LEAH HENRY-TANNER: What is unexpected infant death–
SUID? You'll see these terms referred to
quite often, so it's helpful to get– to know what SUID is,
as versus SIDS. So, SUID is sudden unexpected death.
So, it's when a baby dies unexpectedly.
So, SUID covers all unexpected infant deaths–
the explained and unexplained. So this is– or unexp– Explained
infant deaths would be something like poisoning,
or any kind of injury, a metabolic disorder,
neglect or homicide, hypo- or hyperthermia,
or accidental suffocation. Those are– can all be
explained by a medical examiner or a coroner.
Unexplained infant deaths are deaths like SIDS–
sudden infant death syndrome, or causes known–
unknown or unspecified, like for example,
"cannot rule out suffocation from an unsafe sleep environment.
We'll have some activities that will go over what
an unsafe sleep environment would be, but it's something like
soft bedding, or a lot of materials in the baby's sleep area,
or toys, and stuff like that.
So, this is just another way of looking at the different
types of sudden unexpected infant death. So, this is the over-arching
umbrella, and then all the different
unexpected ways babies can die.
And so much– so many
of deaths get classified as unknown,
which is really challenging to try to figure out what
you can do to prevent those. Approximately 4200 babies
die of sleep-related, sudden unexpected infant deaths,
and about half of those sudden unexpected infant deaths are categorized
as SIDS. So, other death terms
are like sleep accidents, such as accidental strangulation
accidental suffocation, overlay,
which is when a parent, or who ever's
sleeping– sharing a bed with the baby accidentally rolls over
on the baby, and then wedging or entrapment.
So, like baby is sleeping on an adult surface and then
gets trapped between the bed and the wall. GERADINE SIMKINS: One of the things we're finding out,
is that different communities are using different terms.
Sometimes the term sudden infant death syndrome does not resonate with people,
and people say "My baby doesn't have a syndrome. My baby's healthy."
You know that "there's nothing wrong with my baby." and so, for example,
like in Michigan, the Michigan Healthy Start Project–
the tribes involved in the Michigan Healthy Start Project, decided to use the term
accidental infant death. That that term was clear–
it resonated with people– Accident. Infant. Death.
And that some of these other terms– strangulation, suffocation,
sudden infant death syndrome were not as– didn't speak
to the people as much as accidental infant death, and that's the term they're using.
LEAH HENRY-TANNER: Now, we'll really delve into
what SIDS is. SIDS is the sudden death of an infant
that's younger than one years old that remains unexplained
after a thorough case investigation that includes
a complete autopsy, an examination of the death scene,
and then a review of the clinical history
of the infant. And so, as Gera said earlier,
SIDS is, um... SIDS is a
catch-all category. So, if the medical examiner or coroner
can't really determine if it was an accidental
suffocation or entrapment or something like that, they'll just lump
it into SIDS. But only after all of these steps have been–
have been undertaken. About 2226
babies died from SIDS in the US in 2009.
SIDS rates are declining in the US, but there are
still disparities that exist among certain communities.
There's still so much that we need to do to reduce the risk of SIDS,
'cause we want every baby to have a chance to grow up and
be successful members of our community.
So, SIDS is the leading cause of infant death between one month
and one year of age. It's a sudden, silent medical
disorder. It's only determined after an autopsy,
examination of the death scene, and a review of the medical records,
and it's 2 to 4 times more likely to occur
in American Indian and Alaska Native families. Since we don't know
the cause, we can't prevent SIDS, but we do know
risk factors. So, what we can do is reduce the risk of SIDS.
SIDS is not preventable, like I just mentioned,
but risks can be reduced. It's not caused by suffocation,
and it's not caused by vaccines.
SIDS is not contagious. It's not the result of
child abuse or neglect. It's not caused by cribs.
It's not caused by choking or vomiting. And, it's not the cause of
every unexplained infant death– or unexpected infant death.
So, this is just a
another data slide showing the proportion of deaths due to SIDS
in urban Indian communities. So, you can see
it's statistically significantly higher
than it is for all other races. We have to have
data to tell our stories, because... um...
that's what funders are requiring. But, you can see it's
not even .6 for all other
races, but for American Indian/Alaska Native families
it's almost 1.4. And, this is broken down–
SIDS rates broken down by the northern tier area,
and you see here's Portland, this is our area, and you can see
here's US all races. And, again
there's statistical significant difference.
So, as I mentioned earlier, there's been a lot of
research going on into trying to figure out what causes SIDS.
There was a study that came out
two/three years ago that was looking at brainstem abnormalities
and they published– I can't remember what journal they published in–
but they had some really interesting findings that came out of that.
There's also some genetic susceptibility
that people are looking at.
They're also looking at things that might affect the infant's
lack of coordination of the vital systems, such as
breathing and blood pressure, temperature and reflexes
and then waking and sleeping. But, these alone aren't
likely to cause SIDS. There's a whole lot of
other factors that go into it.
GERADINE SIMKINS: Studies from researchers at Children's Hospital
in Boston showed that the brains of babies who died of SIDS had abnormalities
in the nerve cells that make serotonin.
Now, that may or may not mean anything to you, depending on what you know about serotonin,
but serotonin is a chemical messenger and a neurotransmitter.
And, it works in the part of the brain that controls functions
like breathing, body temperature blood pressure,
heart rate, and waking from sleep. I'm on page 26, if anybody
wanted to look that up. So, this serotonin–
when serotonin is missing, one of the things that may
not happen is the baby's breathing may not be regulated well.
Um... the person who made our prayer, what was your name?
Linda? Linda was mentioning something
about her grandson who.. um.. you know... didn't breathe–
couldn't breathe during sleep– is that how it was?
So, that's one of the things that they're finding out in terms of
um... susceptibility.
Is that some babies are born with some abnormalities–
some brainstem abnormalities, where the normal mechanisms
for breathing and temperature aren't there.
So, what the triple risk theory tells us is that there's critical period
where babies develop, both fetally and
when they're newborns. and during that time, for example,
say we have a baby that has
this– has this– has a lack of serotonin or a very
diminished serotonin. So, this baby has a risk factor already, right?
His brain– or her brain does not tell her
to breathe regularly, so when she goes to sleep, she goes too deeply
into sleep. Right? So, that's a critical development period.
Then you have some outside stressors.
Say the mom smokes, or say the infant lives in an environment
where there's smokers, and we have
a lot of secondhand smoke. Say... um...
we have a mom who has been using alcohol
her entire pregnancy. So we have some– we have some stressors.
Then we have a vulnerable infant. Say that infant lives in a
household that is highly stressed– that it's unsafe.
It's too cold or too hot. It has..um...
you know, it has something in that environment that makes that infant more
vulnerable. So, these three things together–
the fact that we have a critical development period where the baby's lacking something,
the fact that we have outside stressors, usually behavioral things, such as smoking
drinking, that kind of stuff. Then we have a vulnerable infant. Poverty.
Right? Um... those kinds of issues. Those three things
together are... are... is one of the theory that causes
SIDS That to have this alone, or to have this alone,
or to have this alone, may not make a baby at high enough risk
to cause SIDS. So, when you have infants that have these three things in place
they're more likely to die of SIDS.
So, for example, um...
a baby like that, who the parents
over-bundle and overheat, and has a brain
stem issue where he doesn't he or she doesn't wake up–
That's a baby that's at higher risk. Then you have a smoker
or somebody who gets into bed who is using alcohol and is rolling too close
to the baby, perhaps smothering the baby.
Those are the kinds of things– we have a compounding situation–
is typically what we're finding out is what causes SIDS.