Bottle feeding and the sudden infant death syndrome

Objective. To compare postnatal growth preceding the sudden infant death syndrome (SIDS) with that of age matched controls. Design. Retrospective case-control study. Each SIDS victim was matched with two controls on date of parental interview, postnatal age, and neighborhood. Clinical and demographic data were collected by parental interview and by review of medical records, and interval body weights were obtained from health visitors' records. Study population. All infants dying of SIDS between 1 May, 1987 and 30 April, 1989 in a geographically defined region consisting of four health districts in Avon and North Somerset in southwest England. Seventy-eight of the 99 SIDS victims and 139 of 156 control infants were included in the final analysis. Results. There was no significant difference between SIDS victims and the controls in either of the two indices of postnatal growth which were analyzed. The mean growth rates (± 1 SEM) between birth and the last live weight (age equivalent weight for control infants) were 27.1 ± 1.0 g/day for the SIDS cases and 28.3 ± 1.5 g/day for the control infants. The mean growth rate (± 1 SEM) between the last two live weights were 31.5 ± 2.9 and 24.9 ± 2.1 g/day for the SIDS and control infants, respectively. Stratification of the infants by sex, gestational age, maternal smoking during pregnancy, breast versus bottle feeding, or age at death, did not result in any significant differences between SIDS and controls in either of the indices of postnatal growth rate. The 20 SIDS cases which were excluded from the final analysis did not differ from 78 whose data was analyzed, with regard to established SIDS risk factors, age at death, or postmortem weight. Conclusions. No difference was found between the postnatal growth of SIDS victims and that of age matched control infants.

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Factors enhancing adherence of toxigenic Staphylococcus aureus to epithelial cells and their possible role in sudden infant death syndrome

Epidemiology and Infection ◽

10.1017/s0950268800050937 ◽

1993 ◽

Vol 110 (3) ◽

pp. 507-517 ◽

Cited By ~ 58

Author(s):

A. T. Saadi ◽

C. C. Blackwell ◽

M. W. Raza ◽

V. S. James ◽

J. Stewart ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Epithelial Cells ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Sudden Infant Death ◽

Bottle Feeding ◽

Sudden Infant ◽

Sleeping Position ◽

Toxigenic Strains ◽

Syncytial Virus

SUMMARYToxigenic strains of Staphylococcus aureus have been suggested to play a role in sudden infant death syndrome (SIDS). In this study we examined two factors that might enhance binding of toxigenic staphylococci to epithelial cells of infants in the age range in which cot deaths are prevalent: expression of the Lewisa antigen and infection with respiratory syncytial virus (RSV). By flow cytometry we demonstrated that binding of three toxigenic strains of S. aureus to cells from non-secretors was significantly greater than to cells of secretors. Pre-treatment of epithelial cells with monoclonal anti-Lewisa or anti-type-1 precursor significantly reduced bacterial binding (P < 0·01); however, attachment of the bacteria correlated only with the amount of Lewisa antigen detected on the cells (P < 0·01). HEp-2 cells infected with RSV bound significantly more bacteria than uninfected cells. These findings are discussed in context of factors previously associated with SIDS (mother's smoking, bottle feeding and the prone sleeping position) and a hypothesis proposed to explain some cases of SIDS.

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