The third piece of the puzzle is that this defect, along with the rapid growth, makes these babies unable to deal with
challenges in their environment. These challenges can be anything from rebreathing carbon dioxide, to second
hand smoke, overheating, or something as simple as a cold or virus. Challenges that a normal, healthy baby can
overcome can trigger sudden death in babies predisposed to SIDS. Using tummy sleeping as one example, this
would explain why some babies do perfectly fine on their tummies, while for others it may be the challenge that
triggers them to die suddenly and unexpectedly. It also sheds light on the fact that a great many babies that die of
SIDS have some sort of upper respiratory virus or infection.
So, in a nutshell, our risk reduction recommendations revolve around removing as many of these “challenges”
from your baby’s environment as possible during that critical first year of life. Experts feel that if we can get them
developmentally “over the hump” so to speak, their brain eventually takes over these bodily functions that are
controlled by the arcuate nucleus (region of the defect) in an infant’s brainstem.
I would also like to address another issue that is commonly misunderstood – and also has to do with the brainstem
abnormality. As I mentioned earlier, the arcuate nucleus controls all of the baby’s major bodily functions – not just
breathing. When something triggers a baby to die of SIDS their entire body shuts down, they don’t just stop
breathing. We liken it to a light switch – once the switch is flipped, there is no going back. These babies cannot be
resuscitated, even if there is immediate intervention. Occasionally, when the baby is in the care of someone
that begins CPR immediately, they can keep the baby’s heart beating and restore breathing by artificial means
(respirator), but within 24-48 hours that baby is determined brain dead and has to be removed from life support.