31 ms·

Butyrylcholinesterase is a potential biomarker for Sudden Infant Death Syndrome

47 points by nailer 5y ago

unwind 5y ago
I way too stupid in both medicine and statistics to interpret this, but if the conclusion holds then my understanding is that this gives an indicator at around ~2 days after birth if a baby is at high risk for SIDS. As a parent having sort of lived through the fear of SIDS when our kids were younger, I really hope that is true. I have no idea what can be done if there is a higher risk, I guess more intense monitoring comes to mind. I don't even know what actually causes death by SIDS, and how you would stop it. It's a truly horrible thing however, and I hope this can help stop/prevent it for future babies' and their parents' sake. Go science!
- maweki 5y ago
  > I don't even know what actually causes death by SIDS That's the problem with syndroms. From wikipedia: "A syndrome is a set of medical signs and symptoms which are correlated with each other and often associated with a particular disease or disorder. [...] When a syndrome is paired with a definite cause this becomes a disease." At least in Europe SIDS cases have dropped off a bit. Our nurses attest this to better ventilation of cribs, more sleep on the back, and overall better sleep-wear, like sleeping bags. But this is quite a difficult topic to study. You can't "try" anything. That's hugely unethical. And post-fact investigations are difficult enough with (1) the parents already blaming themselves, and (2) having an incredible observation bias by not looking at alive infants.
  - hnbad 5y ago
    The problem with SIDS is that it largely just describes unexpected death while the parents are absent or asleep. This clearly includes a large number of accidents. One of the SIDS prevention tips is literally not to sleep next to a baby while intoxicated. It's possible that alcohol breath would be the contributing factor but it's also possible that an intoxicated adult is simply more likely to accidentally suffocate an infant while asleep. I'm not saying all cases of SIDS are accidental suffocation (though the vast majority of SIDS prevention tips boil down to "avoid obstructing the infant's airways and provide ample ventilation" and the rest are largely about temperature control to prevent hypothermia and hyperthermia) but I find it far more plausible that some infants simply are more vulnerable to accidental suffocation (or other forms of physical stress like temperature). We ended up going against most SIDS prevention tips (our newborn slept in the family bed starting with an age of half a day) but we were also extremely attentive (living in a country with healthcare and being able to take the time off helps with that) and our baby was very healthy, strong (already able to lift his head shortly after birth), took well to breastfeeding (and my wife was able to breastfeed, luckily) and was very obvious when signalling discomfort (usually being too hot when we followed the recommendations). This doesn't mean SIDS prevention tips are bogus and it doesn't mean any other baby would have fared the same, but if we had put him in his own bed with a pillow and duvet I could easily imagine that he could have suffocated in his sleep and it would have been labelled SIDS. EDIT: FWIW because of the implication that SIDS is a "disease" that can strike at any moment, we had a guilty conscience the entire time. I think a more honest framing of "some infants can be physically more vulnerable than they seem and here are some tips to keep them as safe as possible" would have made it a lot less stressful, but I'm not sure how much framing it as "SIDS prevention" helps people actually think about these things (or at least just follow the guidelines if they don't think about it).
    - triyambakam 5y ago
      > We ended up going against most SIDS prevention tips (our newborn slept in the family bed starting with an age of half a day) It's emotionally healthier for everyone that way. And most of the world does that.
    - gambiting 5y ago
      >> but if we had put him in his own bed with a pillow and duvet Well, for newborns you aren't meant to do that anyway. Definitely no pillow, and a very breathable blanket if any(sleeping bag is actually preferable nowadays). Our little boy is 1 year old and he still doesn't use a pillow - there's just no need.
      - hnbad 5y ago
        Oh, absolutely. I meant that as an example of also not following the SIDS prevention tips, but in a way that's less controlled than trying to keep him safe in the family bed (which of course also has pillows and duvets).
  - msh 5y ago
    Also that people don't smoke around infants anymore in any large numbers.
- mstipetic 5y ago
  I have small kids and completely understand the worry and wouldn’t wish it on anyone, but I think the whole fear of sids is a bit overblown - from what I’ve read the chances are in the order of 1:14000, and is probably on par with leukemia or a host of other things that can happen. I don’t think we should be living in fear of that thing
  - WaxedChewbacca 5y ago
  - tapland 5y ago
    Afaik it should be around 1 in 1000. Which is still rare.
  - CraigJPerry 5y ago
    Availability bias massively shapes any person’s risk view here. A parent who lost a child to this vs one who didn’t are going to have wildly divergent views. The one who lost is going to be more aligned to “you don’t fully appreciate the cost of losing a child, you can afford to do more“. The one who didn’t will be more aligned to “it’s a low risk, take sensible precautions but don’t go overboard investing in avoidance here and keep an eye on the other risks besides this”. It’s not clear to me how to navigate that because as rational as the numbers are, i would be willing to exchange everything to avoid being the parent who lost. I don’t know. Risk is utterly fascinating, the numbers side is casually interesting but the psychology of how we deal with it… you could spend a lifetime studying that.
  - jebus989 5y ago
    I agree, I'm guessing the highest (arguably avoidable) risk to a baby or child is driving them around in a car.
- shakes_mcjunkie 5y ago
  In the case that this blood test becomes widely available, if your baby tests positive, you'd probably then use something like the Owlette to monitor your baby's breathing while they sleep. The problem seems to be the baby's brain "forgets" to breathe while sleeping and if you catch it in time you can prevent death.
- vixen99 5y ago
  Stupid? Would you want to apply that to anyone else unable to interpret this finding? I don't think so. What you mean is that you're insufficiently knowledgeable in that domain.
quirino 5y ago
I believe this was posted here yesterday https://news.ycombinator.com/item?id=31356377 https://news.ycombinator.com/item?id=31356377
sanxiyn 5y ago
All funding provided by a crowd funding campaign...
peterburkimsher 5y ago

47 points by nailer 5y ago

I way too stupid in both medicine and statistics to interpret this, but if the conclusion holds then my understanding is that this gives an indicator at around ~2 days after birth if a baby is at high risk for SIDS. As a parent having sort of lived through the fear of SIDS when our kids were younger, I really hope that is true. I have no idea what can be done if there is a higher risk, I guess more intense monitoring comes to mind. I don't even know what actually causes death by SIDS, and how you would stop it. It's a truly horrible thing however, and I hope this can help stop/prevent it for future babies' and their parents' sake. Go science!

maweki 5y ago
> I don't even know what actually causes death by SIDS That's the problem with syndroms. From wikipedia: "A syndrome is a set of medical signs and symptoms which are correlated with each other and often associated with a particular disease or disorder. [...] When a syndrome is paired with a definite cause this becomes a disease." At least in Europe SIDS cases have dropped off a bit. Our nurses attest this to better ventilation of cribs, more sleep on the back, and overall better sleep-wear, like sleeping bags. But this is quite a difficult topic to study. You can't "try" anything. That's hugely unethical. And post-fact investigations are difficult enough with (1) the parents already blaming themselves, and (2) having an incredible observation bias by not looking at alive infants.
- hnbad 5y ago
  The problem with SIDS is that it largely just describes unexpected death while the parents are absent or asleep. This clearly includes a large number of accidents. One of the SIDS prevention tips is literally not to sleep next to a baby while intoxicated. It's possible that alcohol breath would be the contributing factor but it's also possible that an intoxicated adult is simply more likely to accidentally suffocate an infant while asleep. I'm not saying all cases of SIDS are accidental suffocation (though the vast majority of SIDS prevention tips boil down to "avoid obstructing the infant's airways and provide ample ventilation" and the rest are largely about temperature control to prevent hypothermia and hyperthermia) but I find it far more plausible that some infants simply are more vulnerable to accidental suffocation (or other forms of physical stress like temperature). We ended up going against most SIDS prevention tips (our newborn slept in the family bed starting with an age of half a day) but we were also extremely attentive (living in a country with healthcare and being able to take the time off helps with that) and our baby was very healthy, strong (already able to lift his head shortly after birth), took well to breastfeeding (and my wife was able to breastfeed, luckily) and was very obvious when signalling discomfort (usually being too hot when we followed the recommendations). This doesn't mean SIDS prevention tips are bogus and it doesn't mean any other baby would have fared the same, but if we had put him in his own bed with a pillow and duvet I could easily imagine that he could have suffocated in his sleep and it would have been labelled SIDS. EDIT: FWIW because of the implication that SIDS is a "disease" that can strike at any moment, we had a guilty conscience the entire time. I think a more honest framing of "some infants can be physically more vulnerable than they seem and here are some tips to keep them as safe as possible" would have made it a lot less stressful, but I'm not sure how much framing it as "SIDS prevention" helps people actually think about these things (or at least just follow the guidelines if they don't think about it).
  - triyambakam 5y ago
    > We ended up going against most SIDS prevention tips (our newborn slept in the family bed starting with an age of half a day) It's emotionally healthier for everyone that way. And most of the world does that.
  - gambiting 5y ago
    >> but if we had put him in his own bed with a pillow and duvet Well, for newborns you aren't meant to do that anyway. Definitely no pillow, and a very breathable blanket if any(sleeping bag is actually preferable nowadays). Our little boy is 1 year old and he still doesn't use a pillow - there's just no need.
    - hnbad 5y ago
      Oh, absolutely. I meant that as an example of also not following the SIDS prevention tips, but in a way that's less controlled than trying to keep him safe in the family bed (which of course also has pillows and duvets).
- msh 5y ago
  Also that people don't smoke around infants anymore in any large numbers.
mstipetic 5y ago
I have small kids and completely understand the worry and wouldn’t wish it on anyone, but I think the whole fear of sids is a bit overblown - from what I’ve read the chances are in the order of 1:14000, and is probably on par with leukemia or a host of other things that can happen. I don’t think we should be living in fear of that thing
- WaxedChewbacca 5y ago
- tapland 5y ago
  Afaik it should be around 1 in 1000. Which is still rare.
- CraigJPerry 5y ago
  Availability bias massively shapes any person’s risk view here. A parent who lost a child to this vs one who didn’t are going to have wildly divergent views. The one who lost is going to be more aligned to “you don’t fully appreciate the cost of losing a child, you can afford to do more“. The one who didn’t will be more aligned to “it’s a low risk, take sensible precautions but don’t go overboard investing in avoidance here and keep an eye on the other risks besides this”. It’s not clear to me how to navigate that because as rational as the numbers are, i would be willing to exchange everything to avoid being the parent who lost. I don’t know. Risk is utterly fascinating, the numbers side is casually interesting but the psychology of how we deal with it… you could spend a lifetime studying that.
- jebus989 5y ago
  I agree, I'm guessing the highest (arguably avoidable) risk to a baby or child is driving them around in a car.
shakes_mcjunkie 5y ago
In the case that this blood test becomes widely available, if your baby tests positive, you'd probably then use something like the Owlette to monitor your baby's breathing while they sleep. The problem seems to be the baby's brain "forgets" to breathe while sleeping and if you catch it in time you can prevent death.
vixen99 5y ago
Stupid? Would you want to apply that to anyone else unable to interpret this finding? I don't think so. What you mean is that you're insufficiently knowledgeable in that domain.

quirino 5y ago

I believe this was posted here yesterday https://news.ycombinator.com/item?id=31356377 https://news.ycombinator.com/item?id=31356377

sanxiyn 5y ago

All funding provided by a crowd funding campaign...

peterburkimsher 5y ago