Unlocking the secrets of cot death

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Exclusive: A major new report seen by the IoS has revealed that smoking holds the key to a mystery that has baffled doctors and brought heartache to thousands. By Roger Dobson and Senay Boztas
Nine out of 10 mothers whose babies suffered cot death smoked during pregnancy, according to a scientific study to be published this week. The study, thought to be one of the most authoritative to date on Sudden Infant Death Syndrome (SIDS), says women who smoke during pregnancy are four times more likely than non-smokers to see their child fall victim to cot death.
The comprehensive report will make a strong case for the Government to increase the scope of anti-smoking legislation. It even suggests a possible move to try to ban pregnant women from getting tobacco altogether.
The study, produced by Bristol University's Institute of Child Life and Health, is based on analysis of the evidence of 21 international studies on smoking and cot death. The report, co-authored by Peter Fleming, professor of infant health and developmental physiology, and Dr Peter Blair, senior research fellow, will be published this week in the medical journal Early Human Development.
The report urges the Government "to emphasise the adverse effects of tobacco smoke exposure to infants and among pregnant women". It also warns that this year's ban on smoking in public places must not result in an increased exposure of infants or pregnant woman at home – smoking in their presence should be seen as being "anti-social, potentially dangerous, and unacceptable".
The study points out that many mothers and mothers-to-be have not heeded warnings about smoking and may need to have their access to tobacco restricted. "Given the power that tobacco addiction holds over its victims, there is grave concern as to whether it will be a successfully modifiable risk factor without fundamental changes in tobacco availability to vulnerable individuals," it states.
Scientists are working to the theory that exposure to smoke during the pregnancy or just after birth has an effect on brain chemicals in the foetus or in infants, increasing the risk of SIDS.
The Government is considering whether it should change its advice on smoking. It recommends that pregnant women should not drink alcohol at all, but simply recommends that mothers and fathers "cut smoking in pregnancy".
These findings will add weight to calls from doctors earlier this year for a ban on parents smoking indoors where children are present. Professor Robert West, of University College London, the Government's most senior smoking adviser, said: "We can apply powerful social pressure on parents not to smoke in the house."
Speaking about the new report, Dr Blair said: "If smoking is a cause of SIDS, and the evidence suggests it is, we think that if all parents stopped smoking tomorrow more than 60 per cent of SIDS deaths would be prevented."