Sudden Infant Death Syndrome Breakthrough!

Sudden Infant Death Syndrome (SIDS) is the unexplained death, typically during sleep, of a baby under the age of one year who shows no signs or symptoms of any illness or medical condition. According to a recent report by the Center for Disease Control (CDC), over 37 percent of infant deaths in the United States can be attributed to SIDS. 

Due to public health campaigns addressing proper infant sleep position, overheating and the cessation of maternal smoking, the number of worldwide cases of SIDS has significantly dropped. However, the rate of SIDS cases still remains high – nearly 50 percent of all post neonatal deaths in Western countries, according to the Sydney Children’s Hospital Network.

The good (or more aptly put – amazing) news is that a team of Australian researchers have made the world’s first SIDS research breakthrough – identifying a biomarker that could help detect those infants more at risk of SIDS. As a result of this groundbreaking discovery, parents’ very possibly worst worry of not knowing if their baby will wake from a normal night’s sleep or an ordinary nap, may cease to exist.

This research team was led by Honorary Research Fellow at Children’s Hospital at Westmead in Australia (which is part of the Sydney Children’s Hospital Network), Dr. Carmel Harrington, who lost a child 29 years ago to SIDS. After losing her son, Damian, Dr. Harrington initiated a funding campaign called Damian’s Legacy and has dedicated her life to SIDS research. Her hope is to eliminate SIDS in the future by gaining valuable knowledge and developing innovative, preventative, lifesaving measures; as well as provide grieving parents answers for the heartbreak caused by SIDS in the past.

It has long been thought that a baby’s cry will let you know if they are uncomfortable, even to the point of experiencing a life-threatening situation, such as difficulty breathing. This game-changing study, however, shows that babies with a Butyrylcholinesterase (BChE) deficit are inherently vulnerable to failure in the autonomic nervous system (which controls natural unconscious and often defensive responses of the body) and, therefore, do not share that same response.

According to specific study findings, BChE plays a critical role in the brain’s arousal pathway, leading these researchers to believe that BChE deficiency indicates an arousal deficit thereby reducing the infant’s ability to wake or respond to its external environment. 

This SIDS study, published in May 2022 by The Lancet’s eBioMedicine, measured BChE across the board in infants with the same date of birth and gender. More specifically, BChE activity was analyzed in 722 dried blood spots (DBS) approved by parents to be taken at birth as part of a newborn screening program. 

Of the 722 DBS, 655 were healthy infants who survived, 26 babies within this study died later from SIDS and 41 of the infants died later from other causes. The study further proves that the BChE levels were significantly lower in babies who died from SIDS compared to those babies who did not die and infants who died from other causes. 

As a result, we now know that BChE is involved in the lack of arousal that causes SIDS. Consequently, it is a natural inference that we will be able to change the outcome for infants with a BChE deficiency, making SIDS a thing of the past. 

After identifying this biomarker, the next step for researchers is to begin screening newborns for the BChE biomarker and initiate research and development for effective interventions in any case where the BChE enzyme deficiency is present. According to Dr. Harrington, she expects that her team’s breakthrough will help forge a pathway toward preventing future tragedy within the next three to five years. 

While the BChE biomarker discovery is an enormous breakthrough as it relates to SIDS, it is still recommended to implement safe sleeping practices for infants – placing them on their back, keeping the head and face uncovered during sleep and keeping the crib as bare as possible.

The New England Journal of Medicine states that there is still work to do in the understanding and prevention of SIDS. For instance, research has also indicated that abnormal levels of serotonin in the nervous system may also play a part in SIDS. So, even if the BChE deficits are confirmed to play a major role in SIDS, the entire solution for eliminating SIDS may need to be farther reaching.

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