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When SIDS isn’t SIDS: Most infant deaths in Tier preventable

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When SIDS isn’t SIDS: Most infant deaths in Tier preventable

Dr. James Terzian became concerned years ago when he started to notice an unusually high number of babies at the morgue who were dying for no clear reason.

After taking a closer look and increasing communication with death-scene investigators, he discovered most of the deaths were completely preventable. In the past five years, 25 infants in the Southern Tier died because they were placed in an unsafe sleeping situation. They’d been put to sleep on their stomach, in a crib with stuffed animals or blankets, or in a bed with a parent or sibling — and suffocated — claiming more infants locally than any other cause.

Deaths previously attributed to Sudden Infant Death Syndrome, Terzian realized, could be avoided.

“We’re learning most of these deaths are explainable once you have the combination of the complete scene investigation, complete medical history and a complete autopsy,” said Terzian, who performs most baby autopsies in the southern Tier. “If those things are done, and done well — completely — then I think the number of cases that would fall into the classic definition of SIDS would be very small.”

Years ago, if an infant died while sleeping, it was attributed to SIDS — a diagnosis of exclusion only to be made if the death could not be explained after a thorough investigation. But in 1994, the U.S. launched the Back to Sleep campaign, urging parents to put their babies on their back to sleep to avoid accidental suffocation. By 1999, the rate of SIDS had dropped by more than half, and researchers realized that many SIDS deaths might not actually be unexplained.

Still, SIDS is still listed as the leading cause of death among infants, according to the Centers for Disease Control and Prevention because not all areas of the country scrutinize baby deaths the way Terzian and others locally are scrutinizing them.

“Unfortunately, the state of death investigation in our country varies so much — from state to state, from city to city, from rural area to city — that trying to analyze the data with the mish mash of death investigation processes creates problems,” Terzian said. “If you have a full-fledged medical examiner’s office with a board certified forensic pathologist, medical examiners whose job it is to find out the cause, mechanism and manner of death, your data is probably going to be much more accurate and complete then if you rely on, let’s say, a lay coroner and a local doctor or pathologist who does an autopsy who’s got a lot of other things to do, and doesn’t keep up on this particular subject.

“They just don’t have the resources in our country to do this investigation the way it should be done.”

Terzian said of the 35 infant deaths he has investigated since 2005, 21 suffocated: 12 due to co-sleeping — sleeping with a parent or caretaker — and nine were attributed to inappropriate bedding.

Among the other 14, nine died of natural causes, one was a homicide, and four were undetermined.

“There were still two or three others (undetermined deaths) where I had my suspicions, but I couldn’t prove anything,” Terzian said. “For example, a baby had LIVOR — settling of blood on the front of the body — and it was settled there, so you knew the body was face down. And yet the parents swore they put the baby to bed face up. Well, it’s hard for me to accept that.”

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