Each year about 2,500 infants in the U.S. die from sudden infant death syndrome, more commonly known as SIDS.
The number of deaths have been cut in half since the 1980s, when more than 5,000 babies died each year from SIDS. However, it is still the leading cause of death among infants between the ages of 1 month and 1 year old, with the highest rate of occurrence between 2 and 4 months of age.
That’s why continued vigilance — and education about SIDS — is necessary.
Here is a look at SIDS and ways to possibly prevent it from happening.
What is SIDS?
Basically, SIDS is a death that can’t be explained by the infant’s medical history, investigation of the scene or autopsy, said Dr. Michelle Leff, an assistant clinical professor of pediatrics at the University of California San Diego.
The vast majority of babies who succumb to SIDS — 90 percent — do so before reaching 6 months of age, said Dr. Sean Daneshmand, a San Diego ob/gyn and founder of Miracle Babies, a nonprofit that provides support and financial assistance to families with critically ill newborns in the NICU.
What causes SIDS?
Leff said the cause of SIDS is unknown. Yet she said some deaths that would have been classified as SIDS in the past are now being classified as accidental suffocation, entrapment or strangulation. This includes babies who are found face-down in soft bedding or trapped between the mattress and railing of a drop-side crib.
However, she said, a few recent studies have found differences in the brainstems of babies who died from SIDS and babies who died from known causes.
“At present, there is no way to test for these differences, but further research is being done,” she said.
Dr. Pat Temple Gabbe, of the Ohio State University Wexner Medical Center and Nationwide Children’s Hospital in Columbus, Ohio, said low birth-weight babies and premature babies are at exceptional risk of SIDS. Also for unknown reasons, African-American and Native-American babies are at two to three times the risk as a non-Hispanic white baby.
Risk factors and sleep environment
While the cause of SIDS remains unknown, there are several risk factors. The list includes leaving a baby to sleep on his or her side or tummy; a mother who smoked while pregnant; second-hand smoke exposure; sleeping on a soft surface; sleeping in the same bed with parents; overheating; premature birth; low birth weight; being born to a young mother; and a lack of prenatal care.
As a nurse in the neonatal ICU at Tri-City Medical Center, Christine Perez works to educate staff and parents of premature newborns about safe sleep. Because babies born early are at higher risk of SIDS, parents in the NUIC watch a video about safe sleep, she said, and staff are trained to place babies on their backs at bedtime and naptime and follow other guidelines of the Back to Sleep campaign, a national effort launched in 1994.
Gabbe said a baby’s sleeping position is especially associated with SIDS. Infants put to bed on their stomachs or in side positions have anywhere from two to 13 times the risk of SIDS as an infant sleeping on his or her back.
Research showed that of 3,136 infant deaths in 2001 resulting from SIDS or SUIDs (Sudden Unexpected Infant Death), only 25 percent of infants were sleeping in a crib or on their backs when they were found; nearly 70 percent were on a surface not intended for infant sleep, such as an adult bed; and approximately 64 percent of infants were sharing a sleep surface, according to the National Institute of Child Health and Human Development.
In addition, parents should keep the baby’s crib free of pillows and blankets. Gabbe said stuffed animals, pillows, bumper pads and sheep skins can increase SIDS fivefold. The American Academy of Pediatrics recommends the ABCs: babies sleep (A) alone, on their (B) back and in a (C) crib. The crib mattress should have a tight-fitting sheet and there should be no loose pillows, quilts or toys that can suffocate the baby.
Daneshmand said in addition to placing the baby on his or her back, the baby should sleep in the same room with parent, but in his or her own bed with a firm sleep surface.
Sleeping in the same room as mom and dad and eliminating the infant’s exposure to smoke can also reduce the risk. Leff said bed-sharing is not recommended because an adult bed is typically softer than recommended for infants and has too much bedding. In addition to increasing the risk of SIDS by bed-sharing, Daneshmand said this also raises the risk of a parent accidentally rolling over a child, which is a common cause of death.
Rather, Leff said, the American Academy of Pediatrics recommends room-sharing where the infant has his or her own sleep area — such as a crib or a bassinet — in the parents’ room. This promotes breastfeeding — which studies show may reduce the risk of SIDS — and allows parents to be more attentive to their infant’s needs.
In addition, Dr. Lisa Gabhart, a pediatrician at Sharp Rees-Stealy Medical Group, said parents need to be watchful that the baby is not too warm. She said they don’t need a blanket or loose bedding in their crib because they could overheat or become entrapped. She said all that’s needed is a warm sleeper or sleep sack. A good way for parents to gauge whether a baby is too warm is by their own level of warmness. She said if they are comfortable in their clothing, then add one more layer to the baby.
Coping with loss
For families who lose a child to SIDS, Gabbe said parents should have tests to see if there’s an underlying metabolic or genetic condition that would put an infant at risk.
“But in general, if a genetic cause has not been found, subsequent babies should not be at increased risk, although the parents are obviously on high alert and worry about a repeat tragedy,” said Gabbe.
Still, the odds of another child in the family dying of SIDS are relatively low. Daneshmand said the risk of a younger sibling in the family being lost to SIDS is less than 1 percent.
For parents suffering a loss, Gabbe said it’s “essential” for parents to seek and obtain support.
“The tragic loss of a previously healthy infant is a lifelong heartache,” Gabbe said. “Everyone should get help to understand and learn how to live and honor the memory of the infant.”
There are a number of organizations dedicated to helping families cope with the loss of a child to SIDS. Such websites include:
- Empty Cradle, Emptycradle.org
- First Candle, Firstcandle.org
- CJ Foundation for SIDS, CJsids.org
By: Erinn Hutkin, Special to U-T San Diego
Source: UT San Diego
