Sudden Infant Death due to carbon dioxide and other pollutant accumulation at the face of a sleeping baby

doi:10.1016/0306-9877(93)90101-U

Medical Hypotheses

Volume 41, Issue 6, December 1993, Pages 483-494

https://doi.org/10.1016/0306-9877(93)90101-U Get rights and content

Abstract

Sudden Infant Death (SIDS) is described as the result of breathing air vitiated by carbon dioxide or other pollutants. Mechanisms are given for SIDS and a description is given of how exhaled air does not leave the vicinity of the face of a sleeping baby in certain combinations of environmental conditions, baby responses to excess CO₂ and bedding. Precautions for the prevention of SIDS are given and the statistical associations are discussed.

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Citation Excerpt :
Increased rebreathing of exhaled air will dramatically increase the inhaled CO2 concentration and could lower mental fitness or destabilize the normal breathing control process. The latter is one of the suggested causes of sudden infant death syndrome [41,42]. The goal of the experiments presented in this paper is quantifying the effect of the proximity of pollution sources to the breathing zone in the sleeping environment on the exposure of the sleeping subject to the emitted pollutants.
There is very little information about human exposure to gaseous indoor air pollutants in the sleeping environment, even though the conditions in this environment are at least worrisome. The exposure during sleep is characterized by long exposure time, both absolute and relative, prevalence of specific pollutants and uncustomary proximity of sources to the breathing zone. This paper reports experimental results that show the impact of the proximity of possible emission sources such as a mattress, pillow and toy, on exposure of the sleeping subjects to these emissions. Based on full scale experiments in an environmental chamber using a breathing thermal manikin the intake fraction for gaseous pollutants are measured as well as the occurrence of rebreathing. Intake fractions for several sleep positions as well as different bedding arrangements are reported. The results show that human metabolism and corresponding heat release by the human body are dominant factors in the dilution of pollutants emitted in close proximity of the nose, reducing exposure by 40% compared to a case without metabolic heat output. This effect is more important than the sleep position. An important finding is that sleeping with the head under the covers increases intake by a factor 24 and results in a rebreathing rate of over 60%.
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The physiological effects on an infant of repeatedly sleeping in an environment consisting of a mixture of exhaled air and fresh air is examined. It is found that adaptation can be predicted. A possible outcome of the adaptation is shown to be the development of hypoxia when the conditions change during sleep from a state with carbon dioxide contamination of inspired air to one without. This hypoxia can be associated with apnoea: this apnoea can provide an explanation for some instances of sudden infant death. This explanation is consistent with the known epidemiology and environmental associations of a proportion of sudden infant death syndrome. Safety precautions for the prevention of re-breathing are given.
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Sudden Infant Death due to carbon dioxide and other pollutant accumulation at the face of a sleeping baby

Abstract

Cot Death Supplement. Results from the first year of the New Zealand Cot Death Study 1987/1988

New Zealand Medical Journal

Cases of suffocation in infants

Edinburgh Medical Journal

Mechanical suffocation during infancy

J Pediatrics

Understanding crib death, the Sudden Infant Death Syndrome