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Infants' deaths become less mysterious.

Getting a baby to sleep can require everything from lullabies to car rides. And deciding the best sleeping position for infants has proved almost as difficult for parents -- and scientists.

Studies suggest that sleeping position may be a life-or-death issue for some infants. Researchers in four countries have found that as a smaller proportion of children slept prone, the rate of sudden infant death syndrome (SIDS) fell. Defined as the unexplained death of healthy infants, SIDS is the leading cause of death of Western children 1 month to 1 year old. As a result of these studies, many physicians now contradict the advice of previous decades and say babies should sleep only on their sides or backs (SN: 7/2/94, p.13).

Nevertheless, "there is by no means a consensus" that changing how children sleep reduces the incidence of SIDS, assert Terence Dwyer and his colleagues from the University of Tasmania in Australia in the March 8 Journal of the American Medical Association (jama). But their new data may convince more doctors to warn of the dangers of infants sleeping prone.

Dwyer and his colleagues have analyzed data on 1,330 infants born each year in Tasmania since 1988. They are seeing fewer cases of SIDS, largely because fewer infants sleep prone, they say. The rate of SIDS decreased from 7.6 to 4.1 per 1,000 live births between 1988 and 1992. During that time, the percentage of 1- month-old babies sleeping prone dropped from almost 30 percent to 4 percent.

In a separate study in Jama, Hillary Sandra Klonoff-Cohen and her colleagues at the University of California, San Diego find that sleeping position is less important than another possible cause of SIDS -- breathing cigarette smoke.

The scientists interviewed 200 parents of children under age 1 who died of SIDS and 200 parents of healthy babies who were similar to the SIDS victims in age, race, and other characteristics. Most children who die of SIDS are 2 to 4 months old.

The team found that about two-thirds of both the youngsters who died of SIDS and the healthy babies routinely slept on their abdomens. However, 80 percent of the SIDS victims were prone when they died.

Exposure to smoke also puts children at risk of SIDS, Klonoff- Cohen and her group report. Infants breathing the smoke of others in the same house were 3 1/2 times more likely to die of SIDS than the youngsters not exposed to smoke in their homes, they say. Smoke may impair the control of children's breathing, scientists suggest.

"In view of these [studies'] results, how should health care professionals advise parents?" Marian Willinger of the National Institutes of Health in Bethesda, Md., asks in an accompanying editorial. She recommends keeping babies away from smoke as much as possible and off their stomachs when sleeping.
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Title Annotation:sudden infant death syndrome linked to sleeping position and exposure to cigarette smoke
Author:Adler, Tina
Publication:Science News
Date:Mar 11, 1995
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