The essence of the new study published in the renowned medical journal JAMA:
Brainstem Serotonergic Deficiency in Sudden Infant Death Syndrome
Jhodie R. Duncan, PhD; David S. Paterson, PhD; Jill M. Hoffman, BS; David J. Mokler, PhD; Natalia S. Borenstein, MS; Richard A. Belliveau, BA; Henry F. Krous, MD; Elisabeth A. Haas, BA; Christina Stanley, MD;Eugene E. Nattie, MD; Felicia L. Trachtenberg, PhD; Hannah C. Kinney, MD
The study was conducted by researchers from the Children’s Hospital in Boston and was published in the renowned Journal of the American Medical Association (JAMA), and it suggests that the possible cause of infants’ death from SIDS is a low level of serotonin in the brainstem.
In the study, the researchers compared the brainstem of infants who died of SIDS with brainstems of infants who died from other known causes. They discovered that in the infants who died of SIDS, the level of serotonin in the brainstem was 25% lower, and the enzyme tryptophan hydroxylase, in charge of the synthesis of serotonin, was 22% lower compared to the control group. The receptors’ level of connectedness to the serotonin was lower in three different areas of the brainstem among 29-55% of the infants who died of SIDS. These findings indicate that a lack of serotonin in the brainstem may be the cause of the infants’ mortality.
Furthermore, researchers found that in 99% of the infants who died of SIDS there were one or more risk factors, such as being placed on their stomach. Two or more risk factors were found in 88% of the infants. Hence the importance of creating a safe sleeping environment and avoiding factors which endanger the infants’ lives. Parents and caregivers should be aware and alert for taking proper care of the infant, because infants who suffer from this defect appear completely healthy and there is no way of telling which one of them may be the victim of SIDS. These finding support the theory that infants who die of SIDS suffer from a hidden condition which is only expressed under specific circumstances which cause a distress during sleep.
The team of researchers from Harvard University and other researchers continue to investigate and examine whether the genetic defect, or the circumstances of its creation are environmental. In light of the assumption that the defect is created in the fetus’ brainstem during pregnancy, it is very important to avoid smoking and alcohol consumption during pregnancy.
Serotonin is a neurotransmitter, which connects between the neurons in the brainstem and is in charge of controlling and regulating vital functions such as breathing, blood pressure, body temperature and the awakening mechanism. Infants with a serotonin deficiency suffer damage to the ability to wake up and respond to life threatening conditions when they are asleep, such as an increase in the level of carbon dioxide while sleeping on their stomach. Healthy infants who do not suffer from the defect recognize the lack of oxygen, wake up and their body can overcome the problem. An infant who suffers from a serotonin deficiency will not wake up and will die in his sleep.
Dr. Anat Shatz adds:
Unfortunately, there is no accurate data available regarding Israel, because autopsies are not performed, as required for diagnosing SIDS, in order to deny all other possible causes of death.
SIDS is the leading cause of death of infants between the ages of one month and one year. The Central Bureau of Statistics estimates the number of sudden and unexplained deaths of infants at app. 40-60 a year. According to data published in previous years, the non-Jewish population suffers from 2 to 3 times more cases of a sudden and unexplained death during sleep, and in the Bedouin population – 4 times more.
Instructions for protecting the baby’s health and reducing the risk of SIDS
1. The baby should be placed only on his back whenever he is asleep (when awake he should get enough tummy time under adult supervision)
2. The baby should be placed on a firm mattress and not a soft surface (a surface which does not sink under light pressure)
3. The baby’s environment should be smoke free (mothers are highly recommended to avoid exposure to smoking even during the pregnancy)
4. Over heating should be avoided – the recommended temperature is 22 degrees Celsius
5. The baby should be placed to sleep in a separate bed in the parents’ room until the age of 6 months (bed sharing should be avoided)
6. The baby’s bed should be kept free and clean of any object, including toys, pillows, and bumper pads
7. The blanket should be tight under the baby’s shoulders, and the baby should be placed on the lower third of the bed in a Feet to Foot Position
8. It is recommended to breast-feed the baby and give him a pacifier when he is put to bed (after the age of one month, when he is already accustomed to breast-feeding)