ALSO TODAY: Table Talk Books for kids - - - - - - - - - - SIDS PACKAGE: 1. New controversy over SIDS Have some parents gotten away with murder? 2. Signs of abuse A physician says we should stop masking child abuse as SIDS. 3. There is nothing new here An activist says SIDS parents should be pitied, not prosecuted. - - - - - - - - - - YESTERDAY: Spice of life By Chitra Divakaruni Wild things Bug love: Ever eat a cricket? - - - - - - - - - - Mamafesto Why it's time for Mothers Who Think Newsletter Win a set of signed Anne Lamott books when you sign up

NATIONAL SIDS ALLIANCE SPOKESWOMAN PHIPPS COHE DISCOUNTS RECENT STUDIES THAT SAY DEATHS REPORTED AS SIDS ARE SOMETIMES HIDING CHILD ABUSE. BY DAWN MacKEEN Aren't the findings in the new book "The Death of Innocents" blowing a hole in some of the theories explaining Sudden Infant Death Syndrome? The findings suggest that many babies thought to have died from SIDS may have died from child abuse. Not really. I'm just sorry to say that there is nothing new here. This isn't anything that we haven't heard before. Essentially, this book is based on the 25-year-old Hoyt case, which was splashed across the media when the woman was indicted several years ago. Then it splashed across the media a year later, and now it is being rehashed for public consumption a third time by this reporter couple who have published this book, I'm sure, hoping to gain some type of recognition from all this tragedy. It's the case that wouldn't go away. So if I sound irritated, it's because there are so few cases like this and this one keeps getting rehashed. We've known for a long time that there is some element of human error in conducting the medical examiners' reports. What we do know is the number of cases that fall through the cracks is a small percentage. What exactly is a "small percentage"? In their 1994 policy statement, distinguishing between child abuse and SIDS, the American Academy of Pediatrics estimated that cases of Sudden Infant Death thought to be SIDS were correct 95 to 98 percent of the time. Thus the overwhelming number of SIDS cases are bona fide medical disorders and remain a medical mystery after all known and possible causes -- including child abuse -- have been ruled out. How do doctors classify a SIDS death? What are the signs they look for? In general, SIDS babies appear to be healthy, but we know that these are not normal babies dying suddenly and unexpectedly. They have some type of subtle developmental delay, anatomical defect or functional failure. For example, it may be that mechanisms within the brain stem are not functioning properly, not sending the correct signals and, therefore, the baby is not mounting the appropriate reflexes. Are there any overlapping areas between SIDS and abuse? Is that why some cases are misdiagnosed? The overlap is about 2 percent, according to the American Academy of Pediatrics. What specific symptoms are in this 2 percent area? I have no idea. I'm sorry that I can't characterize the child abuse cases because I'm not familiar with that part of the area. That's not something that we work with, that we deal with. We're involved in research efforts, in supporting SIDS families. The Hoyt case happened 25 years ago; it is exceedingly rare that it would happen today. Why? Do you think the medical establishment is, in general, too hasty when ruling a death a SIDS? No, no. This book looks at a case that occurred in New York state 25 years ago. A lot has changed in the medical examiner's system, a lot has changed about apnea, about SIDS, about mothers who are trying to deceive doctors. We have a tremendous growth in medical understanding over the last 25 years. And I think that this book does not address any of that. The book is in a time warp. < - - - - - - - > SIGNS OF ABUSE "The million dollar question is, what were these physicians trying to hide? Were they totally incompetent or were they totally naive? Or did they know about the possibility of abuse and suppress it?" -- Dr. Thomas Truman < - - - - - - - > But the book includes other cases that didn't happen that long ago. This book is based on a handful of cases of infanticide mistaken for SIDS and also on this unpublished Thomas Truman report. It's based on the circumstantial speculation of a research fellow. What do you think of the Truman report? He concludes that 5 to 10 percent of the SIDS cases are misdiagnosed. Who is he? And whoever he is, he can bandy about whatever numbers he wants. A baby with repeated stoppage of breath episodes is not automatically suspicious by any means. How about when it happens with the same caregiver? It's bound to happen with the presence of the same parent or caregiver. What we're talking about is not suspicious at all, it's a medical problem, it's the rare case that might be suspicious, not the commonplace case. These are not typical SIDS cases, and babies who do not die are not SIDS cases at all. Truman also talks about some cases of some babies who were admitted to the hospital and didn't have any problems while in the hospital and as soon as the babies left with the same parent or caregiver, they stopped breathing again. Unfortunately, babies don't change parents. So they're bound to go home with the same parent. There's a difference between talking about babies that have died and multiple deaths in a family. There is a tiny percentage of the SIDS deaths that are multiple deaths, where you have more than one death in a single family. And then if you look at the number of multiple SIDS deaths, and begin to look for signs of child abuse, you first have to rule out possible metabolic disorders that may run in families. And so that eliminates some of the multiple SIDS. How about Dr. David Southall's report, which reportedly includes videotaped evidence of mothers choking their infants? Have you seen the report? Because I have not. What period of time was he looking at? Now 39 deaths, how many years did this involve? If we're looking at three cases like this a year, then that's off into the exceedingly rare category. Isn't it important to increase awareness about these cases that fall through the cracks, so parents who murder their kids don't go unpunished? Well, hopefully it will help in a handful of cases that fall through the cracks. We are for protecting and saving infant life. But we have a duty to support bona fide legitimate SIDS families. There are 3,500 SIDS deaths a year. Over a generation we're looking at almost 100,000 families who have been affected by this. In contrast, there are only a handful of cases that are falling through the cracks. Of course we want sudden infant deaths fully investigated, but also investigated with compassion and sensitivity because the vast majority of these sudden deaths are SIDS. With the possibility of rising suspicion of SIDS cases, will there be a lot of unfounded allegations against parents who lost their children because of SIDS? Over the course of the history of SIDS, that has been the rule and not the exception. Parents, in general, have been ostracized and criminalized and unjustly accused and have basically had the stigma of having a yellow crime tape around their home, being driven to the police station in a paddy wagon, having an obituary notice that reads "Sudden Infant Death Syndrome investigation pending." It's an indignity to be a SIDS parent. So there was already a cloak of distrust associated with SIDS? There has been. I think that we've made a lot of progress through the introduction and passing of legislation mandating autopsy, which to a certain degree, in death scene investigations, helps to lift the burden of responsibility off the shoulders of the parents who were not to blame, who could not have controlled the course of events and did nothing wrong, did everything right and their baby still died. I think that over the course of the last decade or two, we have been able to establish the fact that Sudden Infant Death Syndrome is a recognized medical disorder. And while we don't know what's causing SIDS at this juncture, we've made great progress in isolating risk factors. What do you think all of these reports of abuse cases being masked as SIDS will do to the person who really loses their child tonight because of SIDS? It's very painful. I think that it is very painful for the thousands of legitimate SIDS parents across this country to be continuously subjected to sensationalized reports of the isolated cases that have somehow fallen through the cracks in the medical examiner system. We contend that the kind of coverage that continuously downplays the thousands of legitimate SIDS cases and intentionally focuses on a minute percentage of misdiagnosed cases is as irresponsible and reprehensible as paparazzi photos. This kind of coverage draws public attention away from SIDS risk reduction programs like "Back to Sleep," which are saving thousands of infants' lives. Do you think that there is a new victim being created with all of this talk of SIDS parents possibly abusing their children? The reality is, any parent that takes the life of a baby is a horrid individual and deserves everything in terms of conviction and everything else. There is no infant life that we would consider insignificant. But we can't position SIDS parents against criminals. It is unfair to continuously compare criminals to SIDS parents. It is far more common for SIDS parents to be unjustly accused than it is for a case of child abuse fatality to be misdiagnosed as SIDS. Sept. 19, 1997 Discuss the controversy over Sudden Infant Death Syndrome in Table Talk.

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