ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Friday, July 26, 1996 TAG: 9607260058
SECTION: NATIONAL/INTERNATIONAL PAGE: A-4 EDITION: METRO
SOURCE: Los Angeles Times
Exposure to tobacco smoke is a much bigger risk factor for sudden infant death syndrome (SIDS) than was previously suspected, and keeping newborns away from tobacco smoke could reduce the death rate from SIDS by nearly two-thirds, British researchers report Friday.
In the largest study of its kind, encompassing more than 350,000 births over a two-year period, the team also found that allowing an infant to sleep on its side doubles the risk of death compared to sleeping on its back, a previously unsuspected finding.
As many as one-third of parents in England have adopted side-sleeping as a compromise because of the high risk of SIDS previously linked to sleeping face down, according to the study. Sleeping on the side reduces the risk of SIDS, but not as much as sleeping on their backs, the researchers said.
Reporting in the British Medical Journal, the team said that in addition to being kept away from tobacco smoke completely, if infants were also placed on their backs to sleep and wrapped only in light blankets, the SIDS death rate in England could be reduced to less than one-quarter of what it is today.
The reduction would be even higher in the United States because so many infants here are still allowed to sleep on their stomachs, said Dr. Peter Fleming of the University of Bristol, who headed the study.
With efforts already being made to control infant sleep positions in the United States, smoking is becoming the next concern that needs to be addressed, said neurobiologist Marian Willinger, special assistant for SIDS at the National Institute of Child Health and Human Development.
For every hour spent each day in a room where people smoke, the risk increases 100 percent, Fleming said. If an infant spends four hours per day in such a room, he or she is four times as likely to die of SIDS as a child not exposed to tobacco smoke.
(Begin optional trim)
The new data are particularly important, Willinger said, because this is the first large study conducted in a population where the majority of infants no longer sleep on their stomachs. As the result of an intensive Back to Sleep campaign conducted in England, the number of SIDS deaths there has dropped by two-thirds over the past five years.
Eliminating the deaths linked to sleeping position makes it much easier to measure the importance of other factors, she said.
The United States is in the midst of a similar campaign that has resulted in a 30 percent reduction in SIDS deaths over the last two years - from a baseline of about 6,000 deaths per year down to about 4,200. The goal is at least a 50 percent reduction.
Current estimates are that about 29 percent of infants in the United States are still permitted to sleep on their stomachs and 32 percent on their sides, Willinger said. Infants below the age of 6 months are generally not able to roll over on their own; when placed on their backs, they stay there.
(End optional trim)
Other risk factors for SIDS include a lack of prenatal care, low birth weight and drug and alcohol abuse by the parents, but these risks are considered lower than those for sleep position and tobacco exposure.
As sleep position is being brought under control, researchers and advocates are turning to other risk factors now becoming relatively more important, and tobacco is first on the list. The new study ``is a clarion call to parents to stop smoking around their babies and to not let anyone else do so either,'' said Phipps Y. Cohe, director of national public affairs for the SIDS Alliance.
Apart from sleeping position, an equally large risk was associated with wrapping the children heavily, having loose bed clothing that can entangle the infant or using heavy comforters, which allow the children to overheat. Parents should place infants in a ``feet-to-foot'' position, with their feet against the bottom of the bed, so they cannot slip down under the covers, he said.
That measure, and not using heavy wrappings would reduce the death rate by another 17 percent, Fleming predicted.
But it was the risk associated with tobacco that was ``really astonishing,'' Fleming said. ``The risk of dying increases directly in proportion to the number of cigarettes smoked in the household and the number of hours per day that the infant spends in a room where someone has smoked.''
(Optional add end)
The study also investigated bed-sharing - sleeping with a parent - which some studies had suggested was statistically linked to a SIDS. The team found that there was no increased risk associated with bed-sharing if the mother does not smoke. If the mother smokes, however, an infant who sleeps with her is four times as likely to die of SIDS - perhaps from toxins in her breath or emanating from her clothing.
If all parents would have their children sleep on their backs, keep them away from tobacco smoke and control bedding, Fleming said, ``our calculations suggest that we could reduce cot (crib) deaths by 75 percent.'' That would be a 90 percent reduction from the rate 5 years ago before the Back to Sleep campaign began, he said.
AP-NY-07-25-96 2019E |Los Angeles Times|
Exposure to tobacco smoke is a much bigger risk factor for sudden infant death syndrome than was previously suspected, and keeping newborns away from tobacco smoke could reduce the death rate from SIDS by nearly two-thirds, British researchers report today.
In the largest study of its kind, encompassing more than 350,000 births over a two-year period, the team also found that allowing an infant to sleep on its side doubles the risk of death compared to sleeping on its back, a previously unsuspected finding.
As many as one-third of parents in England have adopted side-sleeping as a compromise because of the high risk of SIDS previously linked to sleeping face down, according to the study. Sleeping on the side reduces the risk of SIDS, but not as much as sleeping on their backs, the researchers said.
Reporting in the British Medical Journal, the team said that, in addition to being kept away from tobacco smoke completely, if infants also were placed on their backs to sleep and wrapped only in light blankets, the SIDS death rate in England could be reduced to less than one-quarter of what it is now.
The reduction would be even higher in the United States because so many infants are still allowed to sleep on their stomachs, said Dr. Peter Fleming of the University of Bristol, who headed the study.
With efforts already being made to control infant sleep positions in the United States, smoking is becoming the next concern that needs to be addressed, said neurobiologist Marian Willinger, special assistant for SIDS at the National Institute of Child Health and Human Development.
As for smoking's effects, Fleming said that for every hour spent each day in a room where people smoke, the risk increases 100 percent. If an infant spends four hours per day in such a room, he or she is four times as likely to die of SIDS as a child not exposed to tobacco smoke.
LENGTH: Long : 131 linesby CNB