personal letter from Mary Sturges of MOMYS.com regarding SIDS and
the "Back-to-Sleep" campaign.
February 20, 2001
Hang on; this is long. I hope it is worth reading. Tina asked whether anyone had statistics on whether Back to Sleep has actually decreased SIDS deaths. I do. Throughout the 1980’s, before back-to-sleep and during the days of doctors advising all babies to tummy-sleep, incidence of SIDS in America was 1.4-1.5 per 1000 – in other words, about 1 in 750. With the advent of aggressive back-to-sleep "propagandizing," it has gradually and steadily gone down—the latest confirmed statistic I have is 1997, when there were .64 deaths per 1000 or about one in 1500 -- less than HALF of the number of deaths before back-to-sleep.
Is back-to-sleep responsible for the entire reduction? It’s hard to say; not much else has changed, though, which would argue strongly for back-sleeping being causative. Additionally, there are studies indicating a dramatic drop in the SIDS rate in a region after that region has been aggressively "propagandized." (A notable study is one in Washington State a few years back, where the newspaper ran a feature on back-to-sleep and the entire subscription area saw a dramatic, 20-month decrease in SIDS deaths, *in the counties which received that paper.* Numbers in the counties NOT receiving that paper remained the same. This would be hard to explain any other way.)
I have something better than statistics, though, because when it’s you, the statistic is 100%, and we shouldn’t lose sight of that. I have been up much of the night, last night, mentally composing letters of various tone on this topic, most of which would be unacceptable to actually send in, due to their snideness. It is very difficult for me to write civilly on this topic because I get really upset about peoples’ cavalier attitudes toward something that stole my baby from me.
I will attempt to summarize some of my thoughts without the nastiness. Let me start with Tina’s suggested format for emotional topics: In our house, we put our babies to sleep on their backs, because at one point in our parenting career, we did not, and when we went to get our little three-month-old son one morning when he overslept his feeding, we found him cold and stiff and not breathing, and my husband had to scream into the phone, "Send an ambulance! I think my son is dead!" and we tried to resuscitate him ourselves while the ambulance screamed down the block, except I couldn’t hardly get a chest rise when I breathed for him because his lungs were badly backed up with fluid (a death thing), and when the paramedics arrived they took one look at him and sort of shook their heads, but they tried to intubate him anyhow except they couldn’t because rigor mortis had already set in (in no more than four hours) and they couldn’t get the tube down his throat. So they fiddled around with him down at the ambulance, not even bothering to put in an IV because he was so obviously gone, and I guess drawing straws about who was going to be the unlucky guy to come tell us our baby was dead; and meanwhile a nice cop sat in our living room and babysat us while a houseful of other cops, and the coroner, conducted a quick murder investigation (required in these instances; nothing personal, ma’am, we’re very sorry) and walked around peering in the fridge and cupboards and going through the trash and looking through the bookcase and closets and taking pictures of "the scene" for their investigation. Meanwhile I sat on the floor with my husband and all I can remember are lots and lots of big black shoes walking past me, around my apartment, judging my parenting by the content of my bookcase and fridge, and assessing the likelihood that I killed my own child so they’d know whether it was OK to leave me there with the other two (who were downstairs with a nice, but horrified, neighbor who had a baby exactly my son’s age).
In our home, we put our babies to sleep on their backs because at one point in our parenting career, we didn’t, and I got to hear the words "I’m sorry; he is gone, there is nothing we can do" from a paramedic who genuinely *looked* really sorry, in fact, he looked miserable; and I remember sinking to my knees in despair in the grass outside my apartment with neighbors quietly peeking through the blinds wondering what all the racket was about; and then I got to go upstairs and hold my little dead baby, who was a lot heavier dead than he was when he was alive, and I held his little hand which was clenched up tight in death and look at his sweet little face for about thirty minutes until the coroner finished with everything she had to do in our apartment (which at one point, included going into our bedroom with our son and locking the door). He was wrapped up in a quilt that a friend of his grandmother’s made especially for him, and which Jim still can hardly stand to look at.
In our home, we put our babies to sleep on their backs, because after the coroner was done, she had other places she had to go and couldn’t wait on *me* all day, so she told me, "OK, it’s time to go, I can’t wait any longer," and I had to hand him to one of her people so he could be wrapped up in white plastic and taken away from our house forever to go be autopsied (required), and then I had to wait weeks and weeks for the autopsy report, and when it came it had gruesome details like the weight of his kidneys and brain and stuff like that, which left nothing to my imagination about what they had done to him or how they had done it (those reports are nothing if not thorough; gotta hand *that* to them), but the report really didn’t tell me anything about how he had died, in fact it said something like "perfectly healthy, well-nourished dead baby; apparent SIDS episode."
In our home, we put our babies to sleep on their backs because for months afterward, every time I heard a siren I would experience a horrible surge of adrenaline leaving me cold and shaky and in tears, and the same thing still happens to me whenever Jim or Ethan raise their voice in alarm or whenever I hear Ethan’s footsteps running toward my room, and in fact I will still usually burst into hysterical tears when this happens, causing the offending party to have to apologize all over himself; and because it was probably 18 months before Jim and I would wake up several times a night to listen for the other one’s breathing, and shaking the other person if we didn’t hear them immediately, because after all, if our baby could die so suddenly, it seemed natural that our spouse would probably die on us too, and the thought of finding them dead in our bed was a consuming one.
In our home, we will always place our babies to sleep on their backs, even though they look uncomfortable, even though they sleep more lightly (actually, that’s one of the reasons Back-to-Sleep *works*), even though it means more work for Mommy, even though everyone we know was a tummy sleeper, ourselves and our first two children included—because after our son was dead and we had scattered his ashes (there weren’t many) on Monterey Bay, we did a lot of reading about back sleeping and how much it has reduced the incidence of SIDS in this country and abroad, and I had to do a lot of repenting, because I had *known* this but didn’t really believe it, and didn’t think our family was at risk, and I knew my son slept better on his tummy and I was SO tired and needed sleep that I was willing to gamble his life. And I did gamble, and I lost. I lost big time.
I have always been amazed at the low incidence of SIDS on MOMYS; the whole time I moderated this list, I only knew of two other families that had lost babies, and they each had lost one (although the chance of losing a subsequent goes WAY up after you lose one, so we get to live with *that* now too). You gals have been lucky; probably breastfeeding has had a lot to do with the low incidence here on MOMYS. I am distressed, though, by the tone and content of most of the letters that were posted. Much of the anti-back-to-sleep rhetoric I have heard over the past two weeks on this list has been very foolish and anecdotal. Please do not build your houses upon the sand. I realize that some percentage of you are types that simply like to argue, or who "have it in" for Western medicine for some reason, and that arguing with you about this is going to be like trying to read a newspaper in a high wind. A certain percentage of the population is never going to use seat belts, for example, because you’re just SURE you’d be safer is you were "thrown free of the wreck." <sigh> Additionally, many letters posted on this topic had a definite feeling of smugness. I was smug, too, before my baby died. I want you to realize that what you are doing is attempting to cheat the odds. I’m glad that none of you have lost a tummy-sleeping baby to SIDS, but I warn you strongly against taking that to mean that back-sleeping is not protective or more importantly, that one day, back-sleeping will not make the difference for one of your babies. The evidence is clear that, although we don’t know *exactly* why, it does lower the rate of SIDS by about half, to place a baby on his back to sleep. For the rest of my life, I get to live with the knowledge that I knew of something I could do to reduce the chance that my baby would die, and I didn’t do it, and then he DID die. The things I wrote above only begin to touch on the agony our family lived through when we lost our son—most of it is too obscene to write about here; I’ll take enough heat for this letter as it is, I am sure -- and I will live forever with the knowledge that my smug complacency ("it couldn’t happen to me") was contributory toward his death and the pain that we, our children, and our friends and family went through. If you place your child to sleep on his tummy to sleep without some very good medical reason (like true reflux), do so with the knowledge that if he dies, you, too, *will* live with this guilt forever.
Understand that "well, WE were tummy babies, and WE lived" makes about as much sense as arguing that WE rode around without car seats, so our children shouldn’t need them either. Barber-surgeons used to *bleed* people who were sick, thinking it would cure them; medical science has advanced. Another one of those advances is the understanding that placing babies to sleep on their backs somehow reduces the incidence of sudden, unexplained infant death. The fact that this discovery was made halfway through your childbearing years does not invalidate it. Truth is truth, no matter *when* it comes to light. You who know me, know that I do not stand behind everything medical science has suggested (or commanded!) -- for example, we selectively vaccinate. But you can bet that I stand behind THIS one, because the statistics are clear. (Well, for that matter, I selectively vaccinate because the statistic are clear on *that,* too, but that’s another post.)
I am somewhat sorry for the graphic tone of this letter, but for people who can’t hear, you shout. And the posts over the past week have demonstrated that some people aren’t hearing. Please do not write me letters about how it was such a downer to read my post. If you think it was hard to read, imagine living it. *I* do not want you to live it; that’s why I wrote this. It wasn’t much fun to write. Remember that I do not get a commission on back-sleeping babies. I am going through all these rotten memories *only* to try to convince you that SIDS is, too, a real danger, and that back-sleeping does, too, decrease its incidence—by probably close to half.
I have *purposely* not touched on doctrine or theology in this post, but be assured that I can serve *that* up by the shovelful to you also if necessary, and nothing in my theology (which includes God’s sovereign hand) excuses negligence on the part of parents to protect their children from known dangers. I’m sorry if you find that strongly-worded, but think about it—what if you drove around holding your infant in your lap, rather than placing him in a car seat, when car seats are proven to improve the chances of crash survival? Back-sleeping is *the same.* Back-sleeping does not *guarantee* survival any more than car seats do but it certainly does decrease your child’s chances of dying like my son did. Anyway, back to doctrine and theology—it is not the place of this post to discuss whether God was directly responsible for my son’s death, or whether I am a better Christian now because of it, or whatever. I am strictly trying to make a case for being as responsible with our children as possible—and I think any Bible believer’s theology would support that. Certainly no one here thinks God would be well-pleased if we all threw out our car seats, because they imply a lack of faith in Him?! Understand that your children are your responsibility, and I cannot dictate what you do with them (thank goodness) but I certainly need to know that I have done everything in my power to persuade you to make INFORMED choices regarding your family. Please do not rely on foolish, faulty, wishful reasoning to protect your beloved infants. Love to your precious families,