Sudden infant death syndrome

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Article Summary

Sudden infant death syndrome - or SIDS - is the abrupt and unexplained death of a baby.

Sudden infant death syndrome (SIDS) is the abrupt and unpredictable death of a baby that remains unexplained after a complete investigation and post-mortem. Also known as cot death because it happens while a baby is napping or asleep at night, SIDS is a leading cause of death among infants. It most often strikes in the first four months of life, usually in the autumn, winter and early spring.

What Causes SIDS?

New Learning, New Policy - How to Reduce the Risk

SIDS Resources

What Causes SIDS?

No one knows the fundamental cause or causes of SIDS. Doctors and researchers have learned that it isn't any one factor so much as a combination of factors. Some of these may include an anatomical defect in the brain, an abnormality in the immune system, a metabolic disorder or a heartbeat irregularity. The theory goes that when babies with any of these problems are faced with a challenge - sleeping on their stomach and breathing too much carbon dioxide, inhaling cigarette smoke, getting a respiratory infection, or being overheated - they may be more likely to succumb to SIDS. Here's a closer look at the latest theories and research:

A brain defect: Growing evidence indicates that some babies who have died of SIDS have an abnormality or immaturity in the brain stem, which controls breathing and waking during sleep. Normally, babies can sense problems such as inadequate air or excessive carbon dioxide, but they might lack this protective mechanism if they have this brain irregularity.

A flaw in the immune system: Research has shown that the immune system of some babies with SIDS generates a higher than normal number of white blood cells and proteins. Some of these proteins may interact with the brain to change heart rate and breathing during sleep, or put the baby into a deep sleep.

A metabolic disorder: Babies born with a certain metabolic disorder may be more vulnerable to SIDS. For example, if they lack one particular enzyme (medium chain acylCoA dehydrogenase), they may not be able to process fatty acids properly, and a build-up of these acids could trigger a rapid, fatal disruption in breathing and heart function.

Research also shows that boys are at higher risk than girls, and that SIDS is more frequent in more socially deprived families or certain ethnic groups. Overall, SIDS is still not explained and more research is under way.

Experts do agree, however, that young infants are more at risk of SIDS if they:

 Are put to sleep on their stomachs
 Are placed on soft bedding or a soft mattress
 Are a sibling of a baby who died of SIDS
 Are overdressed or sleep in an overheated room
 Were born prematurely, or with a low birth weight
 Are exposed to second-hand smoke
 Were born to a mother who smoked or was a drug abuser during pregnancy
 Were born to a mother who had no or late antenatal care
 Live in poor housing

New Learning, New Policy - How to Reduce the Risk

Before leaving the hospital with your newborn baby, you'll be given a long list of instructions. Among them is this: Always place your baby on his back to sleep.

Researchers began giving out this advice in 1992 based on research in the Netherlands, UK and USA. Surveys have confirmed that more and more people are putting their little ones to sleep on their back, which has reduced the incidence of SIDS by up to a half.

New parents have so much they're trying to learn. While most of the training happens as you go along, you can take certain steps ahead of time to keep your baby safe, ease into your new role, and lessen any fears you may have about child-rearing. When it comes to sleep and reducing the risk of SIDS, be sure to follow the guidelines below.

Click here for the guidelines by the Department of Health and the FSID. Here are some wise strategies to minimise the risk of SIDS. Print out this checklist and stick it up by your baby's bed.

 Antenatal regime: Make sure you get early and regular antenatal care, including frequent doctor visits and good nutrition, and don't take drugs or alcohol.
 Bedding: Use a firm mattress in the cot or bassinet so your baby doesn't sink in. Do not put fluffy blankets, thick quilts, comforters or a sheepskin under or over the baby, and remove any soft stuffed toys or pillows from the baby's sleeping space.
 Positioning: Always put your baby to sleep on his back. To keep a newborn on his back, swaddle him in a blanket with his hands placed up by his mouth so he can comfort himself.
 Temperature: Avoid too much heat in your baby's room. Keep the temperature at a level that feels comfortable to you, and don't overdress your baby at night-time.
 Well-baby checkups: Take your baby to the health visitor and doctor for routine checkups and scheduled immunisations.
 Clean air: Never smoke around your baby or in his room.
 breastfeeding: Breastfeed your baby, if possible, to get him off to a strong, healthy start.
 Tummy Time (always supervised): Encourage your baby to spend time on his tummy when he is awake to strengthen his arms and shoulder muscles. Put him on the floor on his blanket, or in a playpen with toys that spark his interest.

SIDS Resources

Where to go for information, referrals and other services:

The Foundation for the Study of Infant Deaths (FSID, Artillery House, 11-19 Artillery Row, London, SW1P 1RT). Helpline (020 7233 2090) General enquiries (020 7222 8001), website www.sids.org.uk/fsid
NHS Direct helpline (0845 4647)

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Safety

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Sleep

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