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After many years of stalled nationwide progress in lowering the speed of Sudden Surprising Toddler Demise (SUID), a class of toddler mortality that features sudden toddler loss of life syndrome (SIDS), researchers at Rutgers Well being have proposed an surprising answer: Caffeine may defend infants by stopping harmful drops in oxygen that will set off deaths.
The speculation, revealed within the Journal of Perinatology, comes because the variety of SUID instances has plateaued nationally at about 3,500 deaths a 12 months for 25 years or one loss of life for each 1,000 stay births. Regardless of an preliminary decline within the Nineteen Nineties with the introduction of widespread training campaigns selling again to sleep and different protected toddler sleep suggestions by the American Academy of Pediatrics, SIDS, even by itself, stays the main reason for loss of life in infants between 1 and 12 months previous.
“We’ve been concerned about why the rates haven’t changed,” mentioned Thomas Hegyi, a neonatologist at Rutgers Robert Wooden Johnson Medical College who led the analysis. “So, we wanted to explore new ways of approaching the challenge.”
That strategy led Hegyi and Ostfeld to a hanging realization: Nearly all identified danger elements for SIDS and different sleep-related toddler deaths, from abdomen sleeping to maternal smoking to bed-sharing to preterm beginning, have one factor in widespread. They’re all related to intermittent hypoxia, transient episodes the place oxygen ranges drop beneath 80%.
“I wondered, what can counter intermittent hypoxia?” Hegyi mentioned. “Caffeine.”
The connection is not totally theoretical. Neonatologists already use caffeine to deal with apnea in untimely infants, the place it really works as a respiratory stimulant. The drug has a superb security profile in infants, with minimal unwanted effects even at excessive doses.
What makes caffeine significantly intriguing as a proposed safety measure is how in another way infants course of it. Whereas adults metabolize caffeine in about 4 hours, the half-life in newborns will be so long as 100 hours. Caffeine stays in an toddler’s system for weeks, not hours.
This distinctive metabolism may clarify a long-standing puzzle: why SIDS peaks between two and 4 months of age. As infants mature, they start metabolizing caffeine extra shortly. The researchers recommend caffeine consumed throughout being pregnant or handed by means of breast milk may present early safety that wanes as metabolism quickens.
The speculation might additionally clarify why breastfeeding seems to guard towards SIDS.
“We hypothesize that the protection afforded by breast milk is, in part, due to caffeine,” wrote the researchers, noting caffeine readily passes from moms to infants by means of breast milk.
Barbara Ostfeld, a professor at Rutgers Robert Wooden Johnson Medical College, this system director of the SIDS Middle of New Jersey and co-author of the paper, mentioned that if the idea proves true, any efforts to provide infants caffeine would complement, not change, current risk-reduction methods.
“The idea isn’t that caffeine will replace risk-reduction behaviors,” Ostfeld mentioned. “A baby dying from accidental suffocation, one component of SUID, is not likely to have benefited from caffeine but would have from such safe sleep practices as the elimination of pillows and other loose bedding from the infant’s sleep environment.”
The researchers plan to check their speculation by evaluating caffeine ranges in infants who died of SIDS with those that died from different causes, comparable to trauma or illness.
The analysis represents a basic shift in approaching SIDS prevention. Whereas present methods concentrate on eliminating environmental dangers, this may be the primary potential pharmaceutical intervention.
“For over 30 years, we’ve been educating New Jersey’s parents about adopting safe infant sleep practices. These efforts have contributed to our state rates being the second lowest in the US. Still, for various reasons, these proven recommendations are not universally adopted,” Ostfeld mentioned. “This new hypothesis offers a way not just to address important risk factors but potentially intervene.”
Crucially, the researchers mentioned that is hypothesis-generating analysis meant to encourage additional examine, not a advice for fogeys to provide their infants caffeine. Any intervention would require in depth testing for security and efficacy.
Nonetheless, in a subject the place progress has stagnated for many years, the opportunity of a brand new strategy affords hope.
As Hegyi put it, the objective is “to stimulate new thinking about a problem that has remained unchanged for 25 years.”
Extra data:
Thomas Hegyi et al, Lowering the danger of sudden surprising toddler loss of life: the caffeine speculation, Journal of Perinatology (2025). DOI: 10.1038/s41372-025-02333-x
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