Sudden Death Syndrome

Loving parents gloat over the baby's encouraging growth and happy gurgles as they put him to bed. He is obviously in the best of health. At the next feed ing time, they are shocked to find him dead in bed. Such "crib deaths" happen in the best-doctored countries and to the best-cared-for babies. And most can never be explained. In the U.S. alone there are 10,000 such deaths a year, and they are so baffling that 50 U.S. and British medical experts met recently at the University of Washington to try to decide what can be done about them. But the experts' report to the U.S. Public Health Service last week showed that they had been able to do little more than tell each other mystery stories and speculate on possible solutions.

Facts of Mystery. Characteristically inexplicable was what happened in Philadelphia during a heat wave in the last two weeks of June. There were 19 crib deaths, more than twice the usual number, among babies under six months, mostly boys. One explanation offered was that the babies died of dehydration, and this seemed plausible for a time because there were only one or two crib deaths right after the heat broke. But post-mortem examination of the victims showed no dehydration. And other cities that had suffered the same heat, or worse, reported no increase in crib deaths, which only served to deepen the Philadelphia mystery.

Until a dozen years ago, most crib deaths were laid to suffocation, and anguished mothers blamed themselves for carelessness. Then Dr. Keith Bowden, an Australian pathologist, did detailed autopsies in 40 consecutive cases and found that suffocation was not the cause in any of them. In most cases, he discovered evidence of a severe respiratory infection, of a type that develops incredibly fast. But for some deaths, he could find no cause.

Red in the Brain. Ironically, Philadelphia is one of the places where the most intensive work has been done on crib deaths. Dr. Marie Valdes-Dapena, who has studied the problem for years, says that as many as 80% of crib deaths cannot be explained even after an unusually detailed autopsy. Dr. Frederic Rieders, the city's chief toxicologist, discovered an unidentified red substance in the brains of 80% of babies whose deaths are unexplained, and has found the stuff in only 20% of cases where there is a known cause of death. But what it is, or what relationship it bears to sudden death, is as mysterious as everything else that is connected with crib fatalities.

The Seattle conferees did not lack for theories. One is that a viral infection may kill these babies while the virus is still in its usually silent incubation period. Another is that the babies are in a transition period between inherited and acquired immunity, and are therefore especially vulnerable. A third is that death may result from a violent immune reaction (anaphylactic shock) to cow's milk. But nobody knows for certain whether breast-fed babies are immune. The experts were unanimous on one point: they need more facts before they can prove or disprove any theory about the elusive causes of what they decided to call the "sudden death syndrome."

This file is automatically generated by a robot program, so reader's discretion is required.