Sudden infant death syndrome

Causes and Risks:
The cause of SIDS is unknown. Multiple theories have been postulated. Many physicians and researchers now believe that SIDS is not a single entity, but infant death caused by several different factors. These may include problems with sleep arousal and an inability to sense a build up of carbon dioxide in the blood. Almost all SIDS deaths occur without any warning or symptoms, when the infant is thought to be sleeping.

Since 1992 sudden infant death syndrome (SIDS) has dropped from 2 nd to 3 rd place as the cause of death in infants between 1 month and 1 year of age. The incidence of SIDS has decreased over 40 percent since 1992 when parents were first alerted to put their babies on their side or back. The National Center for Health Statistics reports a rate of 0.784 SIDS deaths per 1,000 infants for 1996 and 0.69 SIDS deaths per 1,000 infants for 1997 (preliminary figures). The peak incidence occurs between 2 and 4 months of age (90 percent occur by 6 months of age). There is an increased incidence in winter months with the peak in January. There is also a greater incidence in native Americans and blacks.

Risk factors include babies who sleep on their stomachs (up to 4 months. of age), soft bedding in the crib (up to 1 yr. of age), multiple births, prematurity, a sibling with SIDS, maternal smoking, maternal substance abuse, young maternal age, short intervals between pregnancies, late prenatal care and low socioeconomic status. Male infants are affected more than females. While studies show an increase in these factors, the impact or importance of each factor is not well defined or understood in sudden infant death syndrome.



Prevention:

The incidence of SIDS has dropped significantly (by almost one-half) since the medical community has asked parents to PLACE INFANTS ON THEIR BACK OR SIDE WHEN SLEEPING (American Academy of Pediatrics - April 1992). Enough data now has been collected to show that this simple procedure is capable of reducing the risk of SIDS dramatically. Putting babies to sleep (naps included) on their back,(or right side) instead of their stomach has drastically decreased the incidence of SIDS. Coincidentally, with sleeping on the back, the incidence of environmentally induced head shape changes has increased just as dramatically.

The U.S. Consumer Product Safety Commission released a statement in April 1999 saying that "as many as 900 infant deaths each year are still associated with suffocation in soft bedding" They recommend babies being placed on a firm, tight fitting mattress and removing all comforters, etc. (for complete details, contact The Office of Information and Public Affairs in Washington, DC 20207) In the past, for homes in which there has been a previous sibling death from SIDS home apnea (breathing) monitors have been recommend but have not brought down the incidence of SIDS. The use of home monitors has largely stopped. Until the nature of the disease is fully understood complete prevention will not be a reality.
Recommendations from other countries also include:
  • Do not let your baby become too hot.
  • Keep your baby in a smoke-free environment.
  • Breastfeed your baby. (breast feeding has been shown not to decrease the incidence of SIDS, however, it does decrease the incidence of some upper respiratory infections which may influence the development of SIDS)
  • Do not lay your baby on pillows, bean bags, or sheepskin mattresses.
  • Put your baby to sleep on its back


Symptoms:

There are no symptoms. Babies who die of SIDS do not appear to suffer or struggle.


Signs and Tests:

None

Treatment:

Parents who have lost a child to SIDS are in tremendous need of emotional support. Because no cause is found for the infant's death, many parents suffer from guilt feelings. These feelings may be aggravated by investigations of police or others who, by law, must determine the cause of death. Timing of a subsequent pregnancy is a concern for many parents after experiencing SIDS. Parents and caregivers of all infants and children should be trained in CPR . A member of a local chapter of the National Foundation for Sudden Infant Death Syndrome can assist with counseling and reassurance to parents and family members (see SIDS - support group ). Family counseling may be recommended to help siblings of all family members cope with the loss of an infant.

Prognosis:

Autopsy results are not able to confirm a cause of death, but may be helpful if viewed as a means of adding to the existing knowledge regarding SIDS. Autopsies may be required by state law in the event of unexplainable death.

Complications:

(not applicable)

Call Your Healthcare Provider:

If your baby is not moving or breathing, begin CPR , call 911, and then take him or her to the emergency room.