Research from David Paterson and his colleagues at Boston Children’s Hospital into “Multiple Serotonergic Brainstem Abnormalities in Sudden Infant Death Syndrome” (see below) generated much excitement in the press in November. The research was part funded by the Trust and we are delighted to be included in the positive outcomes. Sudden infant death syndrome is the leading cause of postneonatal infant death in the United States as well as in Scotland and, despite intensive research, the causes of SIDS remain unknown. Previous research has suggested that abnormalities in the brainstem area that regulates breathing may play a role in SIDS.

The researchers analysed frozen samples of the medulla from 31 infants who died from SIDS and from 10 infants who died from causes other than SIDS. These were then compared. The authors write “We found that the abnormalities in SIDS are more extensive than previously suggested”.

This study strengthens the hypothesis that brainstem dysfunction is associated with SIDS and may lead to death by a failure of respiratory responses.

This study also found reduced receptor binding in male compared with female SIDS cases, an observation that may help explain why males are more vulnerable to SIDS. These abnormalities were documented during the era of stringent public messages on risk reduction, including that for supine sleep position.

The majority (65 percent) of the SIDS cases in this data set, however, were sleeping prone or on their side at the time of death, indicating the need for continued public health messages on safe sleeping practices. The researchers speculate that the increased risk of SIDS in the prone or face-down position may reflect the infants’ inability to respond to the challenge to breathe in the face-down position.