New US research confirms the toxic gas theory for the cause of cot death, stated New Zealand cot death prevention expert Dr Jim Sprott OBE today.
Research published in the October 2008 issue of Archives of Pediatric & Adolescent Medicine (1) found that having a fan on during sleep was associated with a 72% decreased risk of cot death among babies, as compared with sleeping without a fan in operation. The reduction in risk was greatest for babies sleeping in warm rooms (temperature above 21 degrees Celsius); and fan use also decreased cot death risk among babies who slept on their stomachs or sides.
"These findings are very strong confirmation of the toxic gas theory for cot death", stated Dr Sprott. "An operating fan dissipates gases generated in the baby's sleeping environment. In particular, the highly toxic gas phosphine (generated from phosphorus, which is very common in bedding) is likely to remain around a baby in the cot owing to the density of this gas, so it is no surprise that research has found that fan use greatly reduces cot death risk.
"The finding that fan use reduces the risk even more in warmer rooms is also consistent with the toxic gas theory for cot death", stated Dr Sprott. "If a baby's bedding is capable of toxic gas generation, overheating in the cot greatly increases the likelihood of fungal generation of the gases in question."
"Crucially, the fact that fan use greatly reduces cot death risk among babies sleeping face-down or on their sides demonstrates that the partial protective effect of face-up sleeping against cot death is not related to any medical condition or physical defect in the baby. So once again we have further demonstration that cot death does not have a medical or physiological cause.
"Face-up sleeping reduces cot death risk because the toxic gases which cause cot death are all more dense than air. They diffuse away from a baby's face, and therefore a baby sleeping face-up is less likely to ingest them."
The researchers' suggestion that fan use may reduce cot death risk by preventing a baby from re-breathing exhaled carbon dioxide is already disproved, stated Dr Sprott. "Longstanding epidemiology demonstrates that cot death is not caused by babies re-breathing exhaled air in the cot."
Dr Sprott called on the New Zealand Ministry of Health to immediately endorse mattress-wrapping for cot death prevention.
Since 1995 a mattress-wrapping protocol for cot death prevention has been publicised nationwide in New Zealand. On the basis of three studies into the incidence of mattress-wrapping (2), it is calculated that at least 170,000 New Zealand babies have slept on "wrapped mattresses". There has been no reported cot death among those babies.
Since the commencement of mattress-wrapping the New Zealand cot death rate has fallen by 68%; and the cot death rate of the population group most likely to wrap babies' mattresses (European/Paheka) has fallen by around 85%. (3)
1. Coleman-Phox, K, et al, "Use of a fan during sleep and the risk of sudden infant death syndrome", Arch Pediatr Adolesc Med 2008; 162: 963-968.
2. NZ Med J 2000; 113: 8-10; NZ Med J 2000; 113: 326-327; Eur J Pediatrics 2008; 167(2): 251-252 (Short Report).
3. Source of statistics: New Zealand Ministry of Health.
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