For years parents have been told to put their newborn babies to sleep on their backs to lower their risk for SIDS.
The Back to Sleep Campaign has reduced the number of crib deaths by about half since it began in the early 90's. Still, thousands of seemingly healthy babies die in their sleep each year.
"You cannot tell if a living baby is going to die of SIDS that night. There's no marker," said Dr. Hannah Kinney of Children's Hospital Boston.
But now doctors at Children's Hospital Boston have uncovered a big clue.
"We've come to focus on serotonin," said Dr. Kinney.
Dr. Kinney and her colleagues found that SIDS babies have low levels of serotonin in their brain stems. Serotonin helps regulate breathing, heart rate and blood pressure. Too little could impair those functions, especially during sleep.
"Something about sleep unmasks the defect when the baby is stressed," said Dr. Kinney.
Stress, like re-breathing carbon dioxide when they're sleeping on their tummies, makes affected babies vulnerable. Researchers say infants with normal brain stem serotonin levels would be able to wake up long enough to turn their heads and breathe fresh air.
The long-term goal of this research is to develop a test to identify which babies have this serotonin defect -- and then try to prevent it altogether.
Researchers say there's nothing in this study to suggest that pregnant women stop taking antidepressants that boost serotonin levels in the mother. However, they should be avoiding alcohol and cigarettes, which are known to greatly increase the risk for SIDS.
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