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Book Review
April 2004

SIDS

Author Affiliations
 

ABRAHAMBERGMANMD

Arch Pediatr Adolesc Med. 2004;158(4):405. doi:10.1001/archpedi.158.4.405

SIDS, by Toke Hoppenbrouwers, PhD, a neurophysiologist, and Joan Hodgman, MD, a neonatologist from the University of Southern California (Los Angeles), was written for a broad audience including parents who have lost children to sudden infant death syndrome (SIDS), their family and friends, and physicians and other professionals who come in contact with these families. There is much to like in this softcover book, which in 106 easy-to-read pages outlines much of what is and is not known about the entity of SIDS.

The first part of the book, entitled "Practical Information," provides valuable guidance on what happens after an infant dies and the multitude of persons and institutions involved: paramedics, police, coroners, funeral homes, public health nurses, SIDS support groups, and SIDS research projects. There are problems, however, in writing a book for multiple audiences. On page 13, for example, the authors say, "Parents should not hesitate to ask to be with their baby for the last time." Although this information should be provided to those who will be dealing with families affected by SIDS, it may be upsetting to the parent reading it after the fact if that parent was not given the opportunity to hold the infant.

In part 2, "SIDS and Grief," there is an excellent summary of the stages of grief as well as brief discussions of how various people are affected by the death. Mothers may grieve differently from fathers. Grieving behaviors of various ethnic groups are described; siblings, grandparents, and day care providers may all be involved and have differing reactions. At the end of this section are helpful discussions about what other people should and should not say to parents who have experienced SIDS.

The last 2 parts, "Medical Information" and "Theories About SIDS," summarize the history and current status of scientific knowledge about SIDS. The sections on the history of SIDS, how to analyze the media coverage, and how to think about "causes" of this medical phenomenon are excellent. Less successful are the recounting of possible pathophysiological explanations for SIDS, risk factors, and countermeasures for those risk factors. The authors try to include too much, such as the epidemiological factors, purported causes (most of which have been disproved), theories (most of which have been discarded), and identification and treatment of those at risk (none successful). Confusion arises because the same topics (such as the Back to Sleep campaign or sleep apnea) are covered several times under the various headings. For the most part, however, the authors cover the common factors and theories about SIDS and do so accurately.

I must question the accuracy of one statement. On page 70, the authors state,

In the eighties, doctors in England reported some very encouraging findings. . . . By providing well-baby care through a nurse visitor, the number of infant deaths declined, including the number of SIDS.

This quote about well-child care occurs in the section titled "Minimizing the Risk for SIDS," in which the Back to Sleep campaign recommendation is also included. Putting these 2 topics together is a disservice to both. Good child care is a sine qua non for pediatrics, but there is no known connection with SIDS. The theory cited by the authors, which is by British pathologist John Emery, MD, has not been substantiated by others.

In summary, this is a book that physicians should know about, read, and recommend to parents affected by SIDS as well as their relatives. Knowing the details of what happens to families after such a death is important information for physicians. Knowing that other families go through the same experience is important information for parents. The sections on medical information and theories are good introductions to these topics, although interested readers will have to find other sources for more detailed information.

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