Sudden infant death syndrome

What is SIDS?
SIDS is the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history. (Willinger et al, 1991).

In a typical situation parents check on their supposedly sleeping infant to find him or her dead. This is the worse tragedy parents can face, a tragedy which leaves them with a sadness and a feeling of vulnerability that lasts throughout their lives. Since medicine can not tell them why their baby died, they blame themselves and often other innocent people. Their lives and those around them are changed forever.

Reducing the risk....What can be done?
Unfortunately, we cannot expect to prevent all SIDS deaths now. To do so requires a much greater understanding of SIDS, which will be achieved only with a commitment from those who value babies and with a considerably expanded research effort. However, there are things that can be done to reduce the risk of SIDS.

Parents-to-be:
1. Get medical care early in pregnancy, preferably within the first three months, followed by regular checkups at the doctor's office or health clinic. Make every effort to assure good nutrition. These measures can reduce the risk of premature birth, a major risk factor for SIDS.

2. Do not smoke, use cocaine, or use heroin. Tobacco, cocaine, or heroin use during pregnancy increases the infant's risk for SIDS.

3. Don't get pregnant during the teenage years. If you are a teen and already have one infant, take extreme caution not to become pregnant again. The SIDS rate decreases for babies born to older mothers. It is highest for babies born to teenage mothers. The more babies a teen mother has, the greater at risk they are.

4. Wait at least one year between the birth of a child and the next pregnancy. The shorter the interval between pregnancies, the higher the SIDS rate.

Parents:
1. Place infants to sleep on their backs, even though they may sleep more soundly on their stomachs. Infants who sleep on their stomachs and sides have a much higher rate of SIDS than infants who sleep on their backs.

2. Place infants to sleep in a baby bed with a firm mattress. There should be nothing in the bed but the baby - no covers, no pillows, no bumper pads, no positioning devices and no toys. Soft mattresses and heavy covering are associated with the risk for SIDS.

3. Keep your baby’s crib in the parents’ room until the infant is at least 6 months of age. Studies clearly show that infants are safest when their beds are close to their mothers.

4. Do not place your baby to sleep in an adult bed. Typical adult beds are not safe for babies. Do not fall asleep with your baby on a couch or in a chair.

5. Do not over-clothe the infant while she sleeps. Just use enough clothes to keep the baby warm without having to use cover. Keep the room at a temperature that is comfortable for you. Overheating an infant may increase the risk for SIDS.

6. Avoid exposing the infant to tobacco smoke. Don't have your infant in the same house or car with someone who is smoking. The greater the exposure to tobacco smoke, the greater the risk of SIDS.

7. Breast-feed babies whenever possible. Breast milk decreases the occurrence of respiratory and gastrointestinal infections. Studies show that breast-fed babies have a lower SIDS rate than formula-fed babies do.

8. Avoid exposing the infant to people with respiratory infections. Avoid crowds. Carefully clean anything that comes in contact with the baby. Have people wash their hands before holding or playing with your baby. SIDS often occurs in association with relatively minor respiratory (mild cold) and gastrointestinal infections (vomiting and diarrhea).

9. Offer your baby a pacifier. Some studies have shown a lower rate of SIDS among babies who use pacifiers.

10. If your baby has periods of not breathing, going limp or turning blue, tell your pediatrician at once.

11. If your baby stops breathing or gags excessively after spitting up, discuss this with your pediatrician immediately.

12. Thoroughly discuss each of the above points with all caregivers. If you take your baby to daycare or leave him with a sitter, provide a copy of this list to them. Make sure they follow all recommendations.

Incidence rates are available at the American SIDS Institute web site.

This information was developed by the American SIDS Institute and is herewith used with permission.

American SIDS Institute. Reducing the Risk. Available at: http://www.sids.org/nprevent.htm. Last accessed February 3, 2014.

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