I had been dreading the moment for weeks now. On the other hand, my two-month old son, who had no clue what was about to happen, smiled at me, trustingly. In a way, it made it even worse. “Just get it over with,” I thought as I sat in the lounge of the pediatrician’s office. One oral dose and four vaccine shots in his two tiny thighs. Just get it over with.
The attendant came with a tray filled with four syringes. I held my son in my arms. He looked straight into my eyes. Boom! He turned red in the face and started screaming as soon as the first one went in. I wanted to look away, but I didn’t. We were in this together. I held him and kissed his forehead multiple times as the doses went in in little body. When it was done, I rushed past the lounge. I held him and tried to comfort him as I took him back home. Now, as I write, he is lying in bed with a mild fever and his mother and I are taking turns comforting him.
I have not had much experience in being a parent, but I already understand that it involves tough choices. As a scientist I was trained to think objectively. But as a parent sitting there in the lounge, I’ll admit that felt uneasy as my son was about to be vaccinated. I understand what goes through the mind of every parent. Every parent wants what is best for his or her child. I’ve reconciled that thought with the knowledge that not every parent knows what is best for his or her child.
Parents are a scared lot to begin with. I’ve seen otherwise rational people apply a spot on a child’s forehead or cheek to ward off the evil eye and pawn off hair to a household deity for his or her well-being. “What is the harm,” they ask (and that is a column, perhaps, for another day). The situation is different when vaccines are concerned. By choosing not to vaccinate, parents put not only their own children at risk, but also the children of others. The anti-vaccination lobby feeds on the natural fears of parents by fueling the misconception that certain vaccines cause autism. Yes, some children are diagnosed with autism after being vaccinated, and presented alone this is enough to scare parents. But children are diagnosed with autism after they are born, start to feed, and leave the hospital. As a scientist, I would say that correlation does not lead to causation, or in other words, just because one event is associated with another event, it isn’t caused by it. As a parent, I do not seek the higher burden-of-proof of causation: we don’t know definitively what causes autism, but there is not a shred of evidence of even correlation of vaccine use and autism.
I bring this point up because correlation is vitally important when we can’t finger causation. In the United States, the leading cause of mortality of infants between the age of one month and twelve months is the morosely named Sudden Infant Death Syndrome (SIDS). SIDS is a blanket term describing a number of situations in which the actual cause of mortality cannot be accounted for. There is no immediate, obvious cause. Therefore, in my mind, while the search for the causation is important, every recommendation (determined by correlation studies) to a parent which can lower the probability is vitally important. The overall prevalence of SIDS in a population may be low, but just by determining what epidemiological factors decrease the probability of occurrence even further, physicians are empowering parents such as myself.
I know these are frightening thoughts. I’d rather not think about them. But I have no other choice. Of what benefit is training the mind to think rationally, if I can’t use it to bear upon the events that impact my family the most?
milkmiracle.net 
SIDS is a loose term of infants dying of suffocation from blankets, pillows, over-soft mattresses, or, if they are co-sleeping with their parents, from being crushed by an adult weight. Most of the time, it is completely avoidable.
SIDS is a syndrome -a collection of ailments for which the statistical probability can be reduced. However, it cannot be completed avoidable as by definition, the cause is unknown.
Suffocation is not the likely cause of death as only ~10% of such cases can be attributable to intentional or accidental asphyxia.
“A causal role for mild infection in sudden infant death is suggested by reports that in approximately half of SIDS cases, the infants have a seemingly trivial infection around the time of death, as well as mild tracheobronchial inflammation and altered serum immunoglobulin or cytokine levels and the presence of microbial isolates at autopsy. In infants who die unexpectedly of infection, the given organism may precipitate a lethal cytokine cascade or toxic response. If all specific causes of infant death are delineated, the designations SUID and SIDS will no longer be needed.”
Via Kinney and Thatch (2009) New England Journal of Medicine.
If we know the cause, or likely the causes for this group of diseases and can prevent or treat it, it will cease to be called SIDS.
I understand, Anirban…I am telling you what is accepted anecdotally. I really don’t think it is as complicated or mysterious as the authors profess
Good post Anirban. I grappled with the same question on vaccines a year and a half ago. I grappled with the same question six months ago when I decided to make the temporary move to China. One will always wonder what the ramifications of a decision would be.Small decisions “Does he need the monkey cap? Is it too windy? Should we go out at all?”. Medium term decisions ” Is a mundan really necessary?” Far reaching ones “Imported or local vaccine?”, “What language should we talk to him in?”, ” Should we pierce his ears?”. Nonsensical ones “Does it really matter if he wears a pink sleepsuit at night which says ‘Mommy’s little girl’ ?”
At the end of the day, as parents we can never be really sure of the decisions we make. Most of the time we have a throw it and see what sticks approach and in most cases, the decisions turn out to being alright and rarely cause major issues. But lets not forget; the decision making process is an intuitive one as much as it is learned one from our environment and our own experiences.
Enjoy fatherhood, Anirban, cherish every moment. You will soon long for the time when your son is younger. You’d soon wish that you could have spent more time watching you baby bat away at that dangling toy. You’d soon wish that you had held him one more time as he crawled on his stomach. You will not even know that you will miss these moments until they are long past.
Beautiful thoughts, well articulated. You were missed, Yogesh, as you disappeared from the face of the digitaloshpere. Very glad you’re back. My best wishes to you, Anirban.
Haha.. I fade in and out based on the whims and fancies of the Great Firewall of China. Hopefully will be back on a little more regularly.