Apparent Struggling and SIDS
There is no physiologic evidence or data of any kind to suggest that SIDS babies struggle. Indeed, the most compelling argument is that they do not arouse (e.g. respond, struggle) in response to circumstances that would lead non-SIDS infants to arouse/awaken in response to a potentially adverse circumstance. Unfortunately, we have not yet been able to find a way to test for this arousal problem prospectively.
In a study published last year, they video-taped healthy infants at home during prone sleeping (these families had chosen to use the prone position for their infants). To our surprise, these infants spent almost 1% of all sleep time with the face straight down and almost another 6% of time with the face nearly straight down. None of these infants got in any trouble because they were able to arouse from sleep and correct the problem before low oxygen levels and increased carbon dioxide levels could cause any difficulty. We think that SIDS infants are not able to sufficiently sense such a problem and thus to arouse from sleep in response to such problems. Unfortunately, we are not able to test for this and there is nothing you could have observed or done to make a difference. I cannot explain the strands of hair held in the hand, but I do not think this indicates any struggle. Again, all the evidence continues to support a lack of struggle or arousal of any kind.
I hope this is helpful. There was no pain or struggle that you could have responded to, and nothing that you could or should have done differently that would change the outcome.
I hope this helps. Thank you.
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