A reporter recently played the devil’s advocate in a phone interview with me a few weeks ago. He brought up a really good point which I had thought of myself while writing the book. He asked, “If all of these problems (torticollis, plagiocephaly and developmental delay) are treatable, what’s the big deal with keeping babies on their back to reduce SIDS?” Excellent point, my friend! I fully agree with keeping infants alive and safe at all times above all else. To fully answer this question, we have to take a look at a few different angles.
First, let’s look at the numbers. There are approximately 4.1 million babies born in the United States every year. Of those 4.1 million, 6.7 infant deaths occur for every 1,000 live births. The leading cause of infant death is congenital abnormalities with heart defects being the most common of that category accounting for approximately 5,500 each year. The second leading cause of death is preterm birth/low birth weight accounting for approximately 4,600 each year. A diagnosis of SIDS is the third leading “cause” of death accounting for approximately 2,000 each year. Breaking that down to something tangible, of the 4.1 million babies born every year, 2,000 receive a diagnosis of SIDS. That is 0.5 in every 1,000.
To remind you, a diagnosis of SIDS is given after a complete autopsy, death scene investigation and a complete review of the baby’s and family’s medical history. When a cause CANNOT be determined, the term SIDS is used to say in essence, “We cannot find a cause of death.” It can be any number of things that caused the death but for whatever reason, the review process did not reveal a known cause. As new medical advances are made every day, the number of things that remain “unknown” is diminishing. It is not necessarily that the rate of SIDS is “declining”, rather we are better able to identify the cause of infant death and more accurately diagnose it. Therefore, SIDS is not necessarily a disease process like cancer, it is what cannot be determined or is unknown. (Yes, I get very frustrated when people use SIDS and suffocation interchangeably. They are NOT the same thing!)
Torticollis and plagiocephaly are occurring at a rate of 1 in 300 infants according the latest available statistics. This rise has been directly related by many experts to the Back to Sleep campaign that began with the primary intention of reducing the rate of SIDS. The biggest benefit of the Back to Sleep campaign was to streamline the requirements of a SIDS diagnosis. The AAP itself compared the “decline” in the SIDS rate with the coinciding rise in other infant diagnoses saying that a more accurate classification was being made where a SIDS diagnosis was used in years past.
If left untreated, torticollis may lead to scoliosis, vision problems, balance issues and TMJ/orthodontic issues to name a few as the child grows. Forty percent of children with untreated plagiocephaly have been shown to require physical therapy, occupational therapy, speech therapy and/or special education once they reach school age. What this translates to is a potential lifelong medical intervention need. Yes, these diagnoses are treatable and many recover fully with intervention by a medical professional, sometimes requiring orthotics or surgery. The treatment process lasts anywhere from a few months to a year. But, these diagnoses are also preventable! Isn’t prevention the best medicine?
So, “If all of these problems are treatable, what’s the big deal?” The big deal is we are seeing a negative impact on an entire generation of infants because of a fear of something that occurs 0.5 in 1000 infants. One in 300 infants are being negatively affected to be precise. Doesn’t it make more sense to follow a few simple rules for a safe sleeping environment than to confine a baby on his or her back day in and day out in the name of “preventing SIDS”? Yes, we can prevent the negative impact of the Back to Sleep/fear of SIDS era and keep babies alive at the same time!
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