Babies’ Unpreventable Deaths : Health: Because Sudden Infant Death Syndrome inexplicably occurs more in cold-weather months, counselors at Orange County Guild for Infant Survival are working harder, helping grieving parents realize they weren’t at fault.

PLACENTIA —  It is comforting to believe that the start of a new year brings us a clean slate, one that’s untarnished by the previous year’s insults to logic, order and happiness.

For John and Linda Dryer, the New Year’s slate, if it existed at all, stayed clean only for nine hours.

John, 33, had gotten up about 8:30 a.m. on Jan. 1 and checked on his 10-week-old foster son, Andrew, who was asleep in a crib, before starting to work on a personal computer in the same room.

“When I checked him, he was fine, “ John said. “He was making a few baby noises, no choking or snuffling or anything.”

But about half an hour later, when Linda came into the room, the nightmare began.

“I came in to start watching the (Rose) Parade,” she recalled. “Something was really bothering me; I knew before I approached the crib. He’d been sleeping all night, which was nothing unusual, but he should have been up by then.

“I went over to the crib and he wasn’t moving. I could feel he wasn’t normal; he was all sweaty. I picked him up and put him on the floor, and John started CPR while I called 911.”

Although paramedics arrived within four minutes, they could not help Andrew, who had died quietly and quickly--and for no discernible reason--while John was working just a few feet away.

Andrew (not his real name) was the year’s first Orange County baby to be victimized by Sudden Infant Death Syndrome, or SIDS. On average, one apparently healthy baby each week in Orange County dies of SIDS, also known as crib death. It is the leading cause of death for infants between 1 week and 1 year old, affecting one baby out of 500, or about 7,000 a year in the United States.

Nothing that the Dryers could have done would have prevented the death, SIDS experts say. SIDS cannot be prevented, and no tests can predict the death, because there is no apparent cause for SIDS.

“A death becomes a SIDS death by exclusion” of all other possibilities, says Penny Stastny, Orange County SIDS coordinator and a senior public health nurse.

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Although research continues internationally, the mysteries of SIDS outweigh the certainties. One of the many questions is why SIDS occurs more between the months of November and March than during warm-weather months. “A lot of research right now looks at why it’s more common in winter,” said Stastny, who pointed out that counties with colder and longer winters don’t have proportionally more SIDS cases than Orange County.

In cold-weather months, the handful of volunteer counselors at the Orange County Guild for Infant Survival work double time. Last month in Orange County, 10 babies died of SIDS, according to the county Health Care Agency, up from the two or three during the summer months.

Impromptu counseling sessions at all times of day and night are a fact of life for Chris Elliott of Fountain Valley, who lost a baby to SIDS 20 years ago and has volunteered her expertise to grieving parents since 1975.

“I’ve been awake talking on the phone for hours,” she said. “The driving force for me is that there was no support group for us (in 1973). We had no one to tell us that what we were feeling was normal, that the death wasn’t our fault.”

Although the county SIDS coordinator job is a 20-hour-per-week position, Stastny works full time in the busy winter months. She contacts parents of all SIDS victims, answers questions and puts the parents in touch with support groups.

Stastny also conducts training programs at two community colleges, teaching paramedics, police and other emergency workers how to deal with apparent SIDS cases. She is a member of the state SIDS advisory task force and attended the California SIDS Conference last October in Long Beach.

California is at the forefront of SIDS education and research, thanks in part to the efforts of state Sen. Daniel E. Boatwright (D-Concord), who lost a son to SIDS in 1988. The state budget for dealing with the syndrome jumped from $150,000 to nearly $1 million in 1989, establishing funds for emergency-worker education and protocols for police and coroner’s investigators.

In California counties that are shorthanded or that lack SIDS expertise, some parents have been jailed while officials investigated deaths that eventually were labeled SIDS, Stastny said.

Recent legislation has required coroner’s investigators to complete a 24-page death-scene form for suspected SIDS cases. “It’s hard on the parents to deal with an investigation right after the death, but it absolves them, and later on they’re grateful they had it,” Stastny said.

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Since the time of the earliest known references, parents have been unfairly blamed for their babies’ deaths from SIDS. In the Old Testament, 1 Kings 3:19--a reference nearly 3,000 years old--it states: “And this woman’s son died in the night, because she lay on it.”

Because SIDS babies are often discovered wedged face-down in a corner of the crib, suffocation is commonly but erroneously assumed to be the cause of death. Or, as in the Biblical example, death has been blamed on a parent accidentally rolling onto the infant while sleeping in the same bed.

“A lot of what was termed ‘maternal overlay’ is now known to be SIDS,” Stastny said. “Suffocation is rare. A baby can die in its parent’s arms or next to a person, and it may not be suffocation.”

SIDS researchers have found that even with a blanket tucked in on all four sides of a mattress, enough oxygen exists for the baby to breathe, and even very young infants know to turn their heads in order to breathe.

Babies’ sleeping position, however, is the subject of international debate. Last spring the American Academy of Pediatrics began recommending that healthy babies sleep on their backs or sides, in the belief that this might prevent SIDS. But some experts, including Dr. Thomas G. Keens of Childrens Hospital Los Angeles, believe that no study has shown conclusively that sleeping face-down increases the risk of SIDS.

“There are possible mechanisms by which sleeping prone could cause SIDS. However, none of these are proved,” Keens said in a talk at the October SIDS conference. “Certainly, many babies have died from SIDS while sleeping on their backs, and many, many more have not died from SIDS while sleeping on their stomachs.”

Although researchers do not know what causes SIDS, they do know what factors are not involved. It is not hereditary or contagious, nor is it caused by immunizations or bottle-feeding.

Because most SIDS victims were healthy before death, it is not possible to identify an infant who will die from SIDS, experts say. Certain factors, however, put some infants at statistically high risk. These include low birth weight, premature birth, slow growth during infancy, and a mother who smoked during pregnancy or who delayed prenatal care. Keens emphasized, however, that only one-quarter of SIDS babies fall into this high-risk category.

Some parents who have lost one baby to SIDS, or whose baby has a history of breathing problems, attach a breathing monitor to their infant to alert them to an apnea, or a long break in breathing. Keens and other experts, however, say that because no single factor--such as apnea--has been proved to cause or elevate the risk of SIDS, the real benefit of these monitors is to reduce the parents’ anxiety and thus improve their parenting skills.

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SIDS deaths often send parents into long periods of bewilderment and introspection, beginning with what Stastny calls the “if onlys.”

“They say, ‘If only I had breast-fed him’ or ‘If only I had picked him up and held him 20 minutes earlier, would that have changed the outcome?’ But there’s absolutely, and I mean absolutely, nothing you can do,” she said.

“They go through the whole thing to absolve themselves--electricians, engineers and medical people do it even more intensely--to get to the point where . . . they know they couldn’t have changed anything.”

When the foster child in her care died, Linda Dryer immediately began learning all she could about the syndrome. “Being a foster parent, I’m not only responsible for a child, but I’m responsible for someone else’s child,” said Linda, 24. “There is a big burden worrying about being blamed.”

Linda said that because her own grieving process has been made worse by the profound ignorance of SIDS among the public, she has begun volunteering some of her time to promote awareness of the syndrome. She has been mailing flyers for Red Nose Day U.S.A., April 2, when people nationwide will be encouraged to wear a red clown nose and donate to SIDS research and education.

For John Dryer, who has had regular nightmares about the death, the healing process will hinge upon the chance to care for another infant.

“After the death, we told each other almost instantly: ‘If they find it to be anything we could have prevented--suffocation, food poisoning--we won’t take any more kids,’ ” he said.

“When it was announced . . . it was SIDS, we said, ‘We’re ready to move on.’ I’m hoping that they place another infant here right away.”

Winter Worry

Experts are unsure why Sudden Infant Death Syndrome claims more lives in the winter months. Cases for the last three months are awaiting final toxicological results, but are presumed to be SIDS.

Number of Deaths January 1993: 10

Source: Orange County Health Care Agency