Sudden Infant Death Syndrome: What You Need to Know

Sudden Infant Death Syndrome, also known by the acronym SIDS, refers to the sudden death of a healthy infant with no known cause. It has also been called Crib Death. The idea that a healthy infant can die suddenly is naturally very frightening to parents.

SIDS is a diagnosis of exclusion. What that means is that the baby has been thoroughly examined (in an autopsy) and the environment around the baby has been investigated. In cases of SIDS, the baby has not been injured or hurt and has no underlying medical condition that could explain the death.

Much research has been done to discover the cause of SIDS and what can be done to prevent it. While no specific cause has been discovered, there are a variety of factors associated with SIDS, and many of these involve behaviors that parents can change. In other words, there are changes that parents can make and ways to care for their infants to lower the risk of SIDS.

SIDS is the number one cause of death among healthy babies. It affects 0.57 per 1000 live births, meaning there is less than one case for every 1000 babies born in the United States. Even that is too many cases. Risk factors include prematurity (less than 37 weeks gestation), low birth weight, and low Apgar scores, among others. More important are risk factors that can be modified, which include:

Sleeping position. Babies who sleep on their stomach, instead of their backs, are at much higher risk for SIDS.
Bed sharing. Babies who sleep in bed with parents or other children are at higher risk of SIDS.
Sleeping in an inappropriate place, not a crib or bassinet. This also increases the risk of SIDS.

In a recent study, 92.2% of SIDS occurred in infants sleeping in one of the ways above, sleeping on the stomach, in bed with others, or in some place other than a bassinet or crib. Other factors increasing the risk of SIDS are mothers-to-be smoking during pregnancy or anyone smoking around the baby, putting the baby on soft bedding, and overheating the infant. Use of a pacifier seems to reduce the risk of SIDS.

Based on this and other information, the following recommendations have been made:

Place your baby on his or her back for sleeping. Not even the side position is safe.
Use only firm bedding surfaces, and keep soft objects and loose bedding out of the crib or bassinet.
Do not overheat the baby - do not overdress the baby or use heavy blankets. Keep the room temperature moderate.
Do not smoke during pregnancy or around the baby. The environment should be smoke-free.
The baby needs to sleep in a bassinet or crib, near your bed. Do not sleep with the baby in bed or on a couch.
Once breastfeeding has been established during the first month, try giving the baby a pacifier before he or she goes to sleep.

Sleeping on the back will flatten the back of your baby's head. To counteract this, when the baby is awake, put him or her face down. This also gives the baby a chance to strengthen his or her neck muscles and gain some upper body control.

You may have heard about apnea relating to SIDS. It was thought that babies stopped breathing and died, causing SIDS. There was a period of time when babies thought to be at risk, for example, premature infants, were sent home with apnea monitors. In fact, apnea has nothing to do with SIDS. Babies with apnea are no more at risk for SIDS than other babies, and the use of apnea monitors does not change the risk of SIDS.

When an infant suddenly dies or has a life-threatening event, doctors will focus on various causes of severe illness in babies, which can include heart abnormalities, problems with the gastrointestinal tract, brain disorders, infections, and trauma, among other things. Since suffocation is one of the reasons for the sudden death of a baby, parents of a child with SIDS are usually examined carefully. The percent of SIDS babies where they have actually been suffocated is anywhere from 1% to 5% of cases. Most cases of SIDS are tragic and inexplicable.

Any family who has lost a child to SIDS needs as much support as possible, access to counseling, and also group therapy. They also need to know that there is no increased risk of having a second baby die of SIDS.

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Sudden Infant Death Syndrome: What You Need to Know

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