For more than 30 years, Fern Hauck, MD, has been involved in research, education, and developing interventions to reduce lives lost due to sudden infant death syndrome (SIDS). And it all started with a call.
What are you working on right now?
I am involved in projects that focus on educating parents about infant safe sleep and breastfeeding, all with the purpose of reducing the risk of sudden infant death syndrome (SIDS) and other sleep-related sudden unexpected infant deaths (SUID). Our rates of SIDS and SUID in the US have been stagnant in the past 20 years, despite many efforts at parent and caregiver education, and are among the highest in the Western world.
The projects I'm engaged in include a great team of collaborators at UVA and other universities. There are two randomized controlled trials. One uses short videos about safe sleep or breastfeeding sent to participants via text messaging starting in pregnancy and continuing post-partum. The other uses private Facebook groups to deliver this messaging, but in a setting that encourages participants to share information and tips with each other.
A third study is known as an implementation and dissemination study. In this study, we have enrolled 20 U.S. hospitals to determine which of the two methods works best for engaging new mothers in the safe sleep text messaging program. Our goal is to be able to share the program widely across the U.S. using the most efficient and effective method.
My final project has a different focus — to examine the genetic and metabolic factors associated with SIDS risk. We had a recent publication that reported the results of a metabolomic analysis on blood samples from 300 infants, including 195 classified as SIDS cases and 105 classified as other causes of death. We identified higher concentrations of certain metabolite biomarkers in samples from infants who died of SIDS compared with samples from the other infants.
The results of this study are very exciting: we are getting closer to explaining the pathways leading to a SIDS death. Our hope is that this research lays the groundwork to help identify, through simple blood tests, infants who are at higher risk for SIDS, with the aim of saving these precious lives.
What are the most intriguing potential clinical applications of your work?
For our safe sleep and breastfeeding interventions, we hope they encourage parents and infant caregivers to adhere to the safe sleep guidelines, and that more mothers initiate and continue breastfeeding as recommended. Our initial work showed improvements in parental safe sleep behaviors, so we are optimistic that these new studies will result in even better outcomes. Our goal is to prevent infant deaths, and I am very hopeful that they will be successful.
The results of the metabolomics study are very exciting. We are getting closer to explaining the pathways leading to a SIDS death. Our hope is that this research lays the groundwork to help identify, through simple blood tests, infants who are at higher risk for SIDS, and to once again save these precious lives.
What recent discovery/paper/presentation has impacted the way you think?
This is a really difficult question, because I attend a lot of conferences and keep up with the literature. So I am continually learning from my colleagues across the SIDS/SUID research spectrum, including epidemiology, pathophysiology, genetics, forensic medicine, and bereavement counseling and family support.
A recent paper is particularly interesting. It relates to the genetics and metabolomics study that my team is currently engaged in. “Early Newborn Metabolic Patterning and Sudden Infant Death Syndrome,” published recently in JAMA Pediatrics, by Scott Oltman and colleagues, examined the newborn metabolic screening data of California newborns and then compared the metabolic profiles of infants who died from SIDS with those who survived. They identified several metabolites that were associated with SIDS. These findings suggest that there may be ways, through metabolic biomarkers, to identify infants soon after birth who are at higher risk of SIDS so that more targeted preventive counseling can be provided.
Such findings may also help us come closer to understanding the biological pathways that lead to a SIDS death and, eventually, to specific therapies.
What made you choose UVA Health as the place to do your research?
I was recruited to UVA by the chair of Family Medicine at the time. He was new to the position and wanted to develop the research arm of the department. He asked me to lead that effort.
In all honesty, I was reluctant to come to Charlottesville, a small city in comparison to Chicago, where I was living and working at the time. I also happened to be pregnant with twins. But, after visiting Charlottesville and meeting with the Chair and faculty, I became convinced that this would be a great place to do my own research and develop research opportunities among my new colleagues, as well as be a great place to raise our family. I was correct on all counts!
What do you wish more people knew about your area of research?
I am really happy when people hear about my area of research because it is an opportunity to share with them information about SIDS and SUID, and ways we know to prevent them. It is important for all people who care for infants and those who educate them, including physicians and nurses, to be on the same page when it comes to the safe sleep guidelines and ways to work with families to maximize their understanding.
Innovation and flexibility are essential in this area of research because families have strong feelings about parenting and infant care practices. So we need to be sensitive to their own experiences and feelings, while providing the evidence and support for following the recommendations. That is what my colleagues and I hope to accomplish through our different studies.
How did you become interested in your area of research?
An opportunity presented itself, and I grabbed it. This is advice I give to young doctors and researchers — take advantage of opportunities and don’t be afraid to go in a different direction. It may lead to amazing things. That was the case for me.
After two years in an epidemiology training program at the CDC, I moved to Chicago to work at Loyola University Chicago Stritch School of Medicine in Preventive Medicine and Epidemiology as an assistant professor. While there, I got a call one day from a former colleague at the CDC. They had been approached by the Chicago Department of Public Health. They were alarmed by the high rate of SIDS in Chicago and, in particular, the large difference in rates between Black infants and infants of other races and ethnicities. They asked the CDC for help in figuring out why this was so, and what they could do to lower the rates and disparity.
One thing led to another. I became the principal investigator of the Chicago Infant Mortality Study funded by the CDC and NIH. This study was the largest and most comprehensive case-control study examining risk factors for SIDS in the largely Black, urban population of Chicago, and the results helped to inform recommendations for safe infant sleep and SIDS risk reduction in the U.S. That began my 30+ year career as a SIDS and SUID researcher. When I got the call, I said, “I don’t know much about SIDS, but I am definitely interested in learning more and helping in any way I can.”
That was indeed a very fortunate call.
