps both those things: it can prevent 'true' SIDS deaths and make it harder for assholes to pretend that their infants death was congenital.

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        • (Score: 2) by JoeMerchant on Wednesday May 11 2022, @02:29AM

          by JoeMerchant (3937) on Wednesday May 11 2022, @02:29AM (#1243986)

          The Munchausen deaths in the NICHD study were not prosecuted nor proven beyond a reasonable doubt, but the likelihood was extremely high and the parents were referred to counseling.

          The more we learn, the more we know, and things do improve; at least as long as we continue to pay attention to the data and ignore the rest of the noise.

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      • (Score: 2) by Freeman on Wednesday May 11 2022, @03:18PM (1 child)

        by Freeman (732) on Wednesday May 11 2022, @03:18PM (#1244068) Journal

        Being out of sight in the kitchen and having fallen from the top of the refrigerator was one that I'd never heard, but one that I suddenly was very acutely aware of. When my wife told me that our 18 month old had climbed on top of the fridge. At that point, I was a bit less worried about it. Probably due to the chronic lack of sleep that a child brings and not having actually witnessed it myself.

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        • (Score: 2) by JoeMerchant on Wednesday May 11 2022, @05:58PM

          by JoeMerchant (3937) on Wednesday May 11 2022, @05:58PM (#1244122)

          They survive some amazingly scary looking things, and sadly occasionally die for stuff that seems near impossible.

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  • (Score: 2) by cmdrklarg on Wednesday May 11 2022, @04:31PM (5 children)

    by cmdrklarg (5048) Subscriber Badge on Wednesday May 11 2022, @04:31PM (#1244088)

    My only comment I can give with regards to back vs. front sleeping was that when my kid got big enough to flip himself over he would sleep on his front, facing one side or the other. He was a PITA to get to sleep before that when we'd put him on his back. We'd keep putting him on his back out of SIDS caution, and he'd flip over

    He was also a bit unusual in that he wanted his formula cold, right out of the fridge. If we warmed it up first he'd fiddle around until it had cooled off again. One night I tried giving it to him cold and he snarfed it right down.

    Must have done it right since he just graduated college.

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    • (Score: 2) by JoeMerchant on Wednesday May 11 2022, @06:01PM (4 children)

      by JoeMerchant (3937) on Wednesday May 11 2022, @06:01PM (#1244124)

      Must have done it right since he just graduated college.

      You at least get a "passing parent" grade, the real tests are yet to come: will he remain financially independent from here forward? Will he support your transition to assisted living?

      Be nice to your kids, they will choose your nursing home. Steven Wright

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      • (Score: 2) by cmdrklarg on Wednesday May 11 2022, @09:39PM (3 children)

        by cmdrklarg (5048) Subscriber Badge on Wednesday May 11 2022, @09:39PM (#1244175)

        He's already financially independent (okay 95%, we still pay for part of his cell phone and car insurance, mainly because he's on the ex's plans. He does contribute to those however). We did spend a little cash helping with college early on, but he's paid for the rest by working and a modest amount of student loans (grad school's gonna change that).

        I'm not worried about him. He's an adult and acts like one, and we get along.

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        • (Score: 2) by JoeMerchant on Wednesday May 11 2022, @09:46PM (2 children)

          by JoeMerchant (3937) on Wednesday May 11 2022, @09:46PM (#1244179)

          Congrats - and always remember: it's more luck than your skill in parenting. Sure, you could have screwed it up, but you also could have done everything right and gotten nowhere near the son you have today.

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          • (Score: 2) by cmdrklarg on Thursday May 12 2022, @02:51PM (1 child)

            by cmdrklarg (5048) Subscriber Badge on Thursday May 12 2022, @02:51PM (#1244408)

            Oh absolutely... he is a very even tempered, intelligent, empathetic person and was never much trouble while growing up. Not perfect (who is?) but I like to think had a hand in raising him right.

            --
            The world is full of kings and queens who blind your eyes and steal your dreams.
            • (Score: 2) by JoeMerchant on Thursday May 12 2022, @04:53PM

              by JoeMerchant (3937) on Thursday May 12 2022, @04:53PM (#1244457)

              Oh, as I said: parents are more than capable of screwing their kids up - so definite kudos for not doing that! And giving all the opportunities for growth and learning and self-sufficiency and all that, not doing all those things is one of a million ways you can screw your kids up. I've just known too many great parents who are doing everything right and still end up with basket case kids (including my younger brother...)

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