What is SIDS?

SIDS is the sudden and unexplained death of an apparently healthy infant younger than one year of age that remains unexplained after a thorough case investigation including the performance of a complete autopsy, examination of the death scene and review of the clinical history. It is the leading cause of death for infants during the post neonatal period.

While most conditions or diseases are diagnosed by the presence of specific symptoms, SIDS is a diagnosis of exclusion.  Often, the cause of an infant's death can only be determined through the process of collecting information, conducting forensic tests and procedures and interviewing parents and physicians.

While the cause or causes of SIDS is unknown, there is evidence that some SIDS infants are born with physiological abnormalities that make them more vulnerable to SIDS.  Studies of SIDS victims have revealed that many of these infants have abnormalities in the part of the brain involved in the control of breathing and waking during sleep.  Infants born with defects in other parts of the brain or body may also be more prone to a sudden death. Some researchers speculate that these abnormalities may stem from prenatal exposure to a toxic substance or the lack of a vital compound in the prenatal environment such as sufficient oxygen.

The Statistics

  · Male to Female ratio 60:40

· African Americans have a SIDS rate more than twice the rate of Caucasians

· Native Americans have an almost three times greater rate of Caucasians

· Hispanic and Asian/Pacific Island infants have the lowest SIDS rates

· SIDS deaths spike in winter months

Research

The most common and recognized SIDS theory is the Triple Risk Model:

The critical development period encompasses the rapid growth phases that occur during an infant'™s first 6 months of life, considered to be a time of vast physiological change and instability for an infant'™s system. During this developmental period, changes occur in homeostatic controls such as sleeping and waking, breathing, heart rate, blood pressure and temperature.

The vulnerable infant represents an infant with an underlying defect or abnormality. In this model, normal infants do not die of SIDS. Instead, there are pathophysiological reasons behind these seemingly sudden deaths such as defects of the brain that control respiration, heart rate or cardiac function.

Finally, exogenous stressors are external or environmental challenges that a normal infant can overcome and survive but an already-vulnerable infant might not. These stressors include the risk factors such as prone sleep position, loose and soft bedding, secondhand tobacco smoke exposure or an upper respiratory infection.

Alone, these stressors do not cause an infant's death, but may reduce an infant's chances of survival. According to this model, all three elements must come together for SIDS to result.

According to this theory, SIDS can occur when three elements come together: an infant'™s critical development period, a vulnerable infant and exogenous stressors.

Risk Factors

"Risk factors" are factors that are found more frequently in a group of people with a certain problem than in a group of people without that particular problem. An expected connection between the risk factor and the problem is often not obvious. Research consistently points to certain risk factors for SIDS. Some risk factors are completely non-modifiable such as gender and age distribution but others are categorized as such because after the infant is born, there is little that can be done to change the circumstances of the birth. Modifiable factors deal with circumstances that relate to the infant health and well-being that can be changed after birth.

Modifiable risk factors for SIDS include:

·   Prone sleep position

·   Soft or loose bedding

· Inappropriate sleep environments

·  Bed sharing

· Overheating

·    Environmental tobacco smoke

·   Maternal alcohol and illegal drug use

Non-modifiable risk factors include:

·  Male gender

· Age Distribution: 2 to 6 months

·  Low birth weight

·   Prematurity

·  Maternal smoking during pregnancy

·  Young maternal age especially mothers less than 18 years old

·  Late or no prenatal care

·  Fall/winter season

·  Higher parity

Protective Measures

· Pacifiers

·    Fan

· Swaddling

· Co-sleeping

· Breastfeeding