Wednesday, October 10, 2018

Book Nook: Rest Uneasy - Sudden Infant Death Syndrome in Twentieth-Century America

Rutgers University Press has released the latest title in the Critical Issues in Health and Medicine series, tackling children's health with Rest Uneasy: Sudden Infant Death Syndrome in Twentieth-Century America by Brittany Cowgill. 

Tracing the Sudden Infant Death Syndrome (SIDS) diagnosis from its mid-century origins through the late 1900s, Rest Uneasy investigates the processes by which SIDS became both a discrete medical enigma and a source of social anxiety construed differently over time and according to varying perspectives. American medicine reinterpreted and reconceived of the problem of sudden infant death multiple times over the course of the twentieth century. Its various approaches linked sudden infant deaths to all kinds of different causes—biological, anatomical, environmental, and social. In the context of a nation increasingly skeptical, yet increasingly expectant, of medicine, Americans struggled to cope with the paradoxes of sudden infant death; they worked to admit their powerlessness to prevent SIDS even while they tried to overcome it. Brittany Cowgill chronicles and assesses Americans’ fraught but consequential efforts to explain and conquer SIDS, illuminating how and why SIDS has continued to cast a shadow over doctors and parents.

Brittany Cowgill has a PhD in history from the University of Cincinnati in Ohio. I had a chance to interview her to learn more.

Why did you decide to write this book?
I first began thinking about SIDS when I was researching brain death for my master’s thesis on the history of organ donation. I stumbled on the writings of Dr. Lester Adelson, one of the early pioneers in modern pathology, and Adelson happened to study SIDS. He was completely baffled and distraught by the mystery of SIDS, and he asked this incredibly striking question: “how do you deal with a disease whose first and only symptom is death”? 
It stuck with me, and I started wondering the same. I became engrossed with trying to answer Adelson’s exact question, and gain some understanding of how and why the SIDS label was created, how families and medicine have tried to deal with and contend with SIDS, and what their efforts have meant. And their stories have a lot to tell us.

Why is it so important to focus a whole book on SIDS?
SIDS is one of new parents’ greatest fears – it was when it was first categorized and studied, in the mid-1900s, and it remains so today. The history of SIDS informs the present in powerful ways; past attitudes and approaches to sudden infant mortality have shaped our current understandings (and misunderstandings) of SIDS. In other words, SIDS’ “origins story” helps explain some of the reasons why we continue to be so terrified of SIDS, why we are still so uncomfortable talking about SIDS, and why there remains so much baggage surrounding the seemingly simple question of where a baby should sleep. SIDS is so unnerving for us on so many different levels that it deserves our undivided attention. Even fifty years after it was defined, SIDS is still paradoxical, devastating, unpredictable, and stigmatized. This book is a first step towards a better understanding of how this terrible loss has, and continues to, impact families and societies.

How can parent work with their pediatricians to reduce the risk of SIDS?
It is so important for families to have open, honest conversations about sleeping practices and habits with their pediatricians. Even though there are numerous unanswered questions about SIDS and its causes, talking openly about the risk of SIDS is the first step toward prevention. There is an overwhelming amount of convincing evidence that supports the “back to sleep” recommendation, so parents can and should practice that – but there are a ton of other components of the American Academy of Pediatrics’ Safe Sleep Guidelines that parents should be aware of. And some of these recommendations (such as room-sharing for a year, or not bed-sharing) are weighed down with uncertainty; the reality is that every family’s situation and needs are distinct. Being transparent about your family’s particular sleeping routines, whatever they may be, will ultimately help you and your pediatrician to work together to facilitate the safest sleeping environment possible for your baby and your family. 

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