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Sudden infant death syndrome (SIDS)

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What is Sudden Infant Death Syndrome (SIDS)?

When there is a sudden death of a healthy infant during his/ her sleep, it is called SIDS.

It is one of the most mysterious medical conditions and is also called “crib death.”

When an infant sleeps on his/her tummy, the sleeping position triples the risk of SIDS.


How does it all happen?

Many research suggests its relationship to sleeping position, environmental, genetic risk factors, biochemical, molecular abnormalities, and homeostasis, which occur from 0 months to 1 year of age.

SIDS remains the leading cause of post neonatal infant death in the United States and is the third leading cause of infant mortality overall.

SIDS has been defined as a “syndrome”; hence it is a consequence of more than one disease affecting a vulnerable infant passing through critical health conditions.

It has shown a peak incidence at 2 to 4 months of age is more common in a male infant.

Since such deaths have no witness to document when does it happen, it is still unclear whether it occurs during the sleeping phase or the transitions between sleep and waking up phase of sleep during the night.

What are the causes?

• Infants with low brain development/ defects suffer from SIDS due to a lack of development of breathing and sleep waking up (arousal) centers in the brain.

• It happens in a few cases of inherited disorders of fatty acid oxidation with particular mutations (1%) and with genetic cardiac disorders (accounting for 5 to 10% of SUID cases).

• Low birth weight infants

• Infants with mild respiratory tract infections

• Then Triple-Risk Model suggested that the first point is the vulnerability of the infant; the second being the critical developmental period; and the third, an exogenous stressor.

• Prenatal exposures to alcohol or cigarette smoking have a direct effect on neurotransmitter systems that are critical to homeostatic control in the developing human brain.

• Prone sleeping or sleeping on sides

• Sharing bed with siblings or parents

• Overheating while sleeping

• Soft sleeping surfaces with fluffy toys, blankets or covers.

• When the mother is younger than 20 years of age at the time of her first pregnancy.

• Unexperienced caretaker/ mother

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What are the Risk Factors?


• Male child

• Polymorphism in the gene encoding the promoter region of the serotonin transporter

• Native or black American race

• Family history of siblings or cousins who died due to SIDS


• Low birth weight

• Prematurity

Extrinsic Factors

• Sleeping on an infant’s tummy or on side

• Soft bedding

• Bed-sharing

• Mild infections, including colds

• Parents who smoke

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What are the prevention methods?

• Sleeping position: make sure the baby is put to sleep on his/her back, especially till your baby has not developed milestones to roll both ways.

• Breastfeeding: it lowers the risk of SIDS.

• Avoid overheating the infant: remember, infants need an extra layer of clothing than the adults. Don’t overheat them by adding additional layers of clothes and warm blankets.

• The crib should be a safe place: make sure to use a firm mattress and avoid placing your baby’s fluffy toys, blankets or covers in the crib.

• Share the room, not the bed: ideally, your infant should sleep in your room with you, but in her/his crib, bassinet or other sleeping area designed exclusively for the infant, for at least six months and its best to follow this till her/his 1st birthday.

• Avoid adult beddings: infant may get trapped and suffocate between the sleeping parent. They may accidentally roll over in between the space of bed backrest and mattress or the space between the wall and mattress.

• Try offering a pacifier: use a pacifier during bedtime and make sure to use one which doesn’t have a strap or string attached to it. If you are breastfeeding, avoid using a pacifier until the infant is 3 to 4 weeks old (it affects the milk supply and breastfeeding routine)

• Immunization: few evidences show that immunizations can help prevent SIDS in infants

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