Chapter 9: Possible Research

There are two main arguments that I have made here: the first is that harmful rebreathing is the cause of SIDS deaths in every case, and second, that harmful rebreathing is the cause of many other disorders, more specifically learning disabilities. However, these are just arguments based on logical and statistical deduction. Just because most learning disabilities follow the same statistical occurrence as does SIDS doesn’t necessarily mean that they result from the same cause. But it is likely. Further studies and analysis are needed before this can be definitely stated.

As I said from the start, these are theories, compelling as they are, which need to be proven further, or disproved. I hope that the scientific, medical and university community would take an interest and carry at least some of them to the next step. The following is a short list of possible areas of investigation and study that could shed some light on the veracity of these theories. Perhaps some of the data is already available.

Other than just verifying or negating these theories, these studies should also shed new light on SIDS which could possibly lead to new avenues of thought, and new practices that help reduce the incidence of SIDS overall.

Ratio of Oxygen to Carbon Dioxide

Is it known or can it be easily determined the proportion or range of ratios between oxygen and carbon dioxide in the lungs that are safe and healthy? At what ratio of O2 to CO2 does an individual react to a deficiency in oxygen or an excess of CO2 by changing their breathing patterns? If this is known, then can a simple and safe test be devised that tests an early infant’s ability to recognize the levels of O2 and CO2 in the lungs? A simple test could be as simple as exposing the infant briefly to short various, but safe, ratios of O2 to CO2 and recording the infant’s reaction. Should there be no reaction, it would be considered that the infant’s breathing control system has yet to develop, and therefore is in greater risk of suffering from harmful rebreathing.

Knowing that an early infant is unable to recognize safe levels of O2 and CO2 in the lungs will signal to the doctor, the parents and caregivers that they must be more vigilant with regards to the baby’s access to an uninterrupted circulation of fresh air. This extra care would need to remain in place until such time as the baby becomes sensitive to O2 and CO2 in their lungs. Knowing the quality of air that must be in the baby’s microenvironment, would it be possible to create a monitoring device that safely tests the air quality in the vicinity of the early infant’s mouth and nose? Should the air quality fall below safe levels, the parents or caregivers could be alerted by the monitor. This would be a significantly important monitoring device.

Does the part of the brain that controls temperature also control breathing? Are they connected in any other way?  If an early infant has difficulty sustaining a constant body temperature, would that be an indicator that they would also have difficulty reacting to oxygen and carbon dioxide levels in their lungs? If the temperature of an early infant rises unexpectedly, could that be a pre-SIDS indicator? Could a simple temperature device that monitors unexpected temperature changes be an effective device to avoiding SIDS, as it warns the parents, or directly arouses the child by some method?

I have suggested that CO2 is heavier than air, and that should the early infant be placed in any container-like environment, such as a crib with tightly fitted bumper guards, the CO2 would accumulate and that it would pool at the lowest levels. If through testing this proves true, then it would further confirm that the success of the Back to Sleep program is in part due to keeping the infants breathing above the dangerous zone next to the mattress surface, and not just because it avoids the infant’s mouth or nose being forced into the bedding to avoid SIDS. This information would reinforce the suggestion that circulating air such as with a fan is of significant importance. If this test were to prove that CO2 does pool at the crib mattress, then it would be imperative that the government immediately ban the use of crib bumper guards, or any other covering that could create a container-like microenvironment. Testing of CO2 levels in these microenvironments would be worth having established.

If it has been proved that the still air in the crib environment can cause CO2 to pool at the lowest level, can we not assume that any other smoke or toxic fumes from smoking in the infant’s home, would also pool in the crib, making it even a more dangerous environment for the infant? This would certainly motivate the government to outlaw any smoking either in the infant’s home or car.

The Back to Sleep program has been credited with an approximate reduction of SIDS cases by 50%. This program almost always recommended the removal of bumper guards and any soft item, as well as recommending the use of thin tightly drawn bed sheets.  But how much of this success is due to sleeping supine and how much is due to the removal of items that could obstruct breathing or limit air circulation. Separating and clarifying this information would be extremely useful, as it might find that sleeping supine, on their backs, is irrelevant when the removal of items that could obstruct breathing or air circulation is carried out. Of course, data might find the opposite.

How much of the risk of sleeping prone is due to the pressure placed on lungs in that position (if any) caused by the weight of the baby on the lungs. Does sleeping supine avoid this limitation, if it exists? If so, then how much of the success of the Back to Sleep program is due to this avoidance, as opposed to the removal of item that could obstruct breathing?

Thumb Sucking and pacifier use

I have put a significant amount of weight on the value of thumb sucking and pacifier use. Yet there is more we need to know about these practices.

It would be very helpful to have a broader test for the relationship between SIDS and pacifier use and the practice of thumb sucking. Many studies have shown that the use of pacifiers reduce the incidence of SIDS by as much as 90%. However, there is less data on the practice of thumb sucking. I would expect data on thumb sucking to be approximately the same as that of pacifier use. However, since the thumb is always available because they don’t fall away from the child as a pacifier can, couldn’t thumb sucking achieve even a higher rate of success? I believe it is important to know that data.

Also, if pacifier use is so effective, why doesn’t it reduce SIDS by 100%? What are the circumstances that prevent the last 10% from avoiding SIDS? Could it be that in the case of pacifier use there is a 10% chance that the pacifier can fall away and not be available to the infant?  And in the case of thumb sucking, could the early infant be bound through swaddling or other bedding such that they can’t reach their thumb? I would be very interested to know what were the conditions of any early infants who had died of SIDS, but who had practiced thumb sucking and/or pacifier use. Were there ever any cases of SIDS found with the pacifier still in the infant’s mouth?

Data has not been gathered that related pacifier use or thumb sucking to ADHD, Autism, or any of the other exceptionality that I consider could be related to harmful rebreathing. If my theory relating harmful rebreathing to these exceptionalities has any validity then there should be similar statistics as there is relating SIDS to pacifier use. This data could totally rule out any significance to harmful rebreathing. Of course, I believe that they are related and that the data would support the theory, if not totally, at least for some.

Data has not been gathered comparing the practice of pacifier use or thumb sucking between boys and girls. Is there any validity to the suggestion I have made that boys are prevented from these practices more than girls, and that therefore because of this boys suffer from SIDS and other exceptionalities more than girls.

Babies that sleep on their backs, those that use a pacifier and those who suck their thumbs are known to swallow more. Because these all reduce SIDS, is there a relationship between SIDS and swallowing? It may very well be that sucking exercises the throat, lungs and diaphragm in ways not yet understood, working to develop healthy strong lungs. Is there an argument that the increased swallowing is the reason for the reduced incidence of SIDS with these practices? I don’t believe so since I don’t see how, but I wouldn’t count it out as having no impact. It still would be worth investigating.

It has been shown that infants age 6 months and older, and who use pacifiers, have an increase in middle ear infections, an increase in yeast infections in the mouth, and an increase in intestinal infections. Is this because they use a pacifier that occasionally falls on the floor or could this be a reaction to the materials, possibly latex, in the pacifier? Are the increases in ear infections due to busy little fingers that touch just about everything, including moving from nose to mouth to ear? Would thumb sucking avoid this problem altogether or does it share the same problem? If, just by chance, researchers discovered that all cases of Autism involved children that used a pacifier, but none practiced thumb sucking, then it could be concluded that the cause of Autism was a reaction to pacifiers.  I doubt this to be the case, but one never knows. Only by gathering this data can this be ruled out or verified. We always learn something through research, even if it is to rule out a possibility. It’s always a step forward.

Bindings

Because it has never been considered, there are no statistics relating the incidence of SIDS and early infants who are being bound by tight swaddling, tight bedding, or tight straps for car seats and stroller.  This data would be very helpful in clarifying whether bindings have any relation to SIDS and other disorders. Sadly, because SIDS is never considered in cases where an early infant is sitting up, without any apparent cause of death, the parent immediately becomes suspect, and there may be cases where they have been incarcerated unjustly, due to this.

Fetal Hemoglobin

Does the level of fetal hemoglobin in the blood increase or decrease the ability of blood to absorb oxygen or shed carbon dioxide as compared to normal adult hemoglobin? Is the presence of fetal hemoglobin there solely because of its ability to transfer oxygen and carbon dioxide via the placenta? Does a high ratio of fetal hemoglobin to adult hemoglobin weaken the lungs ability to absorb oxygen and shed carbon dioxide thereby increasing the risk of harm due to harmful rebreathing or do high levels of fetal hemoglobin interfere with the lungs ability to recognize high levels of CO2 or low levels of  O2?

Brain Cell Development

 How would brain cells become damaged by harmful rebreathing? Would certain cells be damaged to the point of not working at all, or would they lose some of their ability to communicate with other cells, or would the cells work perfectly however in a stalled state of growth?  If a relationship between exceptionalities and harmful rebreathing is established, then knowing how the brain is damaged can focus researchers on the best way to improve or eliminate these conditions. A bit of dreaming here, but I would hope that our knowledge of harmful rebreathing would not only lead to ways of avoiding SIDS and many disabilities, but also lead to cures or treatments for those disabilities should they occur, because we have learned how these cells become damaged.

I would hope that the above suggestions would lead to some very important discoveries, even if they were to prove that the theories I have put forward are false. And I hope that these discoveries would lead to other avenues of research that would prove valuable.