REDFORD TOWNSHIP -- A study showing infants inhaling secondhand smoke are at heightened risk of sudden infant death syndrome stops just short of implicating cigarette smoke for causing the syndrome known as SIDS. But it raises provocative questions about

"We were actually able to test the babies' lung tissues to determine what they breathed close to their deaths," said Dr. Gideon Koren of Toronto, the lead investigator of the report in the latest Journal of Pediatrics. "Most tested positive for nicotine." Most SIDS publications, including handouts from the University of Michigan's C.S. Mott Children's Hospital, target other possible causes -- primarily babies sleeping on their stomachs, which could stifle their breathing. The fresh report, Michigan specialists say, highlights the need to persuade parents to give up cigarettes. "Many don't know how to quit other than going cold-turkey," said Scott Walker, director of health promotions at the Michigan Department of Community Health. "We need to get the word out that things like the patch and nicotine gum really do work." Past SIDS studies depended on parents' own reports about tobacco use, which are considered unreliable. Forty-one Metro Detroit infants and 58 elsewhere in Michigan died in 2000 from SIDS, the leading cause of death before age 1. It kills more than 2,600 U.S. babies each year. Amy Ingersoll of Redford Township, a nonsmoker like her husband, is among the grieving parents. The year was 1997 and Ingersoll, now 41, was a new mom. She had gently placed her 4-month-old son on his back for a nap as she went about her chores. Two hours later, she went to check on him. Mark James Ingersoll II had rolled onto his stomach and was found dead. The cause was SIDS. "My husband and I knew all the things to do to try to avoid SIDS, but our son still died," she said. In fact, the new study of 44 SIDS cases shows that at least three babies died without nicotine in their lungs. But most of the others had nicotine in their bodies, lab tests confirmed. "We know that smoking is detrimental to a fetus. But this new study shows that even though parents may not accurately describe their smoking habits, babies exposed to secondhand smoke in the home are dying of SIDS," said Koren, senior research scientist at Toronto's Hospital for Sick Children. He's also a professor of pediatrics and pharmacology at the University of Toronto. His study was performed with the University of Maryland. The results don't surprise Walker in Lansing. "This study confirms what earlier studies have shown for many years in terms of a link between secondhand smoke and SIDS," said the health promotions director. "When we talk with parents about their own smoking and how it affects their health, they often say their primary motivation for quitting is their children." Some children's welfare agencies would like stronger measures, beyond warning parents of the risks and spreading the word about ways to quit. The Ontario Association of Children's Aid Societies is considering whether to endorse some kind of intervention to protect children from inhaling tobacco smoke at home. Children in Michigan already are protected to some degree. "If a smoker jeopardizes the health or safety of a child -- for example, an asthmatic child living in a house with smokers -- our children's protective services laws allow us to do an evaluation in the home," said Maureen Sorbet at the Family Independence Agency. "But unless there's some reason to investigate a specific risk, we would not investigate." Laura Reno of Grosse Pointe Woods welcomes steps to boost awareness of secondary smoke risks. Her 3-month-old son, Daniel Patrick Reno, died of SIDS in 1984. "Even though my husband and I did not smoke, I just hope the information about secondhand smoke gets into the right hands of people who are willing to change," said the suburbanite, 44, who works at the Detroit office of the National SIDS Alliance. It wasn't until 1992 that the American Academy of Pediatrics announced that infants should sleep on their back. "It was called crib death back then, and there wasn't much information about it at all," recalled Reno. "We didn't know not to put our babies to sleep on their backs. It was all very hush-hush." Now the focus is on spreading the word about tobacco smoke risks. "Some (parents) still don't understand the seriousness of it, but more now say they smoke outside the home instead of inside," said Dr. Samya Nasr, director of pediatric pulmonary clinical services at Mott Children's Hospital in Ann Arbor. "And there are measures that parents can take to help avoid SIDS, like using the sleep apnea monitors." Amy Ingersoll, who now has two other sons -- Bryce, 2, and Grant, 4 months -- used a monitor with her older son and still uses one with Grant. "It will not prevent SIDS, but it will at least give you time to perform CPR before calling 911," she said.

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