By Rachael Rettner
MyHealthNewsDaily 

On Dec. 29, 2009, Dearea, a mother in Baltimore, lived every parent's nightmare. After taking her 1-month old son Charlie out of his bassinet in the early morning, and laying him down to sleep next to her when he had finished nursing, she awoke later to find he was not breathing.

She yelled to her husband to call 911, and to her mother to begin CPR. They rushed Charlie to the hospital. "I'm praying that he's going to be ok," Dearea later recalled.

There had been no signs of trouble before that day. Dearea had had a healthy pregnancy, and brought Charlie home shortly after he was born.

But after Charlie was taken to the hospital, doctors informed Dearea that there was nothing they could do to safe her son's life.

In following weeks, Dearea, who did not want her last name used in this story, called the medical examiner's office every day to see if they had determined the cause of Charlie's death.

When she finally received the death certificate, she learned Charlie had died of Sudden Infant Death Syndrome, or SIDS. The medical examiner informed Dearea her son's heart had stopped, but there were no signs of crushed ribs or suffocation.

"It was such a relief, almost, that it wasn’t my fault," Dearea said. "[It's] hard for a mother to live with the fact that you could have done something else," she said.

Charlie was one of the more than 4,500 infants in the United States who die suddenly from no obvious cause each year. Anytime there is a sudden unexpected infant death (SUID), experts investigate. Sometimes a medical examiner will find the cause; if a cause of death cannot be determined after an investigation, the death is deemed to be caused by SIDS, or "unknown cause."

But the sole listing of SIDS on a death certificate reveals little about how the baby really died. With a new database, called the SUID Case Registry, run by the Centers for Disease Control and Prevention, experts are now aiming to collect detailed information about such cases to figure out how to better prevent such tragedies.

Health officials have already investigated more than 1,000 cases over the last three years, and have used that information to begin to implement prevention strategies.

Unclear cause of death
The main problem when researching cases of SUID is often that medical examiners may classify deaths differently depending on their level of training and experience, as well the information that they receive from the scene.

"To one medical examiner, everything is suffocation. To another, everything is SIDS," said Lena Camperlengo, program coordinator of the SUID Case Registry.

The database collects more than 1,200 variables related to each case, including information about where the baby was sleeping, what position he was in when he was found, whether there were additional items in the crib, whether the baby was breastfed and whether there have been any other cases of SIDS in the family.

Often, parents are asked to re-enact, with dolls, how they placed the baby down, and how they found the baby after his or her death. The position of the nose and mouth in the re-enactments can help a medical examiner determine whether a death was due to suffocation, Camperlengo said.

Currently, nine states receive funding to collect information for the database (Arizona, Colorado, Louisiana, Michigan, Minnesota, New Jersey, New Mexico, New Hampshire and Wisconsin), and many others are collecting the information voluntarily. Previously, such detailed data may not have been gathered, said Shannon Stotenbur-Wing, director of Center for Child & Family Health at the Michigan Public Health Institute.

Prevention strategies
Michigan researchers reviewed 140 cases of sleep-related infant deaths in 2010. In nearly 60 percent of cases, blankets were in the crib, bassinet or playpen where the child was sleeping at the time of death, Stotenbur-Wing said. An ideal baby bed consists solely of a firm crib mattress covered by a fitted sheet, with no additional blankets, toys or other objects, according to the American Academy of Pediatrics.

Registry information from Michigan also showed that mothers in 70 percent of cases were on Medicaid. Now, parents of newborns on Medicaid in the state are given brochures on safe sleep. It took a push to get the brochures made and distributed, but "it's saving lives," Stotenbur-Wing said.

New Jersey is working to get information on safe sleep into family resource centers, said Lisa Hartmann, program manager of the SUID grant in New Jersey. Hartmann said she has worked to understand parents' circumstances, and recognizes that not everyone has the resources to purchase a crib for their baby, or keep it when they move.

Hartmann said it's important to encourage parents not let their babies sleep in the parents' bed, and tells them the baby would be safer "in a drawer on the floor," than in the bed with them.

Hartmann is also working with the New Jersey department of education to have middle schoolers make drawings of safe sleep environments, which will be entered into a calendar contest. The calendar will be given out at Medicare and Women, Infants and Children (WIC) centers, Hartmann said. This way, the message will reach both younger and older generations.

After Charlie passed away, Dearea was part of a public service campaign on safe sleep for B'more for Healthy Babies, which aims to improve the health of babies and mothers in the Baltimore area. She said she had not received information about safe sleep before she was a part of the campaign.

Campaigns are a good place to start, but Dearea said there should be more research into the risk factors for unexpected infant death.

"It shouldn’t be that the only way you found out [your child is at risk] is through an autopsy," Dearea said. "There should be some kind of warning," she said.

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By MyHealthNewsDaily Staff

More young and middle-aged adults are having strokes, a new study suggests.

In 1994, 12.9 percent of strokes occurred in adults between ages 20 and 55, whereas in 2005, 18.6 percent of strokes occurred in this age group, according to the study of stroke rates in a four-county region of Ohio and Kentucky.

Additionally, the data showed that the average age of people who experienced a stroke fell from 71 in 1994 to 69 in 2005.

"The reasons for this trend could be a rise in risk factors such as diabetes, obesity and high cholesterol," said study author Dr. Brett Kissela, of the University of Cincinnati College of Medicine in Ohio. However, factors such as improved diagnosis may also have contributed to the increase, he said.

"Regardless, the rising trend found in our study is of great concern for public health, because strokes in younger people translate to greater lifetime disability," Kissela said.

In the study, researchers looked at data on all stroke patients between ages 20 and 54 seen at hospitals, clinics and nursing homes during three separate, yearlong periods: July 1993 through June 1994, and the calendar years of 1999 and 2005. Only a patient's first stroke was included in the analysis.

The stroke rate among people over age 75 decreased between 1994 and 2005, according to the study, and other studies have shown a general decrease in stroke rates over recent decades. For example, the Framingham Heart Study reported a decline in stroke rates between 1950 and 2004.

"Any decline in stroke incidence is positive from a public health prospective, but reduced incidence in older ages is counterbalanced by the worrisome trend of younger strokes," Kissela and colleagues wrote in their study. Strokes at younger ages can mean a greater loss of productive life years, and greater health care expenses over time.

The new findings show that the trend toward younger stroke patients was seen in both African-Americans and Caucasians. The yearly stroke rate among African-Americans increased between 1994 and 2005 from 83 strokes to 128 strokes per 100,000 people, according to the study. Among Caucasians, the yearly stroke rate increased from 26 strokes to 48 strokes per 100,000 people over the same period.

Most of these increases were seen in a type of stroke called an ischemic stroke, which occurs when an artery bringing blood to the brain is blocked. (Another type — called a hemorrhagic stroke, which occurs when a blood vessel leaks or bursts — was less common.)

While the reasons for the increased stroke rate among younger people are not entirely clear, the researchers pointed to the findings of a separate survey of people in the region, which showed an increasing percentage had high cholesterol. Data from national surveys also show that rates of diabetes, high cholesterol, and obesity increased over the study period, they said.

"The good news is that some of the possible contributing factors to these strokes can be modified with lifestyle changes, such as diet and exercise," Kissela said.

One question raised by the study is whether the increase is partly due to better diagnoses of stroke, according to two researchers who wrote an editorial accompanying the new study in the journal. 

"The progressive adoption of MRI as a diagnostic tool during the study period challenges the validity," of comparing the stroke rates between the early 1990s and 2005, wrote Drs. Sally Sultan and Mitchell S. V. Elkind, both neurologists at Columbia University Medical Center in New York City.

While the researchers tried to account for the increased use of MRI in their study, it likely still had an effect, Sultan and Elkind said.

However, if strokes are affecting more young people, there are public health implications, they said. "If strokes occur at earlier ages, as life expectancy increases, stroke-related disability will increase even more," they wrote.

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James Cheng / msnbc.com

Babies can tell if an adult is reliable nor not, a new study finds.

Babies may be a lot more savvy than we think.

A new study has found that babies little more than a year old can tell whether we’re trustworthy enough to listen to, according to a report published in Infant Behavior and Development.

“Even at a young age, children do not blindly swallow information,” said the study’s lead author Diane Poulin-Dubois, a professor of psychology at the Centre for Research in Human Development at the University of Concordia. “Doubtful or contradictory information is automatically screened by their cognitive system. Young children are not gullible.”

To determine whether babies took everything at face-value or whether they actually mull over the credibility of the people around them, Poulin-Dubois and her colleagues set up an intriguing experiment involving 60 babies aged 13 to 16 months.

Half the babies would interact with a “reliable” adult, while the other half would interact with an “unreliable” one, while playing with a box that in some cases contained a toy and in others was empty.

In the first part of the experiment, the adult would look inside the box and express excitement and happiness. Then the babies were invited to look inside the box themselves to see what the fuss was about.

Unreliable adults were the ones who ooo’d and ah’d over empty boxes, while reliable ones made a fuss only when there was a toy inside.

The second part of the experiment used the same adult-baby pairs. This time the adult used her forehead instead of her hands to turn on a push-on light. The idea was that babies who trusted their new adult friends would try to imitate them.

Sure enough, babies were much more likely to try using their heads to turn on the light if they’d played the “what’s in the box?” game with a “reliable” adult, compared to those who’d played with an “unreliable” one.

For little ones, what it all comes down to is survival.

“We are a very social species and human offspring are dependent on their caregivers for a long time,” Poulin-Dubois explained. “Learning from others is key to cultural learning but it comes with potential costs, such as inaccurate information. Being equipped with an ability to detect ‘unconventional’ or unreliable people is a protection against acquiring false information.”

One of the simplest examples of this is the credibility conferred on adults, Poulin-Dubois said.

“Age is one of these cues and is used by infants and preschoolers,” she added. “They will imitate an adult more than a child unless the adult seems unreliable and the child reliable.”