We are all aware of the drop in Sudden Infant Death Syndrome (SIDS) rates as a result of the national and international campaigns to put babies on their backs to sleep. Yet even with that strategy, SIDS deaths still occur and the question is why? This week Goldstein et al. (10.1542/peds.2015-2298) look at US mortality records over 3 decades and compare mortality rates from SIDS death with non-SIDS mortality rates and find them concordant over time. This means the changes in SIDS rates were similar to changes in death from congenital malformations, respiratory distress of the newborn and diseases of the circulatory system even when you control for the effect of changing sleep position and the external sleep environment. The authors thus introduce intrinsic biological pathways that play a role in SIDS and other forms of infant death that need better explanation.
To make sense of what might be happening internally to cause unexpected death in the first year of life, SIDS experts Dr. Rachel Moon and Fern Hauck (10.1542/peds.2015-3665) offer an insightful commentary that will hopefully lead to further studies to better understand these intrinsic pathways and their implications as to what we can or should work on next to reduce post-neonatal mortality in the first year of life. Read both the study and the commentary—and you’ll have a new perspective on what we do and don’t know about SIDS.