Thursday, 7 April 2011

SIDS: Cot deaths could be caused by abnormalities in the brain that stop babies breathing when they choke

Richard Alleyne,  31 Mar 2011
The findings could improve understanding of Sudden Infant Death Syndrome (SIDS) and lead to better screening and preventions.
The body automatically cuts off breathing when you swallow in order to stop food going down the "wrong way" into the windpipe and lungs.
Ordinarily this happens for just a fraction of a second and even when you do choke, breathing is restored once the blockage is coughed up.
But scientists believe there may be a fault in this "reflex" in some babies that causes the breathing to stay off too long and this could be a cause of the mysterious cot death.
Now they have identified how this reflex works and believe further study could discover why it goes wrong – and how to prevent it.
Professor Paul Pilowsky, of Macquarie University, Sydney, said: "Until now, the centres in the brain that coordinate breathing and swallowing were poorly understood.
"But our research has finally teased apart the two mechanisms in the brain, demonstrating how they work together when something goes down the wrong way.
"The eventual hope is to have the ability to manipulate these two systems separately to prevent the excessively long breathing arrest that may cause SIDS."
The mechanism is vital to everyone, but babies in particular as they have a tendency to regurgitate liquids after feeding and saliva tends to pool in their throats.
The two parts of the brain are the nucleus tractus solitarius (NTS), which is the area that receives sensory information about the presence of airway irritants, and a combination of the caudal nucleus ambiguus and the other is the Bötzinger Complex (BötC).
To understand how the central nervous system controls breathing and swallowing, the team recreated the brain and body's response to a choking in rats using electrical stimulation of the nerve using an electrical charge.
About 300 babies aged under one die of cot death each year in the UK.
No single cause has been identified.
Most cases occur when the baby is under the age of six months, and can happen anywhere, not only in a cot.
The risk is greater in boys, premature babies and those of low birth weight and babies whose parents smoke.
The Foundation for the Study of Infant Deaths (FSID) did not believe there was any evidence to support the latest theory.
The scientific adviser Prof George Haycock said: "No doubt the work will interest other specialists in the field of experimental physiology but there is no good reason to believe that it has any real relevance to SIDS in human infants."
The findings were published in The Journal of Physiology.

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