Sudden Infant Death Syndrome (SIDS) Overview

Before I start talking about this topic let me say that this is just an overview. There is way too much information on this subject to put it all in one post. There are links at the end of the post with more information for you.

Since I started this blog when Willow was past the age of greatest risk of Sudden Infant Death Syndrome (SIDS) (2-4 months old) I have never talked about it. But, I think it's a great topic and something every new parent should be worried about. You might think, like I did, "What parent DOESN'T know about SIDS?". The answer may just surprise you.

I can't believe some of the things I have seen after becoming a new mom that I completely shook my head at. After seeing some things, I had to physically stop myself from going to rip a mother a new one (the time I saw a rear-facing infant seat in the FRONT seat of a sedan with a NEW baby in it comes immediately to mind). Suffice it to say that I try not to be shocked by what I perceive to be stupid questions that new moms ask (there are not really many stupid questions when it comes to caring for a baby, just people who are uninformed). I remind myself that not everyone does the type of research that I do and that they rely on blogs and on line communities as their first choice to ask their questions. That's why we are here, right?

According to a Baby Center Poll of about 2600 parents, when asked how worried they were about SIDS, 38% were terrified their child would suffer from SIDS. Only 11% didn't see it as a big concern and 1% of those polled didn't know much about SIDS. When asked the related question "How often do you check your baby's breathing?", about the same amount as the terrified group, 39%, answered "constantly". 51% said every once in a while and 4% weren't worried because they had a "movement monitor". 6% of those polled didn't feel a need to check the breathing of their baby.

Another Baby Center Poll asked parents if they put their child to sleep on their belly. Of the over 47,000 parents that answered, 39% put their child to sleep on their stomach, 15% on their side, and 46% put their baby to sleep on their back. When asked the related question "If you put your baby down on his tummy, do you worry about SIDS?", 47% said yes, 21% no, and 32% sometimes.

So, what is Sudden Infant Death Syndrome (SIDS)? According to Wikipedia (which I like because they give the medical description in layman's terms that are easy to understand), Sudden Infant Death Syndrome (SIDS) is a syndrome marked by the symptoms of sudden and unexplained death of an apparently healthy infant aged one month to one year. The term "cot death" is often used in the United Kingdom, Australia and New Zealand, while "crib death" is sometimes used in North America.

According to the United States Centers for Disease Control and Prevention (CDC), Sudden Infant Death Syndrome (SIDS) is the leading cause of death among infants aged 1 to 12 months, and is the third leading cause overall of infant mortality in the United States. Although the overall rate of SIDS in the United States has declined by more than 50% since 1990, rates have declined less among non-Hispanic Black and American Indian/Alaska Native infants. Preventing SIDS remains an important public health priority. SIDS is defined as the sudden death of an infant less than one year of age that cannot be explained after a thorough investigation is conducted, including a complete autopsy, examination of the death scene, and review of the clinical history.

The reason for the decline in SIDS over the past 14 years is the initiation of the "Back to Sleep" Campaign by the National Institute of Child Health and Human Development (NICHD). According to the NICHD, The "Back to Sleep" campaign is suitably named for its recommendation to place healthy babies on their backs to sleep. Placing babies on their backs to sleep reduces the risk of Sudden Infant Death Syndrome (SIDS), also known as "crib death." This campaign has been successful in promoting infant back sleeping to parents, family members, child care providers, health professionals, and all other caregivers of infants. This campaign is sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Maternal and Child Health Bureau, the American Academy of Pediatrics, the SIDS Alliance, and the Association of SIDS and Infant Mortality Programs.

Unfortunately, the number of cases of SIDS that are reported are not necessarily accurate. According to the CDC, many Sudden Unexplained Infant Death (SUID) cases are not investigated, and when they are, cause-of-death data are not collected and reported consistently. Inaccurate classification of cause and manner of death hampers prevention efforts and researchers are unable to adequately monitor national trends, identify risk factors, or evaluate intervention programs. We need valid and reliable data to support research and prevention efforts if we want to reduce these infant deaths. Which is why the Sudden, Unexplained Infant Death Initiative (SUIDI) was formed.

The thing that really gets me about SIDS is that it refers to a healthy baby "suddenly" dying, but most of the cases that I have seem refer to suffocation. So, why aren't those deaths classified as suffocation or strangulation? It's not placing blame (in my opinion), just making a classification. And since most of the prevention deals with keeping your baby from smothering themselves that just seems to make sense to me. But then I am not a doctor. However, there is no way to "prevent" SIDS since there is no definitive "cause".

But researchers are trying to find answers. According to a study published in October 2007 in the Journal of the American Medical Association, babies who die of SIDS have abnormalities in the part of the brain called the medulla oblongata which helps control functions like breathing, blood pressure and arousal. Researchers examined the brains of 31 babies who had died of SIDS and 10 who had died from other causes. It was discovered that the medulla oblongata had neurons that released a chemical called serotonin. The number of these neurons was greater than normal in 55% of the brains of the babies who had died of SIDS. They also found that babies had fewer receptors for serotonin and that abnormalities in the brain stem appear to affect the ability to use and recycle serotonin, which is responsible for regulating mood as well as vital body functions. According to the National Institutes of Health, which funded the study, the new finding is the strongest evidence to date suggesting that innate differences in a specific part of the brain may place some at increased risk of dying from SIDS.

In a British study released May 29 2008 researchers discovered that the common bacterial infections Staphylococcus aureus (staph) and Escherichia coli (E. coli) appear to be the cause of some cases of Sudden Infant Death Syndrome. Both the "staph" and E. coli bacteria had a greater presence in the unexplained deaths of infants. SIDS cases peak between eight and ten weeks after birth, which is also the time frame in which the antibodies that were passed along from mother to child are starting to disappear and babies have not yet made their own antibodies.

This begs the question, how is SIDS even diagnosed? According to Health.com, SIDS is named the cause of death only when no other cause is found. To find out why a baby died, medical experts review the baby's and parents' medical histories, study the area where the baby died, and do an autopsy.

So, what can YOU do to try and reduce the risk of SIDS? The NICHD has 10 tips:

1. Always place your baby on his or her back to sleep, for naps and at night. The back sleep position is the safest, and every sleep time counts.


2. Place your baby on a firm sleep surface, such as on a safety-approved crib mattress, covered by a fitted sheet. Never place your baby to sleep on pillows, quilts, sheepskins, or other soft surfaces.


3. Keep soft objects, toys, and loose bedding out of your baby's sleep area. Don't use pillows, blankets, quilts, sheepskins, and pillow-like crib bumpers in your baby's sleep area, and keep any other items away from your baby's face.


4. Do not allow smoking around your baby. Don't smoke before or after the birth of your baby, and don't let others smoke around your baby.


5. Keep your baby's sleep area close to, but separate from, where you and others sleep. Your baby should not sleep in a bed or on a couch or armchair with adults or other children, but he or she can sleep in the same room as you. If you bring the baby into bed with you to breastfeed, put him or her back in a separate sleep area, such as a bassinet, crib, cradle, or a bedside co-sleeper (infant bed that attaches to an adult bed) when finished.


6. Think about using a clean, dry pacifier when placing the infant down to sleep, but don't force the baby to take it. (If you are breastfeeding your baby, wait until your child is 1 month old or is used to breastfeeding before using a pacifier.)


7. Do not let your baby overheat during sleep. Dress your baby in light sleep clothing, and keep the room at a temperature that is comfortable for an adult.


8. Avoid products that claim to reduce the risk of SIDS because most have not been tested for effectiveness or safety.


9. Do not use home monitors to reduce the risk of SIDS. If you have questions about using monitors for other conditions talk to your health care provider.


10. Reduce the chance that flat spots will develop on your baby's head: provide "Tummy Time" when your baby is awake and someone is watching; change the direction that your baby lies in the crib from one week to the next; and avoid too much time in car seats, carriers, and bouncers.
    

Also:

• 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. Tuck the ends of the blanket under the crib mattress to ensure safety. Keep soft objects, toys, and loose bedding out of your baby's sleep area. Don't use pillows, blankets, quilts, sheepskins, and pillow-like crib bumpers in your baby's sleep area, and keep any other items away from your baby's face.


• Your baby needs Tummy Time! Place babies on their stomachs when they are awake and someone is watching. Tummy time helps your baby's head and neck muscles get stronger and helps to prevent flat spots on the head.

More information:

• The American Academy of Pediatrics has a PowerPoint presentation on Reducing the Risk of SIDS in Child Care and a Fact Sheet on the same topic.


• The Foundation for the Study of Infant Deaths (FSID) is the UK's leading baby charity working to prevent sudden deaths and promote health. FSID funds research, supports bereaved families and promotes safe baby care advice.


• The American Guild for Infant Survival, Inc. (AGIS) is a nonprofit corporation advancing the mission to provide information, referral, follow-up, and counseling to parents and family members who have lost a child due to Sudden Infant Death Syndrome (SIDS) or crib death and other causes. Further, AGIS supports research and prevention efforts related to SIDS.


• The MISS Foundation is a 501 (c) 3, volunteer based organization committed to providing crisis support and long term aid to families after the death of a child from any cause. MISS also participates in legislative and advocacy issues, community engagement and volunteerism, and culturally competent, multidisciplinary, education opportunities.


• The Great Battle Against SIDS is an organization is dedicated to providing bereaved families with the essential support needed to travel the road of grief in a healthy and appropriate manor.


• The SIDS Network


• SIDS Families is a support group for families who have lost children to SIDS.
  

I hope you found this information helpful!! I know I feel more educated on the topic and even though Willow is past the risk stage for SIDS, I still sometimes worry if she is breathing so, I'm not sure when exactly that goes away.