- Kids Health
The Truth About SIDS in Infants
Of all the dangers your baby faces as an infant, this one is probably the scariest. Research has been conducted on this syndrome for decades to no avail, and still remains ever unpredictable despite the efforts to discover a solution. There are no symptoms, doctor visits, or even vaccinations to protect you.
SIDS is the leading cause of death among infants 1 month to 1 year old, and claims the lives of about 2,500 each year in the United States. In 1994, the Back to Sleep Campaign and the Healthy Child Care America Campaign, known as the Healthy Child Care America Back to Sleep Campaign, were launched to promote the health and safety of infants in child care settings by providing education and outreach to child care providers regarding safe sleep recommendations.
Since the start of these campaigns, the incidences of SIDS in the Unites States have literally been cut in half. Although there are still cases where infant deaths are simply misdiagnosed (or coded), the truth is the spread of awareness and education on SIDS is making a huge difference.
What is SIDS?
SIDS (Sudden Infant Death Syndrome) is the sudden and unexplained death of an infant, who is younger than 1 year old, while he or she is sleeping. This cannot accurately be predicted by medical history and it remains unexplained even after many a thorough forensic autopsy and detailed death scene investigation. As infants are at the highest risk for SIDS during sleep, it is sometimes referred to as cot death or crib death. (Kids’ Health)
SIDS is a frightening prospect because it can strike without warning, usually in perfectly healthy babies. It is so scary because typically the infant is found dead after having been put to bed for a nap or for the night.
Fortunately, the infants who have died of SIDS have shown no signs of suffering. Unfortunately SIDS can only be diagnosed once all recognizable causes of infant death have been ruled out, including infection, trauma, or a condition related to the heart, lungs, or central nervous system (Medicine Net), the medical history of the child has been checked, and the scene of the death has been investigated to rule out accidental asphyxiation, abuse, or crime.
Have you or anyone else you've known suffered from SIDS?
What Does SIDS Look Like?
Spotting SIDS would seem fairly straightforward, but the truth is quite the opposite. As SIDS is seen as sudden death in infants, for no reason, as they are sleeping, all we can do is spot the warning signs and attempt to prevent it. The biggest warning sign is baby being in a position of restricted airflow. The nose and mouth of your infant should always be completely unrestricted so that they may breathe normally in any position, even if he turns his head or adjusts his position.
When an infant’s face is turned toward the bedding, he's in a position to re-breathe the carbon dioxide he exhales, which limits the amount of oxygen he takes in. If pillows, stuffed animals, blankets, decorations, or even toys are placed in the crib alongside your baby, one of those items may restrict airflow, causing the same problem, or may block any and all airflow altogether as baby turns his head towards (or into) the item.
When they aren't getting enough oxygen, most babies will do something to change their environment, like turn their heads, sigh, change position, or yawn. It’s a natural human reaction to reduced airflow, which is one reason we yawn when we get tired. We simply aren’t breathing deeply enough to get the oxygen we need. But many babies who die of SIDS don't wake up, or aren’t alerted, when they get into trouble, and fix the problem.
A new Italian study that found that serotonin overproduction in the brain has caused many SIDS-like deaths. Along with its role affecting mood, serotonin helps regulate breathing and arousal. If that arousal center isn't functioning properly, an infant sleeping in a position that limits his oxygen may not wake up in time. However, as a baby grows and matures, the brain will also mature and eventually able to process serotonin appropriately. This is why the biggest danger tends to pass after about 4 months of age.
For parents, this is why it's more important than ever that they follow the safe-sleep recommendations, and insist that babysitters and caregivers do the same, including putting babies to sleep on their backs. Nothing that is known at the present time will completely prevent SIDS, but the risk can be substantially reduced. (Parenting)
Did I Do Something to Cause It?
As awareness and education increase about this danger in infancy, parents all over the country are taking all of the necessary precautions to keep their healthy babies safe, but are still losing their babies. Many risk factors and medical relationships are proposed for SIDS. But genetics also plays a huge role, as we know that SIDS is more prevalent in male infants. Also, black males are twice as likely to die of SIDS, and Native American males are four times as likely. However, research is lacking to explain why just yet.
Foremost among these risk factors is stomach sleeping. Numerous research studies across the United States have found a much higher incidence of SIDS among infants placed on their stomachs to sleep, than among those sleeping on their backs or sides.
Also, infants who succumb to SIDS may have an abnormality in the arcuate nucleus, a part of the brain that may help control breathing and awakening during sleep. If a baby is breathing stale air and not getting enough oxygen, the brain usually triggers the baby to wake up and cry. That movement changes the breathing and heart rate, making up for the lack of oxygen. But a problem with the arcuate nucleus could deprive the baby of this involuntary reaction and put him or her at greater risk for SIDS. (Kids’ Health)
Most deaths due to SIDS occur between 2 and 4 months of age, to mothers in their teens, to households in which at least one person smokes, and interestingly enough, incidence increases during cold weather, when parents tend to cover their children in blankets or dress their children in particularly fluffy, thick pajamas.
Largest Potential Risk Factors for SIDS
- smoking, drinking, or drug use during pregnancy
- poor prenatal care
- prematurity or low birth weight
- mothers younger than 20
- second hand tobacco smoke exposure following birth
- lack of breastfeeding
- items in the crib with baby during sleep
- baby sleeping on stomach
Could My Infant be Pre-disposed to This Disease?
It’s completely possible. There are many risk factors that can be controlled, and a few that cannot, that can determine an infant’s pre-disposition to succumbing to SIDS from the moment they are born. Many of these pre-dispositions are related to the care of the infant during pregnancy and the actual birth of the child itself.
As the rate of SIDS in infants decreases with an increasing age in birthing mothers, mothers in their teenage years are at the greatest risk of having children with SIDS. Mothers that delay or receive inadequate prenatal care from a doctor, including prenatal vitamins, an emphasis on not smoking, drinking, or taking drugs during pregnancy, and a proper diet, can also be at great risk.
Babies that are born with a low birth weight, and especially those that have a premature birth, have an increased risk of SIDS death that is roughly fourfold that of healthy babies. Finally, a lack of breastfeeding, as this is where babies get most of their antibodies, and the necessary nutrients they need to develop healthy bodies and a healthy immune system, is linked to a high risk SIDS. Anemia has also been linked.
It is important to know the possible factors that put your baby at risk of SIDS before you even have an infant in your arms to care for, so that you can be proactive and give your infant the best shot at life.
Is There Anything I Can Do to Prevent it?
A lack of awareness and answers for frightened parents is part of what makes Sudden Infant Death Syndrome (SIDS) so terrifying. But if you take the time to learn what you can about this syndrome, and get the answers you need, the risk of SIDS for your infant can be greatly reduced.
First and foremost, infants younger than 1 year old should be placed on their backs to sleep, and should never sleep face-down on their stomachs. Understand that tummy-time during the day is perfectly fine. It is simply sleep time that is the concern.
Place your baby on a firm mattress to sleep, never on a pillow, waterbed, sheepskin, couch, chair, or other soft surface. This will insure that he will never find himself in a position where he cannot get the oxygen he needs no matter which direction he turns his head.
Put your baby to sleep in his or her own crib from the very beginning. Too many infant deaths have been caused by soft adult bedding, accidental smothering from parents, and other issues that put your infant at risk of SIDS while in your bed. However, it's a good idea to keep the cribs and bassinets in the room where parents' sleep for at least the first 3-4 months so you can be there should there be any problems. This has been linked with a much lower risk of SIDS.
Put your baby to sleep with a pacifier during the first year of life if possible. A pacifier will work to keep your baby’s airway open all night long, or as long as they have the pacifier in their mouths, but don’t force it. The use of pacifiers has lowered risk of SIDS in infants dramatically.
Make sure your baby receives all of the doctor’s recommended immunizations. I know many parents have concerns about the many immunizations their babies are receiving and what is being put into their little bodies, but this is how we have thwarted many of the illnesses of old that you no longer see today; Black plague, diphtheria, yellow fever, etc. Studies have shown that proper infant immunizations reduce the risk of SIDS by over 50%.
Make sure your baby has regular well-baby checkups. A doctor can make sure that your little one is consistently free from illness, especially if he or she contracts a respiratory virus that could increase his or her chances of SIDS due to a difficulty in breathing. You want to know that your baby is healthy at all times and a doctor can catch any problems before they become dangerous.
Receive early and regular prenatal care while you are carrying your child. Prenatal vitamins, a healthy diet and exercise, prenatal vaccines, and a doctor’s close eye will make sure your baby has the best chance at living a healthy life, even while he is still in your belly.
And MOST IMPORTANTLY, do not smoke, drink, or use drugs while pregnant and do not expose your baby to secondhand smoke. Infants of mothers who smoked during pregnancy are three times more likely to die of SIDS than those whose mothers didn’t smoke. Exposure to secondhand smoke doubles a baby's risk of SIDS.
Even worse than any kind of respiratory illness that may hinder an infant’s breathing ability, cigarette smoke, even second-hand (and even if you’re blowing it out the window at home or in the car), can completely block a baby’s developing respiratory system from breathing altogether. An infant’s system is simply not mature enough to handle inhalants like cigarettes. I mean, look what it does to fully-grown and mature adult respiratory systems.
Have You Been Touched by SIDS?
There’s nothing that matches losing a baby, even if that little one is a niece, nephew, grandchild or loved one. Sudden infant death is a tragic event for any parent or caregiver. If you’ve lost a baby to SIDS, the emotional support of others, such as friends, family members, or even others in your situation, is especially important in the healing process.
Consider checking out or joining a support group in your area for others that have experienced a loss such as this, or you can visit an online SIDS chat room. Make sure to keep a consistent, open line of communication with your friends and family members about how you're feeling. The baby's parents, especially, need to be as open as possible with one another.
Losing a child can put a terrible strain on a marriage. (Mayo Clinic) If counseling is needed so that both individuals can express their frustrations and feelings, there are many services all over the United States, and even in your area, that are specifically trained to help couples in your position. You need that other person to get through this. Stick by each other and lean on each other for support.
Finally, give yourself time to grieve. Healing takes time.
Why Hasn’t Someone Figured This Out by Now?
SIDS, which has been classified as a natural cause of death, is considered super rare. The official rate from the National Centers for Health Statistics (NCHS) is roughly one death for every 2,000 live births, or less than 5%. (Parenting) In most cases, further incident is simply due to lack of awareness on the part of parents and caregivers.
Many parents believe that the only babies still dying of SIDS are the ones whose caregivers just aren't following the safe-sleep rules. Although fewer than 2,500 infant deaths this year will be classified as SIDS, an additional 2,000 seemingly healthy babies under 12 months will also die mysteriously in their sleep.
Hopefully, growing public awareness of SIDS and precautions to prevent it should leave fewer parents searching for answers in the future. I'm hopeful that in my lifetime, people will say, 'SIDS? What's that?' And no other family will have to go through losing an infant to SIDS ever again.