SIDS, or sudden infant death syndrome/crib death, is defined as the sudden death of an infant under 1 year of age which remains unexplained after a thorough case investigation. This includes the performance of a complete autopsy, an examination of the death scene, and a review of the clinical history. This is the most common cause of death in children from ages 1 month to 1 year. The peak incidence of SIDS is 2-4 months of age. The ratio of boys to girls is 60:40.

sids, sudden infant death syndrome

SIDS CAUSES:

By definition, there is no known cause for SIDS, however, there are risk factors that can increase the chances of a SIDS occurrence.

  • First and foremost is sleeping on the stomach. The prone position or sleeping on the stomach should NEVER happen until a baby is rolling over from their back to their stomach all by themselves. With babies on their stomachs, the incidence of SIDS is 1.6/1000 children. If all babies were placed on their back to sleep, the incidence would reach as low as 0.2/1000 children.
  • Other risk factors include poor maternal prenatal health (history of smoking, use of illicit drugs, anemia, low weight gain, sexually transmitted diseases, and/or urinary tract infections).
  • Lack of breastfeeding is considered a risk factor.
  • Certain types of bedding can be a problem. The baby should be on a firm mattress or other firm surface. There should be no toys, stuffed animals, blankets, comforters or other choking hazards near the baby. Do not use pillows, sheepskin, waterbeds, or other soft materials.
  • The temperature of the room should not be too hot. A temperature between 68-74 degrees is sufficient.
  • A bottle should never be propped in the baby’s mouth or left for the baby to drink from while sleeping.

SIDS DISCUSSION:

For years the medical recommendation in the USA was for all babies to be placed on the stomach to sleep. People were concerned about choking on spit-up if a baby were placed on the stomach (this does not happen). Also, some babies seem to sleep much more comfortably on their stomach. Research now proves that this is a dangerous position and unfortunately many babies did not survive this practice. As a matter of fact, almost 1 out of every 500 babies did not survive this practice. Now there is a huge effort to educate people about the dangers of placing babies on their stomach to sleep. There is a ‘back to sleep’ campaign by the American Academy of Pediatrics. Many diapers have ‘back to sleep’ with a picture of proper sleeping position on them, and all physicians are now advocating the back as the optimal sleeping position. For a few years the side was considered acceptable but the back is by far the safest.

The reason for a child to just stop breathing is unknown but there are some theories. Current theories are that the baby is in such a comfortable, deep sleep that breathing simply stops. Some think that a baby suffocates because the head control is poor and the baby cannot lift up the head to breathe.   Others blame the infant’s floppy airway that closes when placed on the stomach. Many cases of SIDS occur just after an upper respiratory infection, so some obstruction is probably part of the cause. Choking hazards in the bed or soft bedding can play a large role. Since the exact cause is unknown, avoiding the risk factors is the best form of prevention.

Written by Dr. Michael Bornstein, who has 30 years of experience as a pediatrician. 

Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.