Probe of 3 infants’ deaths may take months
10/15/09 | 13 comments

Probe of 3 infants’ deaths may take months


By Christopher Cousins
BDN Staff

BANGOR, Maine — It will be three to four months before authorities know what happened to three Central Maine infants who died last week while sharing beds with their parents.

The result of the autopsy process could range from specific diagnoses such as asphyxiation to a complete mystery. Investigators are trying to avoid the latter.

“When we can’t determine the cause of death for an adult, it gets listed [on the death certificate] as unknown,” said Margaret Greenwald, the state’s chief medical examiner. “When we can’t determine the cause of death for an infant, it gets listed as sudden infant death syndrome. We don’t like that.”

A news release Tuesday from the state Department of Public Safety, which detailed the unrelated deaths of infants in Canaan, Madison and Windsor, raised the possibility that they died of suffocation because they were sharing beds with their parents. Medical experts used the unrelated tragedies as an opportunity to remind the public about safe sleeping practices for infants — including that they should not sleep with adults.

But the director of a national group called The Natural Child and a Notre Dame University researcher, both of whom advocate that nursing mothers sleep with their children, told the Bangor Daily News that authorities here should not assume bed sharing was the cause of death until everything else is ruled out.

“It’s critical for the coroner to actually determine whether everything else can be excluded, rather than concluding very quickly that the deaths had to do with bed sharing,” said Dr. James McKenna, director of the Mother-Baby Behavioral Sleep Laboratory at Notre Dame. “What I worry about is that when sweeping public health recommendations like this come out, what happens to those parents who choose to routinely bed share with their babies?”

Greenwald agreed about the importance of arriving at the correct cause of death, which is why the autopsy process and battery of tests associated with it take so long. She said Maine has always been diligent about investigating infant deaths, but that new directives from the National Centers for Disease Control in the past five years have urged medical examiners and law enforcement officers nationwide to redouble their efforts. The goal is to avoid settling on diagnoses of “sudden infant death syndrome” as much as possible.

“Nothing in the investigation becomes excluded,” said Greenwald. “That’s basically the way we operate.”

In the course of investigating an infant’s death, Greenwald and her staff look for a variety of infections; poisoning caused by medications or substances in the home; microscopic clues that indicate cancer or a mutation; problems in any of the body’s fluids; and metabolic disorders, among other things.

“All of that takes a lot of time to be processed,” she said.

Just as important to a medical examiner is information that comes from police investigations, such as the environment the baby lived in, whether he or she was exposed to cigarette smoke, sleeping arrangements and a range of other factors.

The CDC and National Institutes of Health are so serious about finding the right diagnosis that they urge use of the term “sudden unexplained infant death” instead of “sudden infant death syndrome” until everything else can be ruled out.

“We’re trying to take people away from the mindset that babies just die for no apparent reason,” said Greenwald.

Dr. Stephen Meister, medical director for the Maine Center for Disease Control’s family health division, said in addition to helping researchers understand the causes of SIDS, policy shifts like the CDC’s have the long-term side effect of educating parents.

“As we focus on the risk factors, such as parents not smoking and babies sleeping in their own beds, we hope the rate of SIDS goes down as close to zero as possible,” said Meister. “For now we have a better understanding of certain risk factors. We can really help to decrease the risks with some really simple steps.”

But there’s a long way to go. The national SIDS rate has been declining since the early 1990s, due in large part to the revelation that infants should sleep on their backs, not their stomachs, but SIDS still ranks as the leading cause of death among infants age 1 month to 1 year. More than half of the 4,500 sudden unexplained infant deaths each year in the United States end up with a SIDS diagnosis, according to the CDC’s Web site. That’s why the CDC in 2003 began pushing for standardized data collection nationwide, including a training initiative for investigators and standardized forms for use by medical examiners.

Greenwald said those efforts have helped a lot.

“Every time we get more information, we look at these cases differently,” she said. “Still, there remain some that we just don’t have answers for.”

ccousins@bangordailynews.net

207-938-3315

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Comments
13 comments on this item
On 10/14/09 at 11:11 PM, sassykat01 wrote:         Repeated separate thumbs down will cause comment to be hidden

rest in peace little ones.. God needed some precious angels. fly high ... my condolences to the families of these precious angels. there are no words that can be said that will ease the pain. but trust me time does help heal. remember the time all the time u shared.. may the near future bring you all peace....

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On 10/15/09 at 8:20 AM, AMomsOpinion wrote:         Repeated separate thumbs down will cause comment to be hidden

Sad news :( I used to let our baby daughter sleep with us for I was breastfeeding and was so much easier, especially since it was the winter months. I was a LIGHT sleeper...so I felt comfortable with it....but if you are not a light sleeper...not a good idea. I pray for these families...as the grief must be unbearable. Our sincere condolences go out to you all through these difficult times.

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On 10/15/09 at 8:54 AM, pcme2000 wrote: Click here to view hidden comment         Repeated separate thumbs down will cause comment to be hidden
On 10/15/09 at 8:55 AM, HarryofBangor wrote:         Repeated separate thumbs down will cause comment to be hidden

"God needed some precious angels. "

This kind of thinking is what killed my faith. What kind of god would stand idle while an infant died?

My condolences are for the parents. I hope their pain is bearable, and they can remember the wonderful moments they had with their kids. They're suffering a hurt that no one should ever have to endure.

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On 10/15/09 at 10:27 AM, realist38 wrote:         Repeated separate thumbs down will cause comment to be hidden

While I am deeply sorry for their losses, this was preventable (pending autopsy results). I have two children, I read every book imaginable while waiting for them to be born. I couldn't count the number of times I've read to never let them sleep with you whether you're breastfeeding or not. I kept a bassinet by my bed for these middle of the night feedings. I was also educated prior to leaving the hospital to never allow them to sleep in your bed with you.

God bless these little ones.

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On 10/15/09 at 10:57 AM, donnelly wrote:         Repeated separate thumbs down will cause comment to be hidden

How horrible! My breastfed babies always slept with me, and I would do it again in a second. People need to await the facts before coming to conclusions.

God Bless the parents of these precious little ones.

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On 10/15/09 at 1:53 PM, JoeDoe wrote:         Repeated separate thumbs down will cause comment to be hidden

There is nothing more natural than a baby sleeping with its mother. keep laws out of peoples homes.

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On 10/15/09 at 2:31 PM, realist38 wrote:         Repeated separate thumbs down will cause comment to be hidden

My breastfed babies did not sleep with me as I was told it would endanger their lives, and I felt it a risk not worth taking. Poor innocent little babies. One more reason why we should require licenses to procreate.

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On 10/15/09 at 5:56 PM, Melancholy wrote:         Repeated separate thumbs down will cause comment to be hidden

My breastfed babies sleep right next to me - both of them. I'd rather be able to peek open an eye and see them breathing then have them in another room across the house. I am 100% confindent that my babies are safe.

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On 10/15/09 at 8:32 PM, MainEER wrote:         Repeated separate thumbs down will cause comment to be hidden

realist38...."My breastfed babies did not sleep with me as I was told it would endanger their lives, and I felt it a risk not worth taking."

How long did you really breastfeed? Bed-sharing is an important part to making it last as long as possible by helping to keep milk production up and Mom comfortable. 6 weeks is not breastfeeding...2-3 years IS breastfeeding...and only possible with bed-sharing.

These people made some tragic mistakes...period. It ends with their own acceptance of it. There is NO God in it (tell me he doesn't have enought "precious little angels already").

Taking it public and saying that bed-sharing can not be done safely is like saying that all Mainers love bean suppas and wear flannel!

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On 10/16/09 at 1:19 PM, realist38 wrote:         Repeated separate thumbs down will cause comment to be hidden

MaineEER, Not that it's ANY of your business but I breastfed for one year, where did you get six weeks from? I do not agree with you that 2-3 years constitutes breast feeding, that's going a little overboard for me. I know of a woman who was nursing her five year old twins, they should have been removed from her care as that is really sick. I suggest you don't worry about what I "take public", I have a right to free speech, just as you do.

Everyone makes choices and some people need more guidance even with common sense issues than others. If you bottle feed your baby, you need to stay awake don't you? Myself being comfortable over risking their life really wasn't a difficult choice to make, sorry some of us have different beliefs over comfort versus life. And your GOD comment? Was that for me too? You're whacked....obviously. These little defenseless babies are gone, if I suggest GOD BLESS THEM AND YOU DON'T LIKE IT................................................KMA!

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On 10/18/09 at 2:06 AM, Amazed wrote:         Repeated separate thumbs down will cause comment to be hidden

I'd like to know if these little ones had been given the H1N1 flu shot(s).

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On 10/22/09 at 12:33 PM, missm123 wrote:         Repeated separate thumbs down will cause comment to be hidden

for REALIST38 who seems to know everything.... except the facts

they do not know for sure how any of these babies passed. They are ASSUMING that because they were all in bed with their parents that that is what happend. Do you realize how many parents HAVE had their babies sleep with them and are fine?

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