Sudden Infant Death Syndrome
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(Crib Death; SIDS)
Definition
Causes
- Abnormalities in a section of the brain that controls breathing during sleep and waking
- Abnormalities in the control of heart rhythm
- Changes in how serotonin, a neurotransmitter, functions in the brain
- Changes in some components of the immune system
- Inadequate arousal response to breathing obstruction or asphyxia—a lack of oxygen or excess carbon dioxide in the body caused by interruption of breathing; may cause unconsciousness
| Brainstem |
|
| Area of the brain involved in regulation of breathing. |
| Copyright © Nucleus Medical Media, Inc. |
Risk Factors
- Infant's age: less than 6 months old
- Low birth weight
- Delayed fetal growth
- History of SIDS death in a sibling
- History of an acute life-threatening event
- Previous incident of unexplained severe apnea—when breathing is repeatedly interrupted and requires resuscitation
- Sleeping on the stomach or side rather than back
-
Other risk factors are more general and include:
- Smoking during pregnancy or in a house where the baby is sleeping
- Alcohol , excessive caffeine, opiate, or cocaine use during pregnancy
- Mother's age: younger than 20 during first pregnancy
- Poverty
- Black, Native American, and Alaskan Native families
- Sex: male
- History of anemia or a urinary tract infection while pregnant
- No or late prenatal care
- Premature birth
- Recent infection and/or fever
- Cold weather in late fall or winter
- Overheating
- Low socioeconomic status or low level of education
- Co-sleeping in parents room
- Loose covers and blankets
Symptoms
Diagnosis
- Autopsy
- Assessment of the death scene
- Review of the baby and family's medical histories
Treatment
Prevention
-
During pregnancy:
- Get prenatal care early and regularly.
- Do not smoke, drink alcohol, or use drugs while pregnant.
-
After birth:
- Babies less than one year old should sleep on their back. Do not allow a young baby to sleep on his stomach or side. However, many babies roll over after 6 months of age and do not require constant monitoring of sleep position. Ask your doctor for more information about positioning your baby for sleep.
-
Other factors that may help reduce SIDS risk include:
- Provide a firm crib mattress.
- Breastfeed your baby.
- Do not place blankets, a comforter, pillow, or sheepskin under your baby.
- Do not let your baby sleep on a waterbed.
- Remove soft, stuffed toys and loose bedding from the sleep area.
- Do not cover your baby's head or face.
- Have your baby sleep in the same room as you do, but do not share your bed.
- Keep the bedroom at a comfortable temperature (68°F-72°F).
- Avoid overheating. Do not overdress your baby.
- Give your baby a pacifier during nap time and bedtime.
- While your baby is awake, place him on his stomach so that he can move his body.
- If you smoke, do not smoke in the house or around your baby. Ask your doctor about ways you can quit.
- Be sure that your baby gets routine medical care, including the recommended vaccines.
- Do not use cardiorespiratory monitors or other commercial devices that claim to reduce the risk of SIDS. There is no evidence that these devices are useful.
- Learn infant CPR .
Make sure anyone else caring for your child is also aware of these recommendations.
RESOURCES
National SUID/SIDS Resource Center http://www.sidscenter.org
First Candle http://www.firstcandle.org
References
American Academy of Pediatrics SIDS Task Force. The changing concept of sudden infant death syndrome: diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics . 2005;116:1245-1255.
Galland BC, et al. Prone versus supine sleep position: a review of the physiological studies in SIDS research. J Paediatr Child Health . 2002;38:332-338.
Hay WW. Current Consult Pediatrics . 17th ed. New York, NY: McGraw-Hill; 2005.
Hunt CE, Hauck FR. Sudden infant death syndrome. CMAJ . 2006;174:1861-1869.
Kleigman RM, Jensen HB, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.
Sudden infant death syndrome (SIDS). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated February 11, 2013. Accessed February 18, 2013.
Sudden infant death syndrome (SIDS). Nemours KidsHealth.org website. Available at: http://kidshealth.org/parent/general/sleep/sids.html . Updated October 2011. Accessed February 18, 2013.
10/23/2009 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Blair P, Sidebotham P, Evason-Coombe C, Edmonds, M, Heckstall-Smith, Fleming P. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. BMJ . 2009;339:b3666.
11/14/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics. 2011;128(5):1030-1039.