by Ann Marie Dwyer

Created on: October 09, 2007

As a mother of ten, knowing the particulars of SIDS was a necessity. I started with my doctor. He told me that no one really knows what causes SIDS, but for preventative measures I could take, ask my pediatrician.

She was a vast empty well of information. Every piece of literature she provided said the same thing: We do not know the cause. If you do not know what causes it, how can you possibly prevent it?

Time for a new tack. I asked the coroner what he looked for in determining SIDS as a cause of death. I will never forget what he told me: "I don't." Seeing the dumbfounded look on my face, he explained in great detail.

When babies sleep in the hospital nursery, they are swaddled for comfort and to prevent rolling and choking and are laid on their backs. The American Association of Pediatrics began their "Back to Sleep" campaign in 1996, urging parents to put infants to sleep on their backs without blankets or toys. The forensic pathologist told me that this decreased the number of asphyxiation deaths due to smothering, not SIDS deaths.

Fumigation poisoning of infants is a another cause of infant mortality. Such common poisons include radon, carbon monoxide, and smoke inhalation. With the commercial availability of detectors for these noxious gases, poisoning deaths have also declined, yet SIDS remains constant.

I stopped him here and asked, "Why are these not SIDS? This would be the definition. An otherwise healthy infant dying suddenly." His explanation was simple:

Improved gas chromatograph machines have led to the discovery that other causes of death were responsible for what would have been determined to be SIDS as little as 15 years ago, in the early 1990s. Blood is drawn from deceased infants as routine for autopsy today and scanned for the compounds now known to cause poisoning. If these are detected, the death is ruled poisoning, not SIDS.

Likewise, pulmonary edema is checked in each deceased infant. This swelling of the lung tissue is resultant from lack of oxygen. In combination with petechial hemorrhaging, breaking of the capillaries of the eyes, these symptoms indicate asphyxiation. These deaths are ruled as such, not SIDS.

Coroners routinely look for brain edema and bruising that is indicative of shaken baby syndrome, blunt force trauma and abuse. The routine examination of infant brains was not commonplace until the late 1990s. These deaths are ruled homicide, not SIDS.

Still not sure he answered my question, I asked, "So what do you look for to determine

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