Child and Adolescent Clinic - SIDS and H Pylori

Ask Dr. Sue

SIDS AND H. PYLORI

Dr. Sue,

Recently I read an article in Parenting Magazine about the link between the H. pylori bacteria and SIDS. I work in a nursing home, and patients with that bacteria are not unusual there. How dangerous is this for my baby?

Mom

Dear Mom,

For those who are unfamiliar with it, the Helicobacter pylori bacteria is an organism that is able to survive in the high-acid environment of the stomach, where it lives quite harmlessly in many people. It now appears, though, that this bacterial infection is involved in the majority of peptic ulcers. It is a very common bacteria, which may be spread by contaminated food or water, or possibly by an infected person's saliva. In the U.S. approximately 20% of people under the age of 20 carry it, and about 50% of those over age 60. Infection can be acquired as early as three months of age, and it is believed that about 2% of healthy infants in the U.S. have it. Both H. pylori infection and SIDS are more common in poor communities and with overcrowding, and both can cluster in families.

The article that you mention was in response to a study done in England and reported in the Archives of Diseases in Childhood in November, 2000. In this study, 32 babies who had died of SIDS were studied, and 25 of them were found to have genetic material from this bacteria detectable in their stomachs (although the bacteria themselves weren't found). In contrast, in 8 babies who died for other reasons, only 1 had this genetic material present. The theory is that an enzyme produced by the H. pylori bacteria might cause a dangerous build-up of ammonia, which in combination with other factors could lead to crib death.

This is an interesting avenue of research to continue, and might eventually lead to information that is useful. At this point, however, it is not proof of anything. The numbers studied were extremely small, especially in the group of non-SIDS cases. The method used to detect the H. pylori genetic material is "way too sensitive" and could give a positive result when there was no H. pylori present (according to Dr. Kevin Winn, a member of the board of the American SIDS Institute). The tissue studied was preserved tissue, which could alter test results. There have been many interesting
connections in the past which at first looked promising and then were found to have nothing to do with SIDS. However, several things have been proven beyond doubt to reduce the risk of SIDS. It is essential to ALWAYS PUT YOUR BABY TO BED ON HER BACK (this simple measure alone has decreased the rate of SIDS by nearly 50%).

Don't smoke while you are pregnant, or after you bring the baby home.
Don't let anyone else smoke in the same room as your baby.
Don't dress the baby too warmly to put her to bed, and don't keep your house overheated.
Use a firm, tight-fitting crib mattress and do not use comforters, fluffy blankets or sheepskin pads for your young infant.
BREASTFEED YOUR BABY (breastfeeding itself does not seem to prevent SIDS, but it does
decrease the rate of some upper respiratory infections which could play a role in SIDS).
If your baby seems sick, see your pediatrician.

In regard to H. pylori itself, there are some simple safety precautions that you can take to make transmission of this bacteria from you (if you should become infected) to your daughter. Always wash your hands after work, before handling your child. NEVER put a pacifier or bottle nipple in your mouth and then in the baby's mouth. Wash toys and pacifiers frequently.

For more information, see the following website:

The National SIDS Resource Center

http://www.sidscenter.org/

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