SIDS - Sudden Infant Death Syndrome

These other possible causes are investigated through autopsy, death scene investigation, or review of the medical history.
Most SIDS deaths are associated with sleep, and infants who die of SIDS show no signs of suffering. Most deaths occur between 2 and 4 months of age, and incidence increases during cold weather. There is a common belief that marital breakup always follows the death of a baby, but this hasn’t been supported by experience or research. Like any sudden death, a SIDS death leaves a family with a sense of shock and loss, as well as an urgent need to understand what has happened. Some of the usual emotions felt by parents include guilt, anger, fear, blame and despair.

Incidence

SIDS is responsible for more deaths than any other cause in childhood for babies between one month and one year of age. About 150,000 victims are reported in the United States in this generation alone - 7,000 babies each year fall victim to this syndrome. That’s one baby every hour of every day. A little known fact is that more children die of SIDS in one year than of cancer, heart disease, pneumonia, child abuse, AIDS, cystic fibrosis, and muscular dystrophy combined during their first 14 years.

No one can predict where SIDS will strike, because  it affects families of all races, ethnic and socioeconomic origins without warning. In fact, most SIDS victims appear healthy prior to death. African-American infants are twice as likely and Native American infants about three times more likely to die of SIDS than Caucasian infants. Also, more boys than girls fall victim to SIDS.

SIDS Death By Race and Origin of Mother, 2002

Race

Number

Ratio

All

2,295

57.1

Native American

52

123.3

African-American

642

110.3

Caucasian

1,269

55.2

Hispanic

260

29.7

Asian/Pacific Islander

51

24.3

Other potential risk factors include: smoking, drinking, or drug use during pregnancy; poor prenatal care; premature birth or low birth-weight; mothers younger than 20; smoke exposure following birth; overheating from excessive sleepwear and bedding; stomach sleeping; and many others.

See Also: Sudden Infant Death Syndrome, Suffocation Risk, and Baby's Sleep Positions

Maternal risk factors include:

• age less than 20 at first pregnancy
• a short interval between pregnancies
• smoking during and after pregnancy
• placental abnormalities
• anemia
• alcohol and substance abuse
• history of sexually transmitted disease

Possible causes of SIDS

Unfortunately, the exact cause of SIDS is still unknown. There is mounting evidence that suggests some SIDS babies are born with brain abnormalities that make them vulnerable to the syndrome during infancy. Studies of SIDS victims reveal that many infants have abnormalities in a brain structure called Arcuate Nucleus. It is the portion of the brain involved in control of breathing and waking during sleep. Supposedly, these abnormalities may stem from prenatal exposure to a toxic substance, or lack of a vital compound in the prenatal environment, such as sufficient oxygen.

Genetics also plays a large role. SIDS is more common in boys than in girls, and it is more common in certain population groups (see table above). Affected infants may have been born with immature brainstems, making it difficult for them to wake up when in trouble.

Other possible causes:

• stress caused by infection or other factors;
• a birth defect
• failure to develop

What is so special about stomach sleeping?

Among many risk factors, stomach sleeping is probably the most important. Numerous studies have found a higher incidence of SIDS among babies put to sleep on their stomachs than among those sleeping on their backs or sides. Stomach sleeping puts pressure on a child's jaw, therefore narrowing the airway and hampering breathing.

A different group of experts disagrees. They claim that stomach sleeping can increase an infant's risk of re-inhaling his or her own exhaled air, particularly if the infant is sleeping on a soft mattress or with bedding, stuffed toys, or a pillow near the face. When a baby breathes exhaled air, the oxygen level in the body drops and carbon dioxide accumulates. 

See Also: Importance of Infant Immunization

Is this condition contagious?

SIDS is not believed to be contagious, but there is the now-accepted idea that ulcers could be the cause. These ulcers are often caused by infections with Helicobacter pylori bacteria. A study suggests that infections with this same bacterium may also be responsible for many cases of sudden infant death syndrome. This bacterium has been found in 88 percent of examined children who had died from SIDS. 

Differential diagnosis of SIDS

Mostly because of the lack of hard facts, people speculate a lot about this condition, sometimes confusing it with another condition that strikes little babies. Many old wives’ tales and superstitions abound about SIDS. From chiropractors claiming stress on the atlas while passing the birth canal, to stories about suffocation from the ammonia in urine, the study of SIDS has suffered from the ignorant. Because the causes remain unknown, parents will often come up with their own explanation for the tragedy and blame themselves. That’s why, it is important to know what SIDS is not:

• Apnea: Apnea has killed many infants. To detect and diagnose a baby with this condition, an apnea monitor can be installed when a SIDS victim stops breathing but one thing should be remembered – a SIDS victim is already dead when that happens. For many years these apnea monitors have been installed mainly for a placebo effect on the parents.
• Predictable: There are no signs that could tell a doctor or parent that SIDS will occur.
• Infant botulism: Infant botulism and SIDS have a similar age of death demographics but the botulism is easily found in an autopsy.
• Caused by immunizations: Most children get their immunizations at about four months which coincides with the average age. But children without immunizations also die of SIDS, so this can’t be considered as the possible cause!
• Caused by poor or bad parents: SIDS happens to parents of all economic, social, educational, and racial groups. 
• Caused by Colds: Many infants get their first runny nose around four months. A SIDS victim can die with a cold, but not from a cold.
• Caused by fire retardants in mattresses
• Caused by suffocation
• Caused by vomiting or choking
• Contagious
• Hereditary
• The result of neglected illness, accidents, or abuse

See Also: Baby Colic (Abdominal Pain in Infants) - Symptoms and Treatment

Prevention of SIDS

Currently there is no known way to prevent SIDS, but there are things that parents and caregivers can do to reduce the risk of a SIDS death:

• Always place your baby to sleep on the back, because this position is the safest. Use a firm sleep surface, such as on a safety-approved crib mattress, covered by a fitted sheet. If you use a blanket, place the baby with feet at the end of the crib. The blanket should reach no higher than the baby's chest. Do not share a sleep surface with your baby. Keep your baby's sleep area close to, but separate from, where you and others sleep.
• Do not allow smoking around your baby
• Use a clean, dry pacifier when placing the infant down to sleep, but don't force the baby to take it. 
• Do not let your baby overheat during sleep. Children should be dressed in light sleep clothing, and the room should maintain a temperature comfortable for an adult.
• Avoid products that claim to reduce the risk of SIDS because most have not been tested for effectiveness or safety.
• Make sure your baby’s head remains uncovered during sleep because babies are at an increased risk for SIDS if their head becomes covered during sleep.
• Good prenatal care, including proper nutrition, abstinence from alcohol, drugs, and smoking, and frequent medical checkups might help prevent a baby from developing any abnormality 
• Breastfeeding has been shown to be good for babies by building their immunity against illness and infections