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Early Days at Daycare

(8/8/00)

Dear Friends,

An article hit the news recently regarding 'Day Care Settings' and SIDS. The news refers to a study that appears in PEDIATRICS Vol. 106 No. 2 August 2000, pp. 295-300. More information follows. We have received many e-mail messages asking for more information. The public has been on an information roller coaster, the result of an explosion of medical reports, each heralding a "breakthrough in SIDS research." We need to help people separate myth from fact and risk factor from cause. We will post information as it becomes available to us.

Please keep the following in mind:

- When it comes to media coverage of SIDS, we often feel a sense of frustration in being confronted with misleading headlines, announcements of so-called breakthroughs and statements taken out of context.

- Please read the article, "Mass Media's" Role in SIDS Education, at <http://sids-network.org/media.htm>.

- The study concludes that a large proportion (20.4%) of SIDS cases occur in child care settings. Factors associated with SIDS in child care settings include older age, race, and highly educated parents. Previous studies have reported that unaccustomed prone sleeping puts infants at high risk for SIDS; this characteristic was found to be associated with SIDS in child care and may partly explain the high proportion of SIDS cases in child care settings. Parents must discuss sleep position with any caretakers of their infants. In addition, further efforts to educate child care providers about the importance of supine sleep for infants must be ongoing.

We are currently gathering more information about this specific research and will keep you updated.

Thanks!

Chuck Mihalko
Executive Manager
SIDS Network

Read the SIDS Alliance Media Advisory on this topic.

Wed, 2 Oct 1996

I have heard a number of SIDS parents tell me that their baby died within the first week of going to Day Care. I do not think there are good data on whether this really increases the risk or not. One problem is that parents often return to work at around 3-months, which is the peak age incidence for SIDS, even before both parents had to work in most families. So, it could be coincidence. However, the story is common enough that we probably ought to try to study it.

I hope this helps. Thank you.
---Tom Keens, tkeens@CHLA.USC.EDU
Childrens Hospital Los Angeles

I read two articles you wrote on the SIDS web site. I was interested in the one on sweating and early days at daycare. My son passed away May 18, 1999 of SIDS. He was 3 1/2 months old. It was his first day at daycare. Also the question on Sweating dated 12 July 1999. I don't understand what clammy sweats are. My son sweated alot. His feet were always sweaty and when he napped he also woke up with his hair all wet of sweat.

Date: Wed, 21 Jul 1999

In response to the following questions:

I have spoken with many SIDS parents who say that their baby died during the first few days of going back to Child Care. Part of this is probably coincidence, similar to what turned out to be true for SIDS and DTP immunizations (baby shots). Baby shots are usually given at 2 and 4 months of age, and the peak incidence of SIDS is between 2-4 months of age. However, a number of scientific studies have been performed, and they showed that there was no relationship between baby shots and SIDS. Similarly, Maternity leave from most jobs is 2-3 months, so that mothers are going back to work when their babies are 2-3 months of age, which is also the peak incidence of SIDS. However, I am not aware of any scientific studies which have been performed on this issue. Certainly we do know that many Child Care Centers were apparently unaware of Back to Sleep recommendations, and thus many babies were put to sleep on their stomachs. This may have contributed to some deaths, although sleeping on the stomach is associated with an increased risk for SIDS but it is not the cause of SIDS. I think it will take some time and investigation before anyone knows for sure if Child Care has some effect on SIDS that we are unaware of. My prediction is that it will be a coincidence.

With respect to sweating, sweating can be a sign of heart failure. It is a symptom of heart attacks, for example. However, people sweat for many other reasons, and not everyone who sweats is having heart failure. The purpose of sweating is to cool the body. Therefore, if a baby is in a warm and/or humid environment, the baby will sweat more. Sweating is an automatic body response to changes in the environment (temperature), and thus is controlled by the autonomic nervous system. This is the same part of the brain which controls whether you are asleep or awake, how you breathe, heart rate changes in response to the environment, blood pressure, etc. Professor Andre Kahn from Belgium, and others, have published scientific studies suggesting that infants at increased risk for SIDS have increased sweating. We interpret this finding as indicating that the autonomic nervous systems of these babies may be subtly dysfunctional. However, again, more study is needed. Sweating, in and of itself, is not a risk factor for SIDS and does not predict which baby will die from SIDS.

I hope this helps. Thank you.
---Tom Keens, tkeens@CHLA.USC.EDU
Childrens Hospital Los Angeles

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