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Cot
Death—Cause and Prevention
Experiences in New Zealand 1995–2004
T.
JAMES SPROTT, OBE MSC
PhD
FNZIC
10
Combes Road, Auckland 5, New Zealand
Abstract
There
is a general perception that the cause of cot death remains
unknown. This is not so. The
cause
of cot death (often erroneously termed Sudden Infant Death
Syndrome or SIDS) has
been
elucidated as being due to extremely toxic ‘nerve’ gases
generated by fungal activity on
chemicals frequently present in cot mattresses and in
certain other bedding commonly used in
baby
bedding. However, this explanation, often referred to in
Britain as ‘the Richardson
Hypothesis’, has aroused considerable controversy,
especially among individuals and
organizations closely associated with cot death.
Interventions based on this explanation
have
been widely advocated in two countries: first in Britain
(1989 and 1994) and far more
intensively in New Zealand through a nationwide public
information programme from late
1994
continouously to the present. Both interventions were
followed by significant reductions
in
cot death, especially the 10-year ‘mattress-wrapping’
programme in New Zealand.
Mattress-wrapping (a logical intervention based on the toxic
gas explanation) is an obvious
corollary to that explanation. If this intervention method
is successful in preventing cot death,
that
outcome provides very strong proof of the validity of the
explanation. And this has been
the
outcome—during the 10-year intervention period in NZ there
has never been a report of a
cot
death when the baby has been sleeping on a mattress wrapped
in accordance with the
simple protocol based on the explanation, and the NZ cot
death rate has fallen markedly.
Given
the close examination of all cot deaths in New Zealand
(about 650 from 1995 to the
present) nil reported deaths on wrapped mattresses
effectively means that there have been no
such
deaths. The apparently total success of the intervention,
and the reduction in cot deaths,
provide a standard of proof of the toxic gas explanation
which nullifies the opposition of those
who
would deny it. The success of mattress-wrapping for the
prevention of cot death is such
that
it behoves all people and organizations who provide advice
to parents about cot death
prevention to inform parents of the NZ experience using this
technique.
Keywords:
cot
death, SIDS, mattress-wrapping.
TERMINOLOGY
In
this text the term ‘cot’ is synonymous with ‘crib’. The term
Sudden Infant Death
Syndrome, and its acronym SIDS to describe cot death, have
become widely used; however,
the
term is a misnomer. The term syndrome is defined in
the
New Oxford Dictionary
as:
‘‘Concurrence of several symptoms in a disease; set of
concurrent symptoms
characterizing it.’’
But
there are no observable or described symptoms of cot
death—the only commonality is
death
itself. Therefore, the term SIDS is incorrect and should be
abandoned. It is highly
Journal of Nutritional & Environmental Medicine
(September 2004) 14(3), 221–232
ISSN
1359-0847 print/ISSN 1364-6907 online/04/030221-12
#
2004
Taylor & Francis Ltd
DOI:
10.1080/13590840400016836
misleading, and has added greatly to the confusion which
surrounds this topic because it
perpetuates the incorrect assumption that cot death has a
medical cause.
THE
CAUSE OF COT DEATH
There
is a general perception that the cause of cot death remains
unknown. This is not so.
The
cause was first suggested, in principle, by the writer (T.J.
Sprott) who postulated in
1986
[1] that cot death was caused by accidental poisoning, the
poisons being one or more
gases
generated by microbiological activity on chemicals in the
baby’s cot; and that the
gases, more dense than air, caused death by interfering with
the baby’s nerve function, thus
causing breathing and then heart function to cease. However,
I was unable to identify the
gas/es
or the chemicals from which they were derived.
In
1989 B.A. Richardson of Britain [2] independently came to
the same conclusion, but
in
addition was able to identify the gases as the hydrides
and/or lower alkyl derivates of
phosphorus (P), arsenic (As) and antimony (Sb). He also
identified a common fungus,
Scopulariopsis brevicaulis,
as being probably the principal organism with that
capability to
be
found in babies’ mattresses and other bedding. In a lengthy
series of elegant tests he
demonstrated the generation of these gases from cot
mattresses on which cot deaths had
occurred, and confirmed the identity of the organism
responsible for the gas generation.
Richardson also noticed that the incidence of cot death
seemed to be much higher when
babies were sleeping on previously used mattresses, compared
with the incidence of death
on
new mattresses.
In
June 1989 Richardson advised parents in the UK to protect
their babies from cot
death
either by providing a new mattress for each baby, or by
covering their babies’
mattresses with an inert gas-impermeable diaphragm
(polythene sheeting). This advice was
given
nation-wide coverage. Immediately following this
announcement sales of new cot
mattresses in Britain rose by 15%
[3].
It is not known how many parents adopted the advice
to
cover mattresses with polythene.
Having risen steadily for the previous 30 years, the British
cot death rate immediately
began
to fall and by November 1991 (the date of commencement of
the ‘Back-to-Sleep’
promotion) the UK cot death rate had fallen by 38%.
The only feasible explanation for this
immediate and significant reduction in cot death was the
adoption by British parents of
Richardson’s advice. A subsequent claim by the UK Foundation
for the Study of Infant
Death
that this reduction was due to face-up sleeping is
incorrect—the Back-to-Sleep
programme in Britain was not introduced until 1 December
1991, 30 months after
publication of Richardson’s advice to parents. The British
cot death rate then fell more
sharply, but levelled off in 1994, the overall reduction
since June 1989 being 73%
[4].
Controversy about the validity or otherwise of ‘the
Richardson Hypothesis’ (as it was
known) became intense, and that controversy continues to the
present time both in Britain
and
in other countries, New Zealand included. Various
researchers became interested in
Richardson’s explanation of the cause of cot death and
embarked on tests to replicate
Richardson’s findings, some with no success, but others with
some success. UK
government-sponsored research was also carried out, again
with variable results, and in
1997
the so-called Limerick Report was published [5]. This report
stated in effect that the
Richardson Hypothesis was invalid.
THE
NEW ZEALAND INTERVENTION
By
late 1994 I had realized that for the validity or otherwise
of the toxic gas explanation for
cot
death to be determined, one way or the other, further
laboratory-type research was
futile. The success in cot death prevention, clearly arising
from Richardson’s initial advice,
222
T. J.
SPROTT
was
self-evident and in order to reduce the very high cot death
rate in New Zealand (2.1/
1000
live births in 1994) I decided to promote a cot death
prevention public awareness
programme based on the toxic gas explanation. I adopted
Richardson’s method of a gasimpermeable
diaphragm over the cot mattress, together with the use of
bedding known to
be
free of P, As and Sb.
Various local factors made NZ an ideal country in which to
carry out a programme of
this
nature:
.
A
relatively small population, about 4 million
.
Excellent nation-wide communications available through a
very small number of media
outlets
.
A
high incidence of cot death
.
A
highly developed system of reporting of cot death
.
Individual examination of every cot death
.
Official compilation of numbers of cot deaths by ethnicity
covering the three main ethnic
groups: Maori, Pacific Islands, other (see definitions
below).
The
term ‘mattress-wrapping’ was coined for this programme, and
I drew up a protocol
designed:
(a)
to protect babies from any gases generated from mattresses
by means of a polythene
wrap;
and
(b)
to ensure that bedding used over the ‘wrapped’ mattress did
not contain any
phosphorus, arsenic and antimony.
This
protocol (detailed below) was widely publicized throughout
NZ and this
publicity has continued (in various forms) to the present
time. In 1996 I designed a
range
of ready-made slip-on, sealable cot mattress covers made of
a selected grade of
polythene, and these products, known as ‘BabeSafe’
covers, have been marketed nationwide
in
New Zealand ever since. I also published a book on the topic
[6], and circulated
nation-wide, and on a continuing basis, a very large number
of free booklets written for
parents, midwives and other babycare professionals [7]. I
also published a series of
brochures [8] which were mailed individually to all known
midwives and babycare
organizations in NZ.
Mattress-wrapping, and then
BabeSafe
covers, were quickly adopted by many parents in
NZ,
and their use is now commonplace throughout the country,
especially among the
major
ethnic group known as ‘Pakeha’ (Pakeha is a Maori word
meaning non-Maori,
referred to in official cot death statistics as ‘Other’).
Essentially Pakeha are of European
descent, predominantly British, with a small proportion of
Asiatics. Pakeha comprise about
80%
of
the NZ population. Maori (the indigenous ethnic group)
constitute about 17%,
the
remainder being mostly Polynesian people from islands in the
South Pacific—Samoa, Cook
Islands, Tonga, etc.
As
stated above, a particular feature in NZ is that official
cot death statistics are kept on
the
basis of these three major ethnic groups [9]. The individual
statistics greatly facilitate
research and determining trends in the three ethnic groups.
It is known that Pakeha parents
have
tended to adopt mattress-wrapping to a greater extent than
the other ethnic groups
[10].
For various communication and cultural reasons [11] it
appears that Maori parents
have
not adopted the technique as readily; and furthermore
bed-sharing between parents
and
babies is much more common among Maori than among Pakeha.
(Mattress-wrapping
is
not applicable to adult beds and I advise strongly against
parents bed-sharing with
babies. The higher incidence of cot death in bed-sharing
situations has been reported by
several observers.)
COT
DEATH—CAUSE AND PREVENTION 223
OUTCOME OF MATTRESS-WRAPPING PROGRAMME
The
outcome of 10 years of mattress-wrapping is impressive and
it can be gauged from
Table
1. An additional and vitally important factor is that during
the period of mattresswrapping,
no
cot death has been reported when a baby has been sleeping on
a mattress
wrapped according to the protocol (see below).
By
contrast, at the time of writing, about 650 cot deaths have
occurred in NZ during the
same
period. Given the close scrutiny of cot deaths by various
organizations in NZ, it can
be
stated with confidence that not one of these deaths occurred
on a mattress wrapped
according to the protocol.
Face-up sleeping was introduced in NZ in 1989 and by 1993
fewer than 5%
of
babies
were
sleeping face down [12]. The above reductions occurred after
the benefits of face-up
sleeping had been recognized (about 45%
reduction), and the NZ cot death rate had
remained static at 2.1/1000 live births for three years.
PROOF
OF TOXIC GAS EXPLANATION FOR COT DEATH
‘Mattress-wrapping’ for cot death prevention is an obvious
corollary to the toxic gas
explanation for cot death, in that—if the explanation is
correct—it is the obvious solution
to
cot death. Put another way, if the explanation is valid then
protecting babies against any
gas
generation in their cots should prevent cot death. Given the
extremely high (apparently
total) success of mattress-wrapping in preventing cot death,
it is therefore suggested that
this
constitutes very strong evidence of the validity of the
toxic gas explanation for cot
death. This type of proof of a proposition (testing of a
corollary) is commonly adopted
when
it is difficult or impossible to test a proposition
directly, and its use in this instance is
equally valid in respect of cot death prevention.
Kapuste
et al
[13]
published a statistical analysis of the results of the New
Zealand
mattress-wrapping campaign and found that the ‘p’ factor for
the mattress-wrapping
intervention was p~less
than 1.9610222.
Since it is usual in medical circles to regard a ‘p’
of
less than 0.01 (1022)
as sound proof of a scientific proposition; and p less than
0.001
(1023)
as virtually certain proof, p of 1.9610222
constitutes undeniable proof of the
proposition.
Certainly the level of proof is such that information on the
mattress-wrapping
TABLE
1. New Zealand cot death statistics 1994–2002
%
New
Zealand
population
Cot
Deaths per 1000 Live births
Maori
Pacific
Island
Other
(Pakeha)
y17%
y3%
y80%
NZ
rate
Mattress-wrapping programme commenced December 1994
1994
6.90 N/A 1.40 2.10
1995
4.94 2.11 1.14 2.10
1996
5.68 1.80 0.65 1.90
1997
4.56 0.81 0.52 1.46
1998
3.05 0.66 0.68 1.21
1999
3.40 0.77 0.40 1.12
2000
3.41 1.08 0.35 1.11
2001
2.87 0.31 0.41 0.95
2002
2.90 0.95 0.28 0.93
2003
No data available from NZ Health Information Service
Reductions
58%
55%
80%
56%
224
T. J.
SPROTT
protocol—and the outcomes—should be provided to all parents
where cot death is a
problem by appropriate government departments, babycare
organizations and professionals
who
offer advice on cot death prevention to parents, and to
individuals responsible
for
the care of babies within the cot death risk age. The
oft-repeated claim by Dr Peter
Fleming that the UK CESDI Study found that three babies had
died on mattresses
wrapped in polythene is not substantiated, as Fleming
conceded in February 2000 when he
was
being interviewed on New Zealand national radio [14].
BabeSafe
mattress covers have now been supplied to parents in about
30 countries
including the UK, with no reports of cot death on wrapped
mattresses. The numbers of
covers supplied overseas is not great; however, acceptance
of this technique is steadily
increasing despite continued and unexplained opposition from
various SIDS and related
organizations in Australia, Canada, the UK and the USA.
CONTROLS
It
has been suggested that during the 10 years of
mattress-wrapping there have been no
‘controls’ whereby a comparison can be made between those
babies who slept on wrapped
mattresses and those who did not. This suggestion is not
valid. The mattress-wrapping
programme has been widely publicized throughout New Zealand
since December 1994, and
since
that time there have always been two groups of babies: those
who slept on mattresses
wrapped according to the protocol, and those who did not.
The latter can be looked upon
as
‘controls’. And all cot deaths during the period occurred
among the ‘controls’.
APPLICATION TO KNOWN EPIDEMIOLOGY OF COT DEATH
The
toxic gas explanation for cot death also provides valid
scientific explanations for the
various so-called ‘risk factors’ which have been identified
by means of epidemiology. For
example:
.
The
known benefit of face-up sleeping comes about because the
baby’s mouth and nose
are
removed from the mattress and bedding where gas generation
occurs. (Face-up
sleeping is unnecessary on wrapped mattresses, and thus
avoids the risk of head-flattening.)
.
The
same explanation applies to the finding that a baby sleeping
with a ‘dummy’ or
‘pacifier’ in the mouth is less likely to succumb to cot
death—a baby with a dummy in its
mouth
cannot sleep directly face down.
.
The
link between smoking and cot death is simply a
socio-economic parallel; it is well
known
that the incidence of smoking rises as socio-economic status
reduces; and (for
economic reasons) the re-use of mattresses also rises as
socio-economic status reduces. It
is
highly significant that no ‘cause-and-effect’ relationship
between smoking and cot
death
has been established or even suggested.
.
It
has been observed that face-up sleeping programmes in
various countries have all
brought about a reduction in cot death, but that the extent
of the reduction is only
partial, usually in the range 45–50%.
Then the cot death rate levels off. This is explained
by
the fact that the gases readily diffuse through the baby’s
skin into the bloodstream, a
process which is unaffected by sleeping position.
.
The
observation that over-heating causes cot death was explained
by Richardson who
found
that the rate of gas generation by the fungus is highly
temperature-dependent, an
increase in temperature of 3‡C
resulting in a 10–20 fold increase in the rate of
generation;
hence
the increase in cot death if babies are over-heated.
.
The
link between cot death and vaccination is explained on the
same basis. Vaccination
usually results in a slight fever, with—on a mattress
capable of generating one or more of
the
gases—a consequent increase in gas generation due to a rise
in temperature.
COT
DEATH—CAUSE AND PREVENTION 225
.
This
explanation also accounts for the frequent observation that
cot death babies often
had a
cold or fever prior to death.
.
Of
prime importance is the explanation provided by the toxic
gas explanation for the
known
rise in cot death with sib-ship (Figure 1) [15]. This data
also refutes all theories for
the
cause of cot death based on medical or physiological
disorders. The only valid
explanation for the increased incidence of cot death with
sib-ship is the re-use of
mattresses.
The
data in this graph repeat year after year, and are typical
of data from other countries
where
cot death occurs. The graph destroys all propositions for
the cause of cot death
relating to babies themselves (genes, illness, vaccination,
smoking by parents, physiological
deficiencies etc). It forms part of the extensive proof that
poisoning by extremely toxic
nerve
gases is the single cause of cot death, fully explains, and
is completely compatible
with,
the toxic gas explanation for cot death.
If a
mattress (or other bedding) contains any compounds of
phosphorus, arsenic or
antimony, and if certain household fungi become established
in the mattress (or bedding),
the
gas/es which cause cot death can be generated. And if fungi
have become established in
the
mattress during previous use by another baby, generation of
toxic gas commences
sooner and in greater volume when the mattress is re-used.
This
science accounts for the rising rate of cot death from one
sibling to the next. It also
accounts for the very high cot death rate among babies of
solo parents, who—for economic
reasons—are more likely to sleep their babies on previously
used mattresses.
CONCLUSION
(1)
The 10-year NZ mattress-wrapping programme provides
overwhelming proof of the
toxic
gas explanation for cot death (the Richardson Hypothesis).
(2)
It provides a cheap, safe and simple means for avoiding cot
death.
(3)
All parents and caregivers of babies within the cot death
risk age have the right to be
fully
informed about the NZ mattress-wrapping programme.
(4)
No individuals or organizations in this field have the right
to withhold this information.
(5)
Those individuals and organizations who continue to oppose
mattress-wrapping for cot
death
prevention and/or deny the validity of the toxic gas
explanation for cot death
should be called upon to justify, scientifically, their
opposition.
FIG.
1. Cot death rates for first and later babies and babies of
solo parents, Britain, 1996–1999.
226
T. J.
SPROTT
(6)
Reliance on the findings of the Turner Committee and the
Limerick Committee is now
not
warranted.
PROTOCOL FOR WRAPPING A COT MATTRESS
(1)
Wrap the baby’s mattress in a chemically inert,
gas-impermeable diaphragm of
adequate thickness (minimum 125 micron) made of a material
which does not contain
detectable amounts of phosphorus, arsenic and antimony.
Small ventilation holes
should be provided in the underside of the wrap. (A
BabeSafe1
cot
mattress cover
complies with these requirements.)
(2)
Make up the bedding according to the following instructions:
(a)
On top of the wrapped mattress place a 100%
pure
cotton underblanket* and tuck
this
in securely.
(b)
On top of the underblanket place two cot sheets. (The baby
sleeps between these
sheets. These sheets may be pure cotton or polyester/cotton
mix.)
(c)
On top of the upper cot sheet place 100%
pure
woollen or 100%
pure
cotton
overblanket/s.
(d)
Do not use any of the following items in the baby’s cot:
Sheepskin
Sheepfleece underlay
Any
form of moisture-resistant crib mattress protector
Any
underblanket which is not made of pure cotton
Acrylic blanket
Any
blanket containing polyester
Any
bedding item which is quilted/padded/filled
Sleeping bag
Duvet
Pillows or cushions
*NOTE: This item must not be a so-called ‘cotton mattress
pad’.
(e)
The baby must not sleep in any ‘clothing’ item which is in
the form of a bag.
DISCLAIMER
While
Sprott invented
BabeSafe
covers, and the covers bear his name, he does not
manufacture these products and he declined an offer of a
royalty by the manufacturer.
Sprott has not received any financial assistance in regard
to cot death research.
REFERENCES
[1]
Sprott TJ. Cot death theory worthy of airing, Sunday Star,
Auckland, New Zealand (20 April 1986).
[2]
Richardson BA. Cot Mattress Biodeterioration and SIDS
[letter]. Lancet 1990; 335: 670;
Richardson BA, Cot Death—Must Babies Still Die? Penarth
Research International Ltd,
Guernsey, Channel Islands (November 1991).
[3]
Richardson BA. Cot Death—Must Babies Still Die?,
ibid,
17.
[4]
Sprott TJ. The Cot Death Cover-up? New Zealand: Penguin,
1996. UK: Penguin, 1997, 56–57.
[5]
Expert Group to Investigate Cot Death Theories: Toxic Gas
Hypothesis (Limerick Report), Final
Report May 1998.
[6]
Sprott TJ. The Cot Death Cover-up? New Zealand: Penguin,
1996. UK: Penguin, 1997, 56–57.
[7]
Sprott TJ. The Cause of Cot Death and How to Prevent it (May
1997 and subsequent issue dates).
[8]
Sprott TJ. Cot Life 2000 brochures (December 1997; March
1998; July 1998; April 1999; February
2000).
[9]
Statistics published by New Zealand Health Information
Service (a division of the New Zealand
Ministry of Health).
COT
DEATH—CAUSE AND PREVENTION 227
[10]
New Zealand Ministry of Health (personal communication to T
J Sprott).
[11]
Manukau Urban Maori Authority Healthcare Manager, personal
communication to T J Sprott,
October 2002.
[12]
Mitchell EA, Tonkin S. Publicity and infants’ sleeping
position [letter]. BMJ 1993; 306: 858.
[13]
Kapuste H
et al.
Giftige Gase im Kinderbett (Toxic Gases in Infant Beds).
Zeitschrift fuer
Umweltmedizin 2002; 44: 18–20.
[14]
Radio interview between K Hill (Presenter) and Professor P J
Fleming (UK), Radio New Zealand,
8
February 2000).
[15]
Compiled by Mitchell PR, Winchester UK (personal
communication to T J Sprott) 1994
et
seq.
APPENDIX
THE
CAUSE OF COT DEATH
AND
HOW
TO PREVENT IT
A
booklet produced by
Cot
Life
2000,
a
non-profitorganization whose
aim
is to eliminate cot death
Cot
death (crib death) is caused by gaseous poisoning, the gases
being phosphine, arsine
and
stibine (and/or derivative gases). These toxic gases can be
generated from the mattress
on
which a baby sleeps. The gases are formed by the action of
common household fungi
(e.g.
Scopulariopsis brevicaulis)
on compounds of (respectively) the elements phosphorus,
arsenic and antimony within the mattress.
The
cot death risk increases as a mattress is re-used from one
baby to the next.
The
risk of cot death can be virtually eliminated by ensuring
that babies sleep on
mattresses known to be free from compounds of phosphorus,
arsenic and antimony (and
using
only certain specified bedding). The
BabeSafe
range
of bassinet and cot mattresses
complies with this mattress specification.
Any
mattress which has not been proved by chemical analysis to
be free from
phosphorus, arsenic and antimony should be enclosed in a
BabeSafe
slip-on mattress cover.
BabeSafe
mattress covers are manufactured in six sizes (one size for
bassinet mattresses
and
five sizes for cot mattresses).
There
is no risk of suffocation on a
BabeSafe
mattress or
BabeSafe
mattress cover.
.
For
instructions on how to wrap a baby’s mattress for cot death
prevention, see below.
.
For
instructions on the specified bedding to use on a
BabeSafe
mattress or
BabeSafe
mattress cover, see points 5 and 6 below.
BabeSafe
mattresses and mattress covers are sold
throughout New Zealand at Baby Factory shops
and
other retail outlets.
BabeSafe
mattress covers
are
available in other countries by mail order.
228
T. J.
SPROTT
HOW
TO WRAP A BABY’S MATTRESS FOR COT DEATH PREVENTION
The
advice to wrap mattresses applies to every mattress on which
a baby sleeps (except a
BabeSafe mattress) and includes: portable cot mattresses;
pram mattresses; rubber mattresses;
and
all mattresses made of or containing natural products such
as wool, sheepskin, tree bark,
kapok, coconut fibre, etc.
To
wrap a baby’s mattress for cot death prevention, use a
BabeSafe
mattress cover and
bedding as specified below.
Instructions for use of a BabeSafe mattress cover:
1.
Air the mattress well before putting it inside the
BabeSafe
cover. Once the mattress is
sealed inside the cover, do not remove it for airing. Airing
is provided by the ventilation
hole/s on the underside of the cover.
2.
Place the mattress inside the
BabeSafe
cover
and seal the cover using the adhesive strip.
3. If
the cover is larger than the mattress, fold the extra width
or length of plastic under
the
side/s or ends/s of the mattress so that the cover is firm
and smooth on the top of the
mattress. Then tape the excess plastic on to the cover using
strong adhesive tape, taking
care
not to cover the ventilation hole/s.
4.
Place the covered mattress in the bassinet or cot. The
ventilation hole/s must be on the
underside
of
the mattress.
5. It
is imperative to use the correct bedding on top of a
BabeSafe-wrapped
mattress. On
top
of the wrapped mattress place a pure cotton underblanket.
Then make the bed using
sheets and pure wool or pure cotton overblanket/s.
6. Do
not use any of the following items: sheepskin; sheepfleece
underlay; moistureresistant
mattress protector; sleeping bag or ‘clothing’ bag; any
underblanket which is
not
made of pure cotton; any blanket which contains polyester or
acrylic; duvet; pillows
or
cushions; any bedding item which is quilted or padded or
filled.
7. Do
not use the
BabeSafe
cover
if it is punctured or torn.
8. To
clean a
BabeSafe
cover, wipe the cover with pure soap and water, and then dry
it
with
a towel. Do not use chemical bleaches or sterilants.
ABOUT
SHEEPSKINS
Sheepskins can contain significant quantities of arsenic.
The action of common household
fungi
on compounds of arsenic can lead to the generation of highly
poisonous nerve gases
known
as arsines. This gas generation resulted in the deaths of
many children in Europe
during the 1800s. The cause of these deaths was discovered
by the Italian chemist Gosio in
1892.
All
sheepskins tested by
Cot
Life
2000
were
shown by chemical analysis to contain
significant quantities of arsenic and therefore were capable
of generating arsine gas.
At
the Sixth SIDS International Conference in February 2000
scientist Dr W R Cullen
reported proof of the generation of trimethylarsine (a form
of arsine) from sheepskin
intended for use as baby bedding.
ABOUT
ORTHODOX COT DEATH PREVENTION ADVICE
.
Breastfeeding does not prevent cot death.
.
Smoking does not cause cot death.
.
If a
baby is sleeping on an
unwrapped
mattress, face-up sleeping is a partial preventive
against cot death. This is because phosphines, arsines and
stibines are all more dense
than
air and diffuse away from a baby’s face. However, many
babies sleeping face up on
COT
DEATH—CAUSE AND PREVENTION 229
unwrapped mattresses have died of cot death. (There is no
need for a baby to sleep face
up if
the baby’s mattress is wrapped in accordance with the
Cot
Life
2000
specifications.)
.
Sleeping a baby with feet to the foot of the cot does not
prevent cot death. If an
unwrapped mattress contains phosphorus, arsenic or antimony,
any area on the mattress
where
the baby sleeps is a potential source of toxic gas, since
that is the area which
becomes warm and moist (promoting the fungal activity which
can cause gas generation).
COT
DEATH RATES FOR FIRST AND LATER BABIES AND BABIES OF SOLO
PARENTS, BRITAIN, 1996–1999
Figure 1 on page 226 forms part of the extensive proof that
gaseous poisoning is the single
cause
of cot death. These statistics refute every proposition that
cot death has a medical or
physiological cause.
The
more times an unwrapped mattress is used from one baby to
the next, the greater is
the
risk of cot death. This accounts for the higher cot death
rate among poorer families,
who
are more likely to sleep babies on previously used
mattresses.
If a
mattress contains any of the elements phosphorus, arsenic or
antimony, and if
certain common household fungi have become established in
the mattress during prior use,
any
generation of toxic gas commences sooner and in greater
volume when the mattress is
re-used. For this reason, previously used mattresses should
be wrapped for cot death
prevention.
New
mattresses should also be wrapped unless they have been
proved by chemical
analysis to be free from phosphorus, arsenic and antimony.
This is because fungal growth
can
quickly become established in a new mattress once a baby
begins sleeping on it.
SUCCESS OF MATTRESS-WRAPPING FOR COT DEATH PREVENTION
Mattress-wrapping for cot death prevention, which has been
publicized nationwide in New
Zealand since late 1994, has had a 100%
success rate. About 600 cot deaths occurred in
New
Zealand during the years 1995–2002 inclusive, but there has
been no reported cot
death
among the very large number of babies who have slept on
mattresses wrapped to the
Cot
Life
2000
specifications.
New
Zealand cot death rates have fallen markedly since
mattress-wrapping commenced.
From
1994 to 2001 the nationwide cot death rate fell by 52%.
The reduction in the Pakeha
rate
over the same period was even greater—about 75%.
These major reductions in cot
death
rates cannot be attributed to the cot death prevention
advice publicized by the New
Zealand Ministry of Health or the New Zealand Cot Death
Association. There has been no
material change in that advice since 1992.
Sales
information relating to
BabeSafe
products shows that a very large number of New
Zealand babies have slept on wrapped mattresses, and also
that mattress-wrapping has
been
enthusiastically adopted by Pakeha parents. The Ministry of
Health has confirmed
that
mattress-wrapping is more prevalent among the Pakeha
community than among other
ethnic groups. Cot death is now very rare among Pakeha
families.
A
considerable body of research has been reported which
supports the toxic gas theory
for
cot death (on which mattress-wrapping is based). Contrary to
media publicity, the 1998
UK
Limerick Report did not disprove the toxic gas theory—as a
highly qualified
environmental scientist has stated in the
New
Zealand Medical Journal.
In fact, the
Limerick Committee’s analyses proved the fungal generation
of toxic gases (forms of
stibine and arsine) from cot mattress materials.
Parents, however, are more interested in the practical
proof:
230
T. J.
SPROTT
No.
Cot death baby bedding Phosphorus Arsenic Antimony
CD1
Pillow cover
zz
2 2
CD1
Pillow polyester inner
z
2
zzz
CD2
Mattress cover
zzz
2 2
CD2
Mattress foam
zz zz
2
CD3
Mattress cover
zzz
2 2
CD3
Mattress foam
zzz z
2
CD3
Sheepskin rug
zzzzzz z zzzz
CD4
Mattress cover
zzz
2 2
CD4
Mattress foam
2 2 2
CD5
Mattress foam
z
2 2
CD5
Mattress cover
zzzzz
2 2
CD5
Sheepfleece underlay
zzz
2 2
CD5
Sheepskin rug
zzzzz
z zzz
CD5
Wool blanket
zz
2 2
2~not
detected (v10mg/kg)
z~10–50mg/kg
zz~51–100mg/kg
zzz~101–200mg/kg
zzzz~201–500mg/kg
zzzzz~501–1000mg/kg
zzzzzz~w1000mg/kg
Mfr
New products Phosphorus Arsenic Antimony
A
Waterproof wool mattress cover
zzz
2 2
A
Bassinet mattress (polyester inner)
zz
2
zzz
A
Bassinet mattress (foam inner)
2 2 2
B
Imported PVC cot sheet
zzz
2 2
C
PVC-lined cotton mattress protector
zz
2 2
D
Acrylic underblanket
z
2 2
E
Sheepskin baby rug
zzzzz
z zz
F
Lambskin rug
zzzzz
z zzz
G
Ti-tree bark bassinet mattress
zzz
2 2
H
Innersprung cot mattress
zz
2 2
I
Ventilated cot mattress
zz
2
zzzz
J
Kapok
zzzz
2 2
K
Innersprung cot mattress
zzzz
2
zzzz
L
Imported innersprung mattress
zzz
2
z
No.
Used products
1
Sheepskin baby rug
zzzz
z zzz
2
Bassinet mattress
zzzz
2 2
3
Innersprung mattress
zzzzz
2 2
4
Foam mattress
zzzz
2 2
5
Foam mattress
zzzzz
2 2
6
Innersprung mattress
zzzzz
2
z
7
Coconut fibre
zzzzzz z
2
8
Foam mattress
zz
2 2
9
Reconstituted foam mattress
zzzzz
2 2
10
Innersprung mattress
zzzz
2
z
11
Innersprung mattress
zzzz
2
z
12
Innersprung mattress
zzzzz
2
zzz
13
Innersprung mattress
zzzz
2 2
14
Innersprung mattress
zzz
2 2
15
Innersprung mattress
zzzzz
2 2
Results of analysis of baby bedding
COT
DEATH—CAUSE AND PREVENTION 231
No
reported cot deaths on correctly wrapped mattresses.
Question:
What
is the mechanism of cot death (crib death)?
Answer:
The
baby’s lungs stop breathing (apnoea) and the baby’s heart
stops
beating.
Question:
Why
do the lungs and heart stop functioning?
Answer:
Because the relevant nerve impulses from the brain don’t
reach the lungs
and
heart to cause them to function.
Question:
Why
don’t the nerve impulses reach the lungs and heart?
Answer:
Because the nerves stop transmitting the impulses.
Question:
Why
do the nerves stop transmitting the impulses?
Answer:
Because of accumulation of acetylcholine in the blood.
Question:
Why
does acetylcholine accumulate in the blood?
Answer:
Because the cholinesterase enzyme is de-activated.
Question:
What
de-activates the cholinesterase enzyme?
Answer:
Anticholinesterase agents.
Question:
What
are these anticholinesterase agents?
Answer:
Nerve
gases formed from compounds of phosphorus, arsenic and/or
antimony.
Question:
Where
are the compounds of phosphorus, arsenic and/or antimony?
Answer:
In
the baby’s bedding (along with fungus which converts the
compounds
into
the gases).
Mattress-wrapping in accordance with the
Cot
Life
2000
protocol prevents exposure of the
baby
to the gases.
There
have been no reported cot deaths among the very large number
of babies who have slept
on
mattresses wrapped to the
Cot
Life
2000
specifications.
232
T. J.
SPROTT