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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

SIDS

sudden infant death syndromSIDS is the leading cause of death among infants between 1 month and 1 year of age. Sudden Infant Death Syndrome is the sudden death of an otherwise healthy infant, under the age of 1 year that remains unexplained despite an extensive post- mortem investigation, including an autopsy, an examination of the scene of death, and a review of the case history.

SIDS is a subcategory of SUIDS or Sudden Unexpected Infant Death. Other subcategories include hyperthermia or hypothermia, accidental suffocation or metabolic disease. If an infant death is reported, investigated and no explanation can be found, it is classified as SIDS.

SIDS occurs most frequently between the ages of 2 and 4 months, with 90% of unexplained infant deaths occurring before the age of 6 months. It occurs during the infant's sleep, most typically between 10pm and 10 am, with 5 am being the peak time of death. SIDS tends to be more common in the winter months and for unknown reasons, occurs more frequently among boys than girls.

Choking or vomiting during sleep does NOT cause SIDS
There is NO correlation between SIDS and immunizations.
SIDS is NOT the result of child abuse or neglect.

Symptoms:

One of the most distressing things about SIDS is that there are no symptoms. Without a warning, parents may feel helpless to protect their child (see reducing the risk).

Call your health care provider

If your baby has periods of not breathing, going limp or turning blue, contact your paediatrician at once.

Excessive gagging is also a concern that needs to be discussed with your child's doctor without delay.

If your baby is not moving or breathing, begin CPR and call for emergency medical assistance immediately.

Tests and diagnosis:

An autopsy may not be able to confirm the cause of death but may add to the existing knowledge about SIDS. In the case of an unexplainable death, law may require an autopsy.

Risk factors:

Risk factors refer to some element in the baby's environment or development that increase their risk of dying of SIDS. These factors are sometimes associated with SIDS. They may provide clues to the mystery of SIDS but are by no means causative factors or cures for SIDS.
  • Prematurity/ babies of low birth weight
  • Being around cigarette smoke in utero or after being born
  • Using illegal drugs during pregnancy
  • Putting baby to sleep on their stomach
  • Parents and baby sleeping in the same bed (co-sleeping)
  • Soft bedding in the crib
  • Having minimal or no prenatal care
  • Having a brother or sister who had SIDS
  • Multiple birth babies (such as twins or triplets, etc.)
  • Short time between pregnancies
  • Unsafe sleeping environment
  • Living in poverty situations

The significance or impact of each of these factors is not clearly defined or understood.

Reducing the risk of SIDS and fatal sleeping accidents:

Expectant parents should:

Get medical care early in the pregnancy, preferably in the first trimester. This should be followed by regular medical check-ups. Expectant moms are advised to eat a nutritionally balanced diet. These efforts will reduce the risk of prematurity, which is a major risk factor of SIDS.

Do not smoke or use illegal drugs during pregnancy. These substances increase the infant's risk for SIDS.

It is recommended that couples wait at least 1 year between the birth of a child and the next pregnancy. Shorter intervals between pregnancies; are associated with a higher SIDS rate.

Tips for parents:

Although some infants tend to cry more when placed on their backs, are difficult to soothe and wake with less stimulation, tummy sleep is not recommended. Research shows that belly-sleep has up to 12.9 times the risk of death as back sleep. Tummy sleep is associated with an increase in body heat that can be dangerous for some infants. Infants are more likely to have apnea or pauses in breathing when on their stomachs. They are also more likely to re-breathe the air they have just exhaled, resulting in an increase in their carbon dioxide levels. Side sleeping is unstable and should also be avoided.

Wrapping is a useful technique that parents can use to help their infants settle and sleep on their back, in the first 6 months of life. Wrapping and placing baby on their back, provides stability and ensures that safe sleeping recommendations are followed. Research has shown that being on the back and being wrapped decreases the risk of SIDS more than sleeping in the back position alone. Wrapping has also been associated with reduced crying time, better quality sleep due to less frequent spontaneous arousals, improved neuromuscular development in preterm babies, and wrapping is effective in reducing baby's response to pain. Ensure that baby is wrapped from below the neck to avoid covering the face. Make sure that they are not over-dressed and use a lightweight wrap such as cotton or muslin. The wrap must not be too tight as this may interfere with physical development.

Place your baby in a clean cot that has a firm, well-fitting mattress. There should be nothing else in the bed except the baby; including covers, toys, positioning devices, pillows, etc. Ensure that your baby's bedclothes (preferably use a light sheet) are firmly tucked in and that their face and head are not covered. Soft mattresses, heavy covering and crowded cots are associated with a higher SIDS rate. Ensure that your infant's feet are positioned at the bottom of the crib.

Infant sleeping bags are designed in such a way, so that baby cannot slip inside the bag and become completely covered. Since babies control their temperatures through their face, infant sleeping bags are a good way to prevent baby from overheating and suffocation. It is essential to choose a sleeping bag that is the correct size and dress your infant according to the room temperature. Evidence suggests that sleeping bags reduce the incidence of SIDS because they delay baby from rolling into the high-risk tummy position. Sleeping bags also prevent baby's legs from dangling out the cot rails.

Allow baby to sleep in your room until at least 6 months of age. It is recommended that babies sleep in their own safe sleeping place, in their parent's room for the first 6-12 months.

Parents should NOT place their baby in an adult bed or allow them to sleep with other children. Adult beds and furniture are typically NOT safe for babies. This includes not putting your baby to sleep on other surfaces, like couches or chairs.

Avoid over-dressing your infant. Only use enough clothes to keep your baby warm without having to use a cover. Ensure that the room temperature is comfortable. Overheating is one of the risk factors for SIDS. Make sure that your baby is NOT hot to the touch. A useful guide of how to dress a baby is how you would dress yourself- to be comfortably warm and dressed appropriately in accordance with the room temperature.

Ensure that your home environment is smoke free and that your infant is not exposed to the second-hand smoke of others.

Breast-feed if possible. Breastfeeding is associated with a decrease in respiratory and gastrointestinal infections. Breast-fed babies have a lower SIDS rate than their formula fed counterparts.

Some studies have indicated that there is a lower SIDS rate amongst babies who use a pacifier. Doctors think that a pacifier may help keep the airways open, or prevent baby from falling into a deep sleep. If baby awakes more readily, they may be able to move out of a dangerous position. Offer your infant a pacifier at naptime and bedtime. If you are breastfeeding only do so after 1 month, so that the pacifier doesn't interfere with feeds. Some babies do not have an affinity for pacifiers. Do NOT force your child if this is the case.

NEVER give honey to children below the age of 1. Honey may cause infant botulism, which is a risk factor for the development of SIDS.

Emotional support

Parents who have lost a child to SIDS need emotional support; not only are they shocked and grieving the loss of their baby but they may be feeling guilty about the mysterious circumstances under which their child has died. Tragically losing a child to SIDS irrevocably changes a parent's life.

Counseling may be recommended to help all family members cope.

References

A.D.A.M., Inc. Sudden Infant Death Syndrome. The New York Times Co.
http://health.nytimes.com/health/guides/index.html. Published June 18, 2012. Accessed June 19, 2012.

A.D.A.M. Medical Encyclopedia. Sudden Infant Death Syndrome: Crib death; SIDS. PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/?term=SIDS. Reviewed August 2, 2011. Accessed June 17, 2012.

American Academy of Pediatrics. Task Force on Infant Sleep Position and Sudden infant Death Syndrome. Pediatrics 2000 Mar; 105(3 Pt 1): 650-656.

American SIDS Institute. What is SIDS? http://www.sids.org/ndefinition.htm. SIDS.org. Published 1983-2009. Accessed June 17, 2012.

The Parenting.com Network. Sudden Infant Death Syndrome. Parenting.com. http://www.parenting.com/category/conditions/about-sids. Published 2012. Accessed June 17, 2012.

AskDoctorSears.com. 7 Steps to Reduce the Risk of SIDS. AskDrSears. http://www.askdrsears.com/topics/sleep-problems/sids/7-steps-reduce-risk-sids. Published 2011. Accessed June 18, 2012.

Sidsandkids. Sudden Unexplained Death in Infancy (SUDI) Frequently Asked questions. Sidsandkids safe sleeping. http://www.sidsandkids.org/wp-content/uploads/2012-May-FAQ.pdf. Published May 2012. Accessed June 19, 2012.