Sudden Infant Death Syndrome

Sudden Infant Death Syndrome (SIDS) is one of the leading causes of death among infants aged 1 month to 1 year old. What makes this condition so ominous is that there are no known symptoms or causes despite years of research. It is reported that each year, 2,500 infants die of SIDS.

Possible Causes of SIDS

The most unsettling thing about SIDS is that it usually doesn’t have any symptoms. It can strike without warning and claim the life of a seemingly infant. In most cases, deaths due to SIDS are associated with sleep. Infants who die of SIDS show no signs of suffering.

Another unsettling factor about SIDS is that unlike most conditions which are usually diagnosed based on the presence of specific signs or symptoms, most SIDS diagnosis come after all possible causes of death have been ruled out – through reviewing an infants medical history and environments. Reviewing an infant’s medical history helps identify real SIDS deaths from those resulting from accidents, abuse, conditions that were not diagnoses earlier such as cardiac disorders or metabolic disorders.

When you try to consider which infants are most at risk, it is impossible to pin-point a single risk factor that is enough to cause (a SIDS) death. Instead, several risk factors combined may contribute to cause an at-risk infant to die of SIDS.

Most cases of SIDS deaths occur in infants aged 2 to 4 months. This occurrences increase during cold weathers. Statistics show that African-American infants are two times more likely than Native American infants to die of SIDS, and are three times more likely to die of SIDS than Caucasian infants. More baby boys are victims of SIDS than baby girls.

Some potential risk factors include:

  • smoking, drinking and/or drug use during pregnancy
  • poor prenatal care
  • low birth-weight or premature
  • young mothers (aged below 20)
  • exposure to smoke following birth
  • overheating caused by sleepwear, beddings, etc.
  • sleeping on stomach

Stomach Sleeping

A number of studies have found a higher incidence of SIDS among babies who sleep on their stomach rather than those who sleep on their backs or sides. Researchers suggest that sleeping on the stomach puts pressure on a child’s jaw and narrows the airway and hamper breathing.

Another theory regarding stomach sleeping is that it can increase the risk of "rebreathing" his/her own exhaled air. This is most likely if the infant sleeps on a soft mattress, sleeps with bedding, stuffed toys or pillow/s near his/her face. Rebreathing happens when the soft surface creates a small enclosure around the baby’s mouth and trap exhaled air. The baby then breathes in exhaled air – which is mostly carbon dioxide. Thus, the oxygen level in the body drops and and carbon dioxide accumulates. This lack of oxygen can contribute to SIDS.

Another possibility is a problematic arcuate nucleus. The arcuate nucleus is that part of the brain which helps control breathing and awakening during sleep. A baby with a normal arcuate nucleus wakes up and cries when it is breathing stale air and is not getting enough oxygen. This is because the arcuate nucleus triggers the baby to awaken and cry. The movements cause his/her breathing and heart rate to change and make up for the lost oxygen. A malfunctioning arcuate nucleus may deprive the baby of this necessary involuntary reaction and increase his/her risk for SIDS.

"Back to Sleep"

Because of the evidence that stomach sleeping might contribute to SIDS incidences, in 1992, the American Academy of Pediatrics (AAP) recommended that all healthy infants aged 1 year and younger be put to sleep on their backs. Since the AAP’s recommendation of putting infants to sleep on their backs, the incidences of SIDS decreased by 50%. However, although the occurrences of SIDS have significantly decreased, it remains the leading cause of infant death, so it important to remind parents and caregivers how necessary back sleeping is.

On the flipside, parents are hesitant to put their babies to sleep on their backs for fear of choking on spit or vomit. The AAP, however, says that there is no increased risk of choking for healthy infants who sleep on their backs. But for infants with gastro esophageal reflux disease (GERD) or other upper airway malformations, sleeping on the stomach may be more advisable. But to be certain, the AAP urges parents to consult with their child’s doctor for the best sleeping position.

Putting babies to sleep on their side is also not advisable, as there is a possibility that they will roll over onto their bellies while they sleep.

Tips for Reducing SIDS Risks

Apart from back sleeping, the AAP also suggests the following measures to reduce the risk of SIDS:

Avoid putting baby to sleep on a soft mattress, avoid putting blankets, pillows, comforters or stuffed toys. Put your baby to sleep on a firm mattress.

Make sure your baby does not get to warm while sleeping. Keep the room at a temperature that is comfortable for an average adult in a short sleeved shirt. It has been suggested by researchers that when babies get too warm it puts them deeper into sleep, making it more difficult for them to awaken.

Do not smoke, drink or use drugs during pregnancy. Avoid getting your baby exposed to secondhand smoke. Exposure to secondhand smoke doubles an infant’s risk of SIDS. Babies whose mothers smoked when they were pregnant are three times more likely to die SIDS than babies whose mothers did not smoke. Researchers theorize that smoking affects the central nervous system starting prenatal and continuing after birth. This places the baby at an advanced risk.

Receive early and regular prenatal care.

Make sure your baby gets regular check-ups.

Opt to breastfeed if it’s possible. Researchers found evidence that breastfeeding decreases the risk of SIDS, though how, is not exactly clear. Researchers speculate that breast milk helps protect babies from infections that increase the risk of SIDS.

If your baby is suffering from GERD, make sure you follow your doctor’s guidelines for sleeping and feeding.

Put your baby to sleep with a pacifier during the first year. If baby rejects it, don’t force it. Pacifiers have been linked with lower risk of SIDS. If you are breastfeeding, wait until after the baby is one month old so that you can establish breastfeeding.

Babies can be brought to the parents’ bed to be nursed or comforted. But when baby is ready to sleep, he/she should be returned to his/her crib or bassinet. It’s a good idea to have the crib or bassinet inside the parents’ room. This practice has been linked with lower SIDS risk.