Infant mortality research grows

Press, Volume CXII, Issue 32958, 3 July 1972, Page 6

Infant mortality research grows

(N.Z. Pres, Assn.—Copyright) BALTIMORE. Each year approximately one of every 330 children dies before it is one year old while apparently in good health and from no evident cause.

This has been going on for a very long time, and not only in the United States, but now for the first time there is a co-ordinated, large-scale effort to discover the mysterious reason for it and, hopefully, with this knowledge to stop it. The American Academy of Pediatrics, the National Foundation of Sudden Infant Death, composed of involved scientists, and the Guild for Infant Survival, whose members are bereaved parents, are pressing Congress and the Nixon Government for slom in tax funds for scientific research. In all instances of sudden infant death there is a similarity which approaches indenticalness, suggesting a specific disease. The baby may have the sniffles of a cold but otherwise there are no signs of illness when he is tucked into his crib for the night or for his nap. When the mother returns he is dead.

Autopsy indicates death

was by suffocation, but there is no indication of how suffocation was brought about. Most deaths occur between the ages of two and three months and all before one year.

It is the leading killer of infants. Official estimates place the annual United States toll at between 10,000 and 12,000 but not all cases are reported as such.

A similar occurrence is reported in Great Britain, Western Europe and all countries where medical science is advanced. All indications are that it is universal among people and perhaps has been since the beginning of the species.

In countries weak in medical science and in some sections of the United States, the belief persists that unattended infants can so tangle their garments and bedclothes that the tangles strangle them. This notion has been thoroughly discredited. Definitely it is not —allowing always for the exceptional case—the explanation of the sudden infant death phenomenon.

If the cause is a specific disease it is in no conventional sense. Though mild respiratory infections are often present, the cause is more than infection. It is likely to be a chance coming together of several deleterious factors, not one

of which would be lethal in itself, in the opinion of involved scientists.

Dr Abraham Bergman of Seattle, President of the National Foundation for Sudden Infant Death, has studied 470 cases. His theory is that a nerve spasm suddenly closes the vocal cords. This shuts off the airway and the infant strangles. A baby with a cold is somehow more susceptible to the spasm.

OTHER THEORIES Other scientists theorise the fatal spasm occurs higher in the throat while some suspect it affects heart muscles. Others postulate that a small percentage of infrants are unable to breathe through their mouths for unknown reasons, during a particular stage of development. If nasal passages become clogged by a cold, they suffocate. Dr Russell Fisher, the Maryland Chief Medical Examiner, has been conducting autopsies on infant victims for 20 years. In his opinion infection is involved, but in no simple way—‘‘There is something lacking in the infant’s ability to fight off or resist the process of infection.” He suspects it is the chemistry which produces antibodies and immunity. The $lO million sought from the Federal Government could vastly expand the present scattered research into sudden infant deaths, especially by financing over a long term concerted efforts by scientific teams.

It would be distributed by the Federally-supported National Institute of Child Health and Human Development, which in the last eight years, has spent only $7 million on such research. Scientists do not accuse the institute of any lack of interest, its difficulty has been a lack of opportunity to spend more money fruitfully. “We need the team approach,” Dr Fisher said. “We could spend a million dollars a year wisely by hiring eight to 15 top-level immunologists, biochemists, pathologists, pediatricians and virologists plus a staff. They would have to be assured of full support for three to five years and could come up with some answers in a few years.” PARENTS’ GROUP The bereaved parents’ group, the Guild for Infant Survival, was formed eight years ago by Saul and Sylvia Goldberg, of Baltimore, a year after they lost a two-month-old daughter to S.I.D. The guild now has chapters scattered across the United States and one in Wales. One of its services is to assure newly bereaved parents that they are in no way at fault and their babies were lost to a definite, though unknown, disease, The old and now discarded strangled-in-bedclothes theory indirectly accused the mother of carelessness.

Even in the absence of spoken accusations, mothers commonly have deeply-held guilt feelings which are not lightened by the common reaction of husbands, that somehow a lapse in mothering was involved.

“It is usually the father who suffers most,” Mr Goldberg said. “He harbours his thoughts. Many women have a tough time with their husbands after a child is lost.”