Shoals is far from immune to SIDS

It's the most dreaded moment a pediatrician can face. An infant patient has just died and the family comes looking for answers.

"You try to help your patient's parents through it, but sometimes there's not an answer that explains what happened to their child," said Dr. Grant Allen, a pediatrician for the Infants and Children Clinic in Florence.

The Shoals is far from being immune from cases of Sudden Infant Death Syndrome. Many infant deaths are classified as SIDS-related when the death of an infant under the age of 1 remains unexplained after all evaluations are completed.

Health department officials say there is little conclusive data showing exactly how many SIDS deaths occur each year in the northwest Alabama counties of Colbert, Franklin, Lauderdale and Lawrence. The number, however, is "nothing high or unusual in our area," according to Karen Landers, regional health officer. Health department data shows that 20 infants died in Colbert and Lauderdale counties from 2004-06. That number does not include newborns who die within 20 days of birth, and not all of those deaths were related to SIDS.

Allen and other pediatricians say it happens five or six times a year.

Wendy Darby, an assistant professor in the College of Nursing at the University of North Alabama, said her department hears about a local SIDS-related death every 6-12 months.

"One is too many," Landers said.

Many involved in child care in the Shoals say the number of SIDS cases in this area, as well as nationwide, has steadily decreased since the "Back to Sleep" campaign was launched in 1994.

The "Back to Sleep" program is designed to teach parents that infants should be placed on their backs, rather than their stomachs, when put in a bed or crib to sleep. It required a radically different approach for parents who were likely told at some point that infants should sleep on their stomachs to avoid choking, Landers said.

"It was a change for me, too, because I was trained not to do that," Landers said. "I had to change the way I taught parents. If you look at the data nationally, you'll see a significant decline in SIDS because of the 'Back to Sleep' campaign.

"As we see science progress, we have to change our practices some times."

Darby, a nurse practitioner for 11 years, said the number of SIDS cases has dropped 40 percent since the 1990s. She said the data seems to indicate that the program works.

"We still really don't understand everything about how a sudden infant death occurs," said Darby, who also said her son used to sleep on his stomach. "We typically find a normal autopsy in those cases. However, investigations show that soft bedding and pillows that are too soft are causes. Infants sleeping on their stomachs can have their faces trapped against soft bedding and don't have the strength to maneuver to a point where he or she can get a breath."

Allen said an infant needs to be 5- or 6-months old before he or she is strong enough to push away from the bedding.

He said changing the culture continues to be an issue because a new mother is often told by her mother or grandmother that it's OK to allow her child to sleep on his/her stomach because their children did.

Allen said one of the biggest problems pediatricians see these days involves what he calls "co-sleeping," the practice of the parents or grandparents allowing the infant to sleep in their beds.

"It's one of the biggest risks you can take," Allen said. "There have been cases - two or three over the past couple of years - of the parent rolling over on the baby and smothering them. We try to warn parents that this is very risky behavior. Any risk is too risky when you're talking about your child's health."

Landers said most counties in northwest Alabama have child death review teams that evaluate all deaths involving children under the age of 1. She said the teams meet periodically during the year.

"We want to see if there's something we can learn or if there was a chance for early intervention that could have saved an infant's life," Landers said.

Allen said the review teams are extremely active in other areas of the state.

"Those teams go to where the death occurred, and look over the circumstances and surroundings," said Allen, a state board member for the American Academy of Pediatricians. "They're not there to collect information to be used to prosecute someone. The data can be collected and used to find out what methods and educational programs should be used to prevent the same thing from happening to another child."

Bernie Delinski can be reached at 740-5739.