• Sudden Infant Death Syndrome

    Also Known as Crib Death or SIDS

    What is SIDS?

    Sudden infant death syndrome (SIDS) refers to the unexpected, unexplained death of a child less than one year old.

    SIDS is rare during the first month of life. It peaks at 2–4 months of age, then gradually decreases.

    What causes SIDS?

    Experts don't know the exact cause of SIDS, though there are many theories.

    Possible causes of SIDS include:

    • Abnormalities in a section of the brain that controls breathing during sleep and waking
    • Abnormalities in the control of heart rhythm
    • Changes in how serotonin, which is a neurotransmitter, functions in the brain
    • Changes in some components of the immune system
    • Inability to wake up if there's a breathing obstruction or asphyxia (a lack of oxygen or excess carbon dioxide)

    brainstem

    Area of the brain involved in regulation of breathing.1

    SIDS risk factors

    SIDS is more common in infants less than 6 months old.

    Factors that increase your baby's chance of SIDS include:

    • Low birth weight
    • Delayed fetal growth
    • History of SIDS death in a sibling
    • History of an acute life-threatening event
    • Previous incident of unexplained severe apnea – when breathing is repeatedly interrupted and requires resuscitation
    • Sleeping on the stomach or side rather than back
    • Co-sleeping in the parents bed
    • Loose covers and blankets
    • Overheating

    Other risk factors are more general and include:

    • Smoking during pregnancy or in a house where the baby is sleeping
    • Alcohol, excessive caffeine, opiate or cocaine use during pregnancy
    • Mother's age – younger than 20 during first pregnancy
    • Poverty
    • Black, Native American and Alaskan Native families
    • History of anemia or a urinary tract infection during pregnancy
    • No or late prenatal care
    • Premature birth
    • Recent infection and/or fever
    • Cold weather in late fall or winter
    • Low parental socioeconomic status or low level of education

    Also, baby boys are more likely to experience SIDS than baby girls.

    SIDS symptoms

    Babies that die of SIDS typically appear healthy. They might have had colds or gastrointestinal infections in the 2 weeks before death.

    There usually aren't any warning signs that a baby is about to have SIDS.

    Diagnosing SIDS

    All possible illnesses and causes of death must be ruled out before a diagnosis of SIDS is made. A complete investigation will take place including:

    • Autopsy
    • Assessment of the death scene
    • Review of the baby and family's medical histories

    How SIDS is treated

    Get medical care immediately.

    Emergency medical personnel should be called as soon as a baby is discovered not breathing. It's important to start infant CPR be start right away.

    You should seek medical care immediately, even if the baby starts breathing again. The cause of the incident should be fully evaluated.

    Families may need grief counseling after the death. Some parents find support groups helpful.

    Preventing SIDS

    There is no way to predict which infants will die of SIDS. However, there are several things you can do that might help you lower your child's chance of SIDS:

    During pregnancy

    • Get prenatal care early and regularly.
    • Don't smoke, drink alcohol or use drugs while pregnant.

    After birth

    • Babies less than one year old should sleep on their backs.
    • Don't allow a young babies to sleep on their stomachs or sides.*

    Putting baby to bed safely

    *Please note that many babies older than 6 months of age are able to roll over. At that point, constant monitoring of sleep position isn't necessary.

    Ask your doctor for more information about positioning your baby for sleep.

    Additional safe sleep tips

    Other factors that may help reduce SIDS risk include:

    • Providing a firm crib mattress
    • Breastfeeding your baby
    • Not placing blankets, comforters, pillows or sheepskin under your baby
    • Not letting your baby sleep on a waterbed
    • Removing soft, stuffed toys and loose bedding from the sleep area
    • Not covering your baby's head or face
    • Having your baby sleep in the same room as you for the first 6 to 12 months – but not sharing your bed
    • Practicing skin-to-skin contact with your baby as soon as possible after birth
    • Keeping the bedroom at a comfortable temperature (68–72°F or 20–22.2°C)
    • Avoiding overheating by not overdressing your baby
    • Giving your baby a pacifier during nap time and bedtime
    • While your baby is awake, placing him on his stomach so he can move his body
    • Not smoking in the house or around your baby (Ask your doctor about ways you can quit.)
    • Making sure your baby gets routine medical care, including recommended vaccines
    • Not using cardiorespiratory monitors or other devices claiming to reduce the risk of SIDS2
    • Learning infant CPR
    • Making sure anyone else caring for your child is also aware of these recommendations

    Learn more about safe sleep for babies here.

    1. Brainstem image copyright © Nucleus Medical Media, Inc.
    2. There is no evidence these devices are useful.


    RESOURCES

    Family Doctor (American Academy of Family Physicians), "Sudden Infant Death Syndrome (SIDS)" on www.familydoctor.org

    Healthy Children (American Academy of Pediatrics), "Reduce the Risk of SIDS & Suffocation" on www.healthychildren.org

    References

    American Academy of Pediatrics SIDS Task Force. The changing concept of sudden infant death syndrome: diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics. 2005;116:1245-1255.

    Galland BC, et al. Prone versus supine sleep position: a review of the physiological studies in SIDS research. J Paediatr Child Health. 2002;38:332-338.

    Hay WW. Current Consult Pediatrics. 17th ed. New York, NY: McGraw-Hill; 2005.

    Hunt CE, Hauck FR. Sudden infant death syndrome. CMAJ. 2006;174:1861-1869.

    Kleigman RM, Jensen HB, et al, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.

    Sudden infant death syndrome (SIDS). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113764/Sudden-infant-death-syndrome-SIDS. Updated July 23, 2014. Accessed September 13, 2016.

    Sudden infant death syndrome (SIDS). Nemours Kid's Health website. Available at: http://kidshealth.org/parent/general/sleep/sids.html. Updated October 2011. Accessed February 18, 2013.

    10/23/2009 DynaMed Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Blair P, Sidebotham P, et al. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. BMJ. 2009;339:b3666.

    11/14/2011 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics. 2011;128(5):1030-1039.

    10/25/2016 DynaMed Plus Systematic Literature Surveillance. http://www.dynamed.com/topics/dmp~AN~T113764/Sudden-infant-death-syndrome-SIDS: SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment Rachel Y. Moon, Task Force on Sudden Infant Death Syndrome. Pediatrics Oct 2016, e20162940; DOI: 10.1542/peds.2016-2940.

    Revision Information

    This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

    Copyright © 2012–2016 EBSCO Publishing. All rights reserved.

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