Consideration of the first year to establish the child mortality indicator is that the first year of life is the most critical in the survival of human beings: when they exceed the first birthday, the chances of survival increase dramatically.

This is an indicator directly related to poverty levels (the higher poverty, the higher the infant mortality rate) and is the subject of one of the eight Millennium Development Goals of the United Nations.

Infant mortality rate = (Deaths children <1 year / Total number of live births per year) x 1000

“In recent decades, innovations in medicine, progress in basic health care and enabling social policies have produced large increases in life expectancy and sharp declines in child mortality” (Kofi A. Annan, We the villages, 20002).

However, the inequalities are so large in the various regions of the planet; this has led to the United Nations to include it as one of the eight Millennium Development Goals of reducing child mortality (under 5 years) by two thirds between 1990 and 2015.

The countries with the lowest infant mortality in the world (2003) are Norway and Iceland, with 3% of children under 1 year and 4% for children under 5 years, respectively.

In Latin America, Cuba has the lowest rate of around 4.7% (2008).  The 20 countries with the worst infant mortality rates all belong to Africa, with Niger, recording the worst in the world with 154% and 262% respectively.  In Latin America, Haiti is the country with the worst records (76% and 118%), and Yemen in Asia (82% and 113%).

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Acetylcholine is a chemical substance, produced by the cardiac nerve that controls the heart rate.  If too much of it is absorbed by the heart it can slow the heartbeat down to the point of stopping completely.  The researchers confirmed that eight out of nine tissue samples taken from victims of SIDS contained high levels of acetylcholine.

Professor Pascal Bousquet, head of the research team at the University of Strasbourg, said that it is highly unusual to find such a marked anomaly in scientific research, and considers it a breakthrough in the quest for a way of pinpointing high-risk babies very early in their development.  He thinks that if the anomaly can be identified with a blood test, we can try out existing drugs to see if they are effective in blocking the absorption of acetylcholine.

In the U.K the Foundation for the Study of Infant Deaths says that the research done by the French team is valuable and may lead to a better understanding of this syndrome.  They agree that more research is called for in terms of the neurotransmitter receptors in the heart and their connection to SIDS vulnerability.   At this stage, according to Professor Bousquet, there is no funding for such additional study.

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Findings published in the Journal of the American Medical Association reported that babies who died of cot death had a level of serotonin in their brain tissue that was about 26% lower than that found in babies whose death resulted from other causes.

The serotonin hormone is the one known to control sleeping and breathing patterns, and lack of a sufficient or ‘normal’ amount of the hormone leaves the baby unable to respond instinctively to reduce oxygen flow to the brain. A baby with adequate levels of serotonin will turn its head even in sleep if the oxygen getting to the brain is constricted.

This can happen when babies sleep on their stomachs. Without the ‘wake-up call’ from this hormone, the baby may suffocate without shifting position or waking.

What scientists refer to as the medullary serotoninergic system controls not only breathing and waking from sleep, but also blood pressure and body temperature. To this date researchers have not confirmed all the factors that may contribute to low serotonin levels. They are certain that sleeping face down, cigarette smoke and respiratory ailments are all probable culprits, usually with two or more of these factors involved.

Until a specific and effective test of infant serotonin levels can be found, parents can reduce the risk of SID by putting the baby to sleep on its back in a separate bed in their bedroom, not smoking, and breastfeeding.

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At the moment, mother’s that smoke have the highest risk rate for losing a child to cot death.

A research team from the Karolinksa Institute in Sweden found that babies that have been exposed to smoke often experience odd surges in their blood pressure, which can occur even while sleeping in their cots away from smoke.

The surges force the heart to beat harder and faster which in turn can damage circulation and cause sudden infant death.

The study was actually created to look at how a newborn is affected by smoking in the womb, but after the lead researcher Dr. Gary Cohen and his team looked over the plight of 36 newborn babies, out of which, 17 had smoking mothers, they found that the babies had poor heart rates and blood pressure throughout their initial few years of life.

Dr. Cohen stated that there are persistent problems in the regulation of blood pressure in babies that having smoking mothers and that although the problems first appear at birth they worsen gradually over time.

He continued to state that the study then took on a new focus becoming the first to suggest that tobacco exposure while in the womb can lead to lasting problems with an infant’s ability to control their own blood pressure.

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The report outlined the fact that most of the cot deaths on a sofa or shared bed, result from a parent who used drugs or consumed alcohol, before going to sleep.

Out of all the deaths studied, one fifth of the babies were found smothered by a pillow and another quarter were swaddled.

The authors of the report stated that while the UK cot death rate is down since the beginning of the 1990’s, further emphasis must still be placed on advising parents not to co-sleep with their children, so that the numbers continue to fall further.

At the same time, another study conducted concerning Sudden Infant Death, unearthed the fact that over a quarter of mothers believe that co-sleeping is not a dangerous habit, and does not increase the risk that their child may be a victim of cot death.

This survey involved 506 mothers, with children between the ages of six months to three years, and was conducted by Ipsos MORI.

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