What is SIDS?
SIDS stands for sudden infant death syndrome — and it's the leading cause of death in the United States for babies between 1 month and 1 year old.
SIDS isn't any one illness or disease. Rather, it's the diagnosis that's given when a child under a year old dies suddenly and an exact cause can't be found after a complete medical and legal investigation, including an autopsy. That it can happen without warning makes SIDS particularly devastating for families.
Approximately 2,500 infants die suddenly and without explanation in the United States each year. SIDS most commonly affects babies between the ages of 2 and 4 months, with 90 percent of cases in infants under 6 months. It occurs most frequently during cold-weather months.
SIDS is also known as crib death because it happens most often during sleep, usually between the hours of 10 p.m. and 10 a.m.
Night isn't the only time that SIDS strikes, however. If your infant is in daycare, it's important to know that 20 percent of SIDS deaths happen in childcare settings, according to a study published in the journal Pediatrics in 2000.
This is a surprisingly high number when you consider that babies spend much less time sleeping at daycare than they do at home. This statistic points out how crucial it is to make sure your daycare providers follow safe sleeping guidelines (see "How can I lower my baby's risk of SIDS?").
What causes SIDS?
Researchers have learned a great deal about SIDS in the past three decades, but they still have no definitive answer to that question.
Some experts believe that SIDS happens when a baby with an underlying abnormality (for example, a brain defect that affects breathing) sleeps tummy-down or is faced with an environmental challenge such as secondhand smoke during a critical period of growth. Others have published studies that contradict this hypothesis.
One study published in 2007 cites a connection between hearing ability and SIDS. Pediatric anesthesiologist Daniel D. Rubens at Seattle Children's Hospital studied the results of newborn hearing tests and found that babies who died of SIDS had consistently tested lower on the inner ear function of the right ear than babies who didn't die of SIDS. (Healthy infants typically test stronger in the right ear than the left; these results flipped those scores.) This study suggests new areas of research and points to the possibility of identifying babies who are at higher risk for SIDS.
Experts are continuing to study the brain, the autonomic nervous system, infant care and sleep environments, infection and immunity, and genetics in search of answers.
Which babies are most at risk?
Although the exact cause of SIDS is unknown, some risk factors have been identified. They include:
Tummy sleeping
A baby's risk of SIDS has been found to be 1.7 to 12.9 percent higher (depending on the study) if he sleeps on his tummy instead of his back. According to Betty McEntire, the executive director of the American SIDS Institute, when a baby sleeps tummy-down he's more likely to overheat, have pauses in breathing, and re-breathe the air he has just exhaled, which can raise his level of carbon dioxide.
In addition, several studies have shown that if a baby is used to sleeping on his back and is placed to sleep on his tummy, his risk of SIDS rises markedly. (This may account for the unexpectedly high rate of SIDS in daycare settings.)
Having a parent or caregiver who smokes
Studies show that a baby's risk of SIDS rises with each additional smoker in the household, with the number of cigarettes smoked around him each day, and with the length of his exposure to cigarette smoke.
Being born prematurely or at a very low birth weight
The earlier a baby is born, the higher his risk of SIDS. Likewise, the lower his birth weight, the higher the risk.
Overheating while sleeping
There's strong evidence that becoming overheated can substantially raise a baby's risk of SIDS. "Overheating can result from being in an overheated room, wrapping or covering a baby in too many blankets, or putting a blanket over a baby's head, particularly when the baby has a fever or respiratory infection," says Warren Guntheroth, a SIDS expert and a professor of pediatrics at the University of Washington in Seattle.
Sleeping on a soft surface
Several studies link soft sleeping surfaces to a higher risk of SIDS. Quilts, comforters, sofas, waterbeds, beanbags, and other soft surfaces are all unsafe for a baby to sleep on. Like tummy-down sleep positions, soft surfaces increase the chance that your baby will encounter problems with breathing or overheating.
Being born to a mother who smoked or abused drugs during pregnancy
Almost every study of risk factors for SIDS has identified smoking during pregnancy as a risk factor. Of course, both smoking and drug use can compromise a baby's healthy development during pregnancy.
Being born to a mother under the age of 20
The risk of SIDS increases with each baby born to a teen mother. Also, the shorter the time between a woman's pregnancies, the higher her baby's risk of SIDS.
Suffering an apparent life-threatening event (ALTE)
Babies who have suffered what's called an apparent life-threatening event (stopped breathing and turned pale, blue, and limp and required resuscitation) have a higher risk of SIDS.
Having certain ethnic backgrounds
African American infants are two and a half times more likely to die of SIDS than are Caucasian infants, and Native American babies have three times the risk.
Some researchers hypothesize that a cultural preference for putting babies to sleep on their stomach puts certain groups at higher risk. Asian families, who have a cultural preference for placing infants on their back, have had a lower than average risk for SIDS. When they emigrated to North America and began placing babies on their tummy, their SIDS rates rose.
Being a boy
Boys of all ethnicities are at slightly higher risk than girls by a ratio of 1.5 to 1.
How can I lower my baby's risk of SIDS?
There's no guaranteed way to prevent SIDS, but you can do a number of things to greatly reduce your baby's risk:
Put your baby to sleep on his back.
This is the single most important thing you can do to help protect your baby.
The rate of deaths from SIDS has dropped more than 50 percent since 1994, when the Back to Sleep campaign was launched by the American Academy of Pediatrics (AAP), the U.S. Public Health Service, the SIDS Alliance, and the Association of SIDS and Infant Mortality Programs. Make sure that anyone who cares for your baby — relatives and babysitters, for example — knows not to place your baby on his tummy to sleep.
Most people don't know that side sleeping isn't safe, either. In fact, if your baby sleeps on his side rather than on his back, his risk of SIDS is doubled. That's because babies placed on their side can easily end up on their tummy.
Of course, by the time your baby is 5 or 6 months old, he may be able to roll over in both directions, making it a challenge to keep him on his back at night. At this age his risk for SIDS starts to drop, though, so just do your best to get him settled on his back, and then don't worry if he rolls over.
Keep in mind that putting your baby on his back all the time can cause him to develop a flat spot on the back or side of his head, called plagiocephaly or flat head syndrome.
You can help prevent this condition by learning how to position your baby when you lay him down. (If you have any questions about your baby's sleep position, talk to your doctor or nurse.)
Take care of yourself and your unborn baby while you're pregnant.
To protect your baby's health and reduce the risk of a premature birth or low birth weight (both of which are risk factors for SIDS), get proper prenatal care and nutrition. Don't smoke cigarettes or use illegal drugs during your pregnancy.
Don't allow smoking around your baby.
Keep the air around your baby — at home, in the car, and in all other environments — free of smoke. If others insist on smoking, make sure they go outside the house to do it. If you need help quitting, read our article and talk to your doctor.
Choose bedding carefully.
Put your baby to sleep on a firm, flat mattress with no pillow and nothing but a fitted sheet under him. Don't put stuffed toys or other soft materials in your baby's crib, either.
Some SIDS prevention groups recommend that you not use any blanket at all. The AAP suggests that if you can't resist covering your baby, you should use a thin blanket. Tuck it around the mattress, under your baby's arms and only as far up as his chest.
If you think your baby is chilly, dress him in warmer clothing such as footed pajamas or in a cotton one-piece under a "wearable blanket" — a sleeveless garment that's closed along the bottom like a bag. (Get more ideas for keeping your baby warm at night without blankets.)
Crib bumpers are not necessary, and SIDS prevention groups recommend that you not use them. If you choose to use bumpers, the AAP advises selecting ones that are thin and firm (not pillow-like) and attaching them securely to the crib. Make sure no strings are dangling inside the crib.
Avoid overheating your baby.
To keep your baby from getting too warm while he sleeps, don't overdress him. The room he sleeps in shouldn't be too toasty, either. The room should be comfortable for a lightly clothed adult.
Signs that your baby may be overheated include sweating, damp hair, heat rash, rapid breathing, restlessness, and fever.
Try to limit exposure to infection.
SIDS sometimes occurs together with respiratory and gastrointestinal infections. Feel free to ask people to wash their hands before holding your baby. And avoid exposing your baby to sick people whenever possible.
Does breastfeeding prevent SIDS?
There's no conclusive evidence that breastfeeding itself will lower your baby's risk of SIDS. However, breastfeeding will help reduce your baby's likelihood of getting of respiratory and gastrointestinal infections, which often occur along with SIDS.
Will sharing a bed with my baby raise the risk of SIDS?
Not everyone agrees on this one.
Some experts believe there are compelling reasons not to take your baby to bed with you during your baby's first months. For one thing, your bed surely has pillows and blankets and other soft bedding, all of which are risk factors for SIDS. It's also easier for your baby to become overheated (another risk factor for SIDS) while sharing your bed.
"The vast majority of studies conducted on this subject have shown that bed-sharing increases the risk of SIDS," says John Kattwinkel, chairman of the AAP Task Force on Infant Sleep Position and Sudden Infant Death Syndrome.
On the other hand, some experts believe that bed-sharing (also called co-sleeping) might allow a mother to respond more quickly to changes in her baby's breathing and movements, and that when risk factors like maternal smoking and tummy sleeping are removed, bed-sharing could lower the risk of SIDS. And many parents are comfortable with and committed to bed-sharing.
If you do decide to co-sleep with your baby, James McKenna, head of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame, advises making sure that your mattress is firm and flat and that it fits tightly against the headboard with no space around it where your baby's head could get stuck. Never co-sleep on a softer surface, such as a couch. Keep heavy, fluffy bedding away from your child, and even in your bed, put him to sleep on his back.
The AAP may discourage bed-sharing, but the organization actually recommends having your baby room in with you. British researchers found that when a baby is in his own bed in his parent's room his risk of SIDS is lower. So as an alternative to having your baby in bed with you, keep him in a crib or bassinet in your room.
Is it okay for me to swaddle my infant?
Some researchers suggest that swaddling — the practice of wrapping a baby securely in a blanket or cloth — may help prevent SIDS because it can help a baby sleep more comfortably on his back. If your baby startles while he's sleeping, his own body movements can wake him up. Swaddling can limit those movements and help a young baby feel more secure.
Other SIDS experts caution that swaddling could contribute to overheating. So if you do swaddle your baby, use a thin blanket and make sure the room isn't too warm. And, of course, never put your baby on his tummy when he's swaddled.
Does using a pacifier affect my baby's risk of SIDS?
Studies show a lower incidence of SIDS among infants who use pacifiers, although experts don't know whether there's a direct cause and effect. Because of the correlation, the AAP suggests that you give your baby a pacifier when putting him down for naps and at bedtime for the first year of life.
It's not necessary to reinsert the pacifier if your baby drops it once he falls asleep, and you certainly shouldn't try to force your baby to use one. The AAP also cautions that if you're nursing, you shouldn't begin using a pacifier until breastfeeding is well established. It's up to you to weigh the pros and cons of using a pacifier.
Does my baby need a sleep monitor?
There are two types of sleep monitors. Your baby's doctor may have prescribed a cardio-respiratory monitor if your baby has had a life-threatening breathing incident or severe respiratory problems. If such a monitor was prescribed for your baby, of course you should use it diligently.
You may also see home sleep monitoring systems sold by baby product retailers. These systems detect a baby's movements and alert you if movement (and presumably breathing) stops for a certain amount of time.
There's no harm in using one of these for your healthy baby if it helps you rest easily at night. Just keep in mind that there's no evidence these systems will help prevent SIDS. You'll still want to take every precaution you can to protect your baby.
What other products can help reduce my baby's risk of SIDS?
Some companies offer mattresses with a built-in ventilation system that supposedly prevents the buildup of carbon dioxide. These mattresses may keep more fresh air circulating around your baby, but there's no evidence that they lower the risk of SIDS — so don't let them give you a false sense of security. If you decide to buy one, you should still follow the SIDS prevention guidelines above.
If you don't like the idea of leaving your baby uncovered, you may want to try a wearable blanket — a sleeveless garment that's closed along the bottom like a bag. A wearable blanket keeps your baby warm while eliminating the possibility that the covers will slip over his head.
Where can I get more information?
• The American SIDS Institute conducts research and offers education and round-the-clock support to pediatricians and families. Call (800) 232-7437 or (770) 426-8746.
• The Back to Sleep Hotline, sponsored by the National Institutes of Health, offers information, support, and referrals. Call (800) 505-2742.
• The CJ Foundation for SIDS is the largest nongovernmental funder of SIDS-related programs in the United States. Visit the foundation's website for news about SIDS, a look at ongoing research, and updates on fundraisers and events around the country.
• The National SIDS/Infant Death Resource Center provides information sheets, annotated bibliographies, and referral services to parents, caregivers, and researchers.
• First Candle (formerly SIDS Alliance) provides education and research as well as support for families who have lost a baby to SIDS.
source from http://www.babycenter.com
