Thoraiya DyerThe Underlying Cause of Cot Death Or Another Marketing Scam?
May 1st 2008 00:50
“THE COT DEATH COVER-UP?” according to its author, “is the culmination of over fifteen years of cot death research by the author, a highly respected consulting chemist and forensic scientist from New Zealand.”
But I’m always sceptical when a scientist claims that his great discovery is being swept under the carpet. The whole point of the scientific method is that true results are reproducible.
So why haven’t hundreds of others replicated Dr Jim Sprott’s research, when he claims to have uncovered the single causative factor of all the cot deaths in the world?
Is his crusade just a scare campaign to sell “BabySafe” mattress covers? Is he an innocently deluded man doing his best to save babies lives? Is there, as he claims, a worldwide conspiracy to ignore his revolutionary research? Or is his research just so full of holes you could drive a herd of sheep through it?
A friend brought to my attention Dr Sprott’s advice for completely eliminating cot death: ( Really Long Link ).
Supporting him is the website CotDeath2000 which states as facts the following:
“Cot death (SIDS, crib death) is not a medical matter. It is caused by poisonous gases generated in the baby's sleeping environment.
The gases concerned are phosphines, arsines and stibines, which are all extremely toxic nerve gases.
The gases are produced in a baby's cot (or other sleeping environment) by the action of common household fungus on compounds of phosphorus, arsenic and antimony present in the mattress and in certain other bedding. The danger of cot death increases as a mattress is re-used from one baby to the next.
Babies can be protected from this gaseous poisoning by enclosing mattresses in a gas-impermeable cover which is itself not capable of the gas generation concerned, and using on top of the wrapped mattress specified bedding which is also not capable of that gas generation.”
As a hypothesis, it seems pretty attractive. All these years we’ve been advised by Australian organization, SIDS and Kids, to make sure babies sleep on their back. We were told to keep their heads uncovered by blankets or pillows.
Doesn’t it make sense, if old cruddy mattresses are giving off toxic fumes, that babies planted face-down in the fungus-infested bedding are going to be more likely to die? Doesn’t it make sense that by covering them up, thereby restricting the flow of fresh air, the risk will be increased?
Sure!
But what about the proven links between maternal smoking and SIDS? Or the fact that having the baby in the same room as you, or giving the baby a pacifier, reduces the chances of SIDS?
CotDeath2000 makes the assertion that, “Smoking does not cause cot death.”
They cite the following study from the British Medical Journal, demonstrating the increased risk of cot death among babies who sleep on previously used mattresses:
“Case-control study of sudden infant death syndrome in Scotland, 1992-5, British Medical Journal 1997;314:1516-20; Used infant mattresses and sudden infant death syndrome in Scotland: case-control study, British Medical Journal 2002;325:1007-1009.”
However, a search of British Medical Journal articles shows hundreds more studies supporting the link between smoking mothers and SIDS. This particular one is an Australian one, just because it's nice to have local evidence:
“In the final multivariable model, predictors of SIDS in this study were usual prone position (P < 0.001), maternal smoking (P = 0.008), a family history of asthma (P = 0.045) and bedroom heating during last sleep (P = 0.039). Protective factors were maternal age over 25 years (P = 0.013) and more than one child health clinic attendance (P = 0.003).”
- Paediatric and Perinatal Epidemiology 9 (3) , 256–272. The Tasmanian SIDS Case-Control Study: univariable and multivariable risk factor analysis, 1995 Anne-Louise Ponsonby et al.
...but the finding seems to be pretty consistent:
“Infant bed sharing is associated with a significantly raised risk of the sudden infant death syndrome, particularly among infants of mothers who smoke.”
- BMJ. 1993 November 20; 307(6915): 1312–1318. Bed sharing, smoking, and alcohol in the sudden infant death syndrome. New Zealand Cot Death Study Group. R Scragg et al.
“A number of cohort and case-control studies have shown clear, dose-related associations between maternal smoking and infant death. The strongest relationships were found when the mother smoked during pregnancy as well as postnatally.”
- Human & Experimental Toxicology, Vol. 18, No. 4, 202-205 (1999), Passive smoking, sudden infant death syndrome (SIDS) and childhood infections, Erik Dybing
I need not go on. The avalanche of evidence is overwhelming.
What about using a pacifier?
CotDeath2000 claims that babies given a dummy are more likely to be on their backs, and that the benefits are solely related to facing upwards.
However, another BMJ study found that “In infants who used dummies, there was no increased risk associated with sleeping position.”
“Use of a dummy seems to reduce the risk of SIDS and possibly reduces the influence of known risk factors in the sleep environment.”
- BMJ. 2006 January 7; 332(7532): 18–22. Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): population based case-control study. De-Kun Li, et al.
In other words, sleeping face down WITH a dummy does not increase the SIDS risk. And you would expect that if SIDS was caused by toxic gases, breathing them in through the nose would be just as deadly as breathing them in through the mouth.
Then again, there is evidence supporting Dr Sprott’s theory. One article on which the CotDeath2000 argument hinges is the aforementioned 2002 Scottish investigation which finds that:
“Routine use of an infant mattress previously used by another child was significantly associated with an increased risk of sudden infant death syndrome … The association was significantly stronger if the mattress was from another home … than if it was from the same home.”
Now, that’s weird. Why would someone else’s stinky old mattress be more deadly than your own re-used stinky old mattress?
Could it be that non-smokers are bringing mattresses in from smoking households, supporting the smoking-as-risk-factor argument? Or, are mattresses from other households likely to be older, as they serve their time for one set of kids, then another set of kids, then another, which would support the poison gas argument?
Then, there's the point made by CotDeath2000 that first babies are less likely to die than second babies, who are less likely to die than third babies, who are less likely to die than single-parent babies.
That could support the Evil Mattress Of Doom Hypothesis.
But there could be many other explanations for that trend. Off the top of my head, I would imagine that the more babies you have, the less time you have to spend tucking them in properly on their backs and making sure they stay there. If you're a single parent, you probably have even less time to spend.
I quote Professor AD Milner.
“What HAS emerged over the past few years is that it is easier and cheaper to propose hypotheses than either prove or disprove them.”
In light of that, and considering that you don’t get any second chances to protect your child from cot death, I would definitely advise everyone NOT to use old mattresses.
Whether it’s poison gas or not, any risk factor is worthy of consideration, and used bedding is clearly a risk factor.
But so is smoking, and I find it extremely irresponsible of CotDeath2000 to say that smoking does not cause cot death.
A final note on the physiology.
CotDeath2000 claims that SIDS babies die of an accumulation of acetylcholine in the blood. Phosphorus, antimony and arsenic compounds from the mattresses deactivate cholinesterase compounds in the body. This, according to them, leads to no “physical symptoms. The babies were not ill in the medical or physiological sense; they were poisoned by environmental gaseous poisoning.”
Any accumulation of anything in the blood should be detectable at post mortem, and deactivation of cholinesterase IS a physiological illness.
A famous example of another poison that causes death by acetylcholine poisoning is sarin gas, used in war and in the Tokyo subway attacks in 1995.
Curious to find out what the victims' symptoms were?
It turns out, in a practice gassing by the crazy sect Aum Shinrikyo in the Japanese town of Matsumoto:
“A total of 274 people were treated in the hospital. Typical symptoms included darkened vision, ocular pain, nausea, miosis, and a decrease in serum cholinesterase (ChE) activities. Autopsy findings showed intense post-mortem lividity, miosis, pulmonary edema, increased bronchial secretion, and congestion of the parenchymatous organs.”
I find it difficult to believe that if decreased serum cholinesterase is the cause of SIDS, nobody else has noticed.
If all those things (oedema, secretions, congestion) can be consistently found at the autopsies of people who keened over and died from sarin gas, why wouldn’t they be common findings in cot death autopsies?
CotDeath2000 has a “research” page, but the most recent paper they quote to show “proof that cot death babies show neurological effects of gaseous poisoning” is no proof at all.
Gas poisoning is not even mentioned.
In the 2006 article by Paterson et al, “Multiple Serotonergic Brainstem Abnormalities in Sudden Infant Death Syndrome,” the authors are not investigating gas at all.
They actually set out to prove the “triple-risk” model - that cot death is a combination of three things, 1) an inborn brainstem abnormality, 2) a vulnerable age group and 3) the occurrence of one of several risk factors.
Those risk factors included prone sleeping position, bed sharing, gender (males more likely to die), history of illness within 1 week of death and prematurity.
Mattress age was not a risk factor they even considered.
Either the CotDeath2000 people didn’t understand the study, with all that complicated talk about counting 5-HT neurons in the medulla, or they just didn’t want to hear that “medullary 5-HT dysfunction may be responsible for a subset of SIDS cases.”
In fact, this study directly contradicts the CotDeath2000 claim that cot death has nothing to do with carbon dioxide. Its findings are also consistent in very young children who have not yet slept on any kind of mattress.
David Paterson and his colleagues “reported a case of an infant with SIDS who displayed altered autonomic and respiratory function at birth and 5-HT receptor binding abnormalities at autopsy 2 weeks later.”
They also identified a gene that appears to be dodgy in SIDS babies.
If these geniuses are putting their money on an underlying developmental abnormality (= wonky, shonky brainstem), why shouldn’t I?
All the same, I wouldn’t recommend a stinky old mattress for a newborn. Like I said before, any and all risk factors are worthy of consideration. Would I bet my baby’s life on the chance that Dr Sprott is wrong, no matter how feeble his argument seems?
Seems like the scare campaign worked.
BabySafe mattress covers can be found at totalbaby.com.au .
But I’m always sceptical when a scientist claims that his great discovery is being swept under the carpet. The whole point of the scientific method is that true results are reproducible.
So why haven’t hundreds of others replicated Dr Jim Sprott’s research, when he claims to have uncovered the single causative factor of all the cot deaths in the world?
Is his crusade just a scare campaign to sell “BabySafe” mattress covers? Is he an innocently deluded man doing his best to save babies lives? Is there, as he claims, a worldwide conspiracy to ignore his revolutionary research? Or is his research just so full of holes you could drive a herd of sheep through it?
A friend brought to my attention Dr Sprott’s advice for completely eliminating cot death: ( Really Long Link ).
Supporting him is the website CotDeath2000 which states as facts the following:
“Cot death (SIDS, crib death) is not a medical matter. It is caused by poisonous gases generated in the baby's sleeping environment.
The gases concerned are phosphines, arsines and stibines, which are all extremely toxic nerve gases.
The gases are produced in a baby's cot (or other sleeping environment) by the action of common household fungus on compounds of phosphorus, arsenic and antimony present in the mattress and in certain other bedding. The danger of cot death increases as a mattress is re-used from one baby to the next.
Babies can be protected from this gaseous poisoning by enclosing mattresses in a gas-impermeable cover which is itself not capable of the gas generation concerned, and using on top of the wrapped mattress specified bedding which is also not capable of that gas generation.”
As a hypothesis, it seems pretty attractive. All these years we’ve been advised by Australian organization, SIDS and Kids, to make sure babies sleep on their back. We were told to keep their heads uncovered by blankets or pillows.
Doesn’t it make sense, if old cruddy mattresses are giving off toxic fumes, that babies planted face-down in the fungus-infested bedding are going to be more likely to die? Doesn’t it make sense that by covering them up, thereby restricting the flow of fresh air, the risk will be increased?
Sure!
But what about the proven links between maternal smoking and SIDS? Or the fact that having the baby in the same room as you, or giving the baby a pacifier, reduces the chances of SIDS?
CotDeath2000 makes the assertion that, “Smoking does not cause cot death.”
They cite the following study from the British Medical Journal, demonstrating the increased risk of cot death among babies who sleep on previously used mattresses:
“Case-control study of sudden infant death syndrome in Scotland, 1992-5, British Medical Journal 1997;314:1516-20; Used infant mattresses and sudden infant death syndrome in Scotland: case-control study, British Medical Journal 2002;325:1007-1009.”
However, a search of British Medical Journal articles shows hundreds more studies supporting the link between smoking mothers and SIDS. This particular one is an Australian one, just because it's nice to have local evidence:
“In the final multivariable model, predictors of SIDS in this study were usual prone position (P < 0.001), maternal smoking (P = 0.008), a family history of asthma (P = 0.045) and bedroom heating during last sleep (P = 0.039). Protective factors were maternal age over 25 years (P = 0.013) and more than one child health clinic attendance (P = 0.003).”
- Paediatric and Perinatal Epidemiology 9 (3) , 256–272. The Tasmanian SIDS Case-Control Study: univariable and multivariable risk factor analysis, 1995 Anne-Louise Ponsonby et al.
...but the finding seems to be pretty consistent:
“Infant bed sharing is associated with a significantly raised risk of the sudden infant death syndrome, particularly among infants of mothers who smoke.”
- BMJ. 1993 November 20; 307(6915): 1312–1318. Bed sharing, smoking, and alcohol in the sudden infant death syndrome. New Zealand Cot Death Study Group. R Scragg et al.
“A number of cohort and case-control studies have shown clear, dose-related associations between maternal smoking and infant death. The strongest relationships were found when the mother smoked during pregnancy as well as postnatally.”
- Human & Experimental Toxicology, Vol. 18, No. 4, 202-205 (1999), Passive smoking, sudden infant death syndrome (SIDS) and childhood infections, Erik Dybing
I need not go on. The avalanche of evidence is overwhelming.
What about using a pacifier?
CotDeath2000 claims that babies given a dummy are more likely to be on their backs, and that the benefits are solely related to facing upwards.
However, another BMJ study found that “In infants who used dummies, there was no increased risk associated with sleeping position.”
“Use of a dummy seems to reduce the risk of SIDS and possibly reduces the influence of known risk factors in the sleep environment.”
- BMJ. 2006 January 7; 332(7532): 18–22. Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): population based case-control study. De-Kun Li, et al.
In other words, sleeping face down WITH a dummy does not increase the SIDS risk. And you would expect that if SIDS was caused by toxic gases, breathing them in through the nose would be just as deadly as breathing them in through the mouth.
Then again, there is evidence supporting Dr Sprott’s theory. One article on which the CotDeath2000 argument hinges is the aforementioned 2002 Scottish investigation which finds that:
“Routine use of an infant mattress previously used by another child was significantly associated with an increased risk of sudden infant death syndrome … The association was significantly stronger if the mattress was from another home … than if it was from the same home.”
Now, that’s weird. Why would someone else’s stinky old mattress be more deadly than your own re-used stinky old mattress?
Could it be that non-smokers are bringing mattresses in from smoking households, supporting the smoking-as-risk-factor argument? Or, are mattresses from other households likely to be older, as they serve their time for one set of kids, then another set of kids, then another, which would support the poison gas argument?
Then, there's the point made by CotDeath2000 that first babies are less likely to die than second babies, who are less likely to die than third babies, who are less likely to die than single-parent babies.
That could support the Evil Mattress Of Doom Hypothesis.
But there could be many other explanations for that trend. Off the top of my head, I would imagine that the more babies you have, the less time you have to spend tucking them in properly on their backs and making sure they stay there. If you're a single parent, you probably have even less time to spend.
I quote Professor AD Milner.
“What HAS emerged over the past few years is that it is easier and cheaper to propose hypotheses than either prove or disprove them.”
In light of that, and considering that you don’t get any second chances to protect your child from cot death, I would definitely advise everyone NOT to use old mattresses.
Whether it’s poison gas or not, any risk factor is worthy of consideration, and used bedding is clearly a risk factor.
But so is smoking, and I find it extremely irresponsible of CotDeath2000 to say that smoking does not cause cot death.
A final note on the physiology.
CotDeath2000 claims that SIDS babies die of an accumulation of acetylcholine in the blood. Phosphorus, antimony and arsenic compounds from the mattresses deactivate cholinesterase compounds in the body. This, according to them, leads to no “physical symptoms. The babies were not ill in the medical or physiological sense; they were poisoned by environmental gaseous poisoning.”
Any accumulation of anything in the blood should be detectable at post mortem, and deactivation of cholinesterase IS a physiological illness.
A famous example of another poison that causes death by acetylcholine poisoning is sarin gas, used in war and in the Tokyo subway attacks in 1995.
Curious to find out what the victims' symptoms were?
It turns out, in a practice gassing by the crazy sect Aum Shinrikyo in the Japanese town of Matsumoto:
“A total of 274 people were treated in the hospital. Typical symptoms included darkened vision, ocular pain, nausea, miosis, and a decrease in serum cholinesterase (ChE) activities. Autopsy findings showed intense post-mortem lividity, miosis, pulmonary edema, increased bronchial secretion, and congestion of the parenchymatous organs.”
I find it difficult to believe that if decreased serum cholinesterase is the cause of SIDS, nobody else has noticed.
If all those things (oedema, secretions, congestion) can be consistently found at the autopsies of people who keened over and died from sarin gas, why wouldn’t they be common findings in cot death autopsies?
CotDeath2000 has a “research” page, but the most recent paper they quote to show “proof that cot death babies show neurological effects of gaseous poisoning” is no proof at all.
Gas poisoning is not even mentioned.
In the 2006 article by Paterson et al, “Multiple Serotonergic Brainstem Abnormalities in Sudden Infant Death Syndrome,” the authors are not investigating gas at all.
They actually set out to prove the “triple-risk” model - that cot death is a combination of three things, 1) an inborn brainstem abnormality, 2) a vulnerable age group and 3) the occurrence of one of several risk factors.
Those risk factors included prone sleeping position, bed sharing, gender (males more likely to die), history of illness within 1 week of death and prematurity.
Mattress age was not a risk factor they even considered.
Either the CotDeath2000 people didn’t understand the study, with all that complicated talk about counting 5-HT neurons in the medulla, or they just didn’t want to hear that “medullary 5-HT dysfunction may be responsible for a subset of SIDS cases.”
In fact, this study directly contradicts the CotDeath2000 claim that cot death has nothing to do with carbon dioxide. Its findings are also consistent in very young children who have not yet slept on any kind of mattress.
David Paterson and his colleagues “reported a case of an infant with SIDS who displayed altered autonomic and respiratory function at birth and 5-HT receptor binding abnormalities at autopsy 2 weeks later.”
They also identified a gene that appears to be dodgy in SIDS babies.
If these geniuses are putting their money on an underlying developmental abnormality (= wonky, shonky brainstem), why shouldn’t I?
All the same, I wouldn’t recommend a stinky old mattress for a newborn. Like I said before, any and all risk factors are worthy of consideration. Would I bet my baby’s life on the chance that Dr Sprott is wrong, no matter how feeble his argument seems?
Seems like the scare campaign worked.
BabySafe mattress covers can be found at totalbaby.com.au .
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Comment by katyzzz
Photography Tips
MS Paint Art
All my children slept on their tummies, I don't think they could have slept on their backs, and when a baby gets sick (vomits) on their back where does it go?
Just a couple of things for people to reflect upon, but, of course, they want to do what is right for their babies so become easy targets.
They've been claiming all sorts of things to do with cot death for years now. When are they going to learn that life itself is a risk and that babies, just like the rest of us, are programmed to stay alive in all but exceptional circumstances.
I'll accept my horsewhipping graciously.
Comment by Thoraiya Dyer
Demented World
(Dare I suggest that you had already given your children the precious gift of a normal brainstem? Huzzah!)
You're right. Life is a massive risk, and the odds of having a cot death are only 1 in 3000.
I think, for me, it's more about what I can do, and what I can't do.
I can't stop my house from being struck by lightning and burning down. I can't guarantee that my kid won't be molested by the babysitter. I can't guarantee that a truck driver on drugs won't wipe out my whole family. I can't guarantee that my kid won't become a junkie and murder old ladies for their pensions.
But I can supervise a child near water, or a child playing with a big, seemingly friendly dog. I can stop a toddler from pulling the boiling potatoes off the stove.
And I can do very simple things, like checking sleeping position and keeping smokers away, to reduce the chances of cot death
Comment by katyzzz
Photography Tips
MS Paint Art
But when dad was in charge mine invariably came home with more tumbles and spills than I would have experienced and a husband full of complaints about how hard done by he was, but as men go he was well above average, but I don't think I'd trust my kids to a house husband.
But others will leap to say I am wrong, I know that.
I still believe in the division between the sexes and being a mum does not come easily to a dad.
But I'm all for dads, if you can work that out.
Life is an amazing experience but carries with it no guarantees, unfortunately.
Keep up the good work, love the monkeys.