Sudden infant death syndrome or SIDS is an event where an infant has an unexplained and sudden death. It may also be referred to as cot death or crib death since it often occurs while the baby is asleep. An investigation into SIDS and the baby’s medical history may not yield a discernible cause of death in many cases.
SIDS commonly affects babies between the ages of one and four months (1). Nearly 2,300 infants in the US succumb to SIDS every year. Thankfully, SIDS’ risk can be managed and reduced through safety precautions and optimum lifestyle changes.
Read this post to know more about sudden infant death syndrome’s causes and risk factors and the measures to lower its risk.
Causes Of SIDS
- Problems in the baby’s ability to arouse from sleep
- Failure of the baby’s brain centers to detect low oxygen and high carbon dioxide levels
- High levels of carbon dioxide build-up in the blood
A combination of the above conditions and sleeping on sides or tummy may contribute to SIDS. When babies sleep on their stomach or their sides, they may breathe in the exhaled air since they are face down. It may increase the carbon dioxide levels in the blood that usually stimulates brain arousal and respiratory centers. It makes babies wake up, turn their heads, and breathe more oxygen. However, babies who fail to wake up may experience SIDS.
Another theory that explains SIDS’s cause is the simultaneous existence of the following three conditions, known as the “triple-risk model” (1).
- The baby has brainstem anomalies causing the inability to respond to oxygen-carbon dioxide levels in the blood
- There is a triggering factor such as sleeping on the tummy
- The baby is less than six months old
These situations or factors could cause SIDS. However, there is no conclusive evidence since SIDS can occur in babies who are older than six months, have no brainstem anomaly, and do not sleep on tummy or sides.
Factors That May Increase The Risk Of SIDS
Although the exact cause of death in SIDS is unknown, there are several factors likely to increase the risk of SIDS (3).
Sleep environmental risk factors include:
- Sleeping on the stomach or sides
- Overheating the room during sleep
- Too soft sleep surfaces
- Cribs with fluffy toys, bumper pads, and soft blankets
- Sharing a bed with parents, siblings, or pets
Maternal risk factors include:
- Three times more risk in cases of maternal smoking during pregnancy
- Mothers younger than 20 at the time of first pregnancy or teen pregnancy
- Maternal drug or alcohol use
- Inadequate prenatal care
- Multiple births during a short period
Physical factors may include:
- Premature birth
- Brain abnormality
- Low birth weight
- Respiratory infections – even just an upper respiratory infection
- Exposure to secondhand smoke may double the risk
Other factors that may increase the risk for SIDS include:
- Sibling affected by SIDS
- Family history of failure to thrive
- Male babies have a higher risk
- Age between two and four months
- More incidence in fall, winter, and early spring months
When the above factors interfere with the baby’s breathing or cause other complications, it might lead to SIDS. Note that a combination of factors may be required to increase the risk of SIDS.
Prevention Of SIDS
- Put your baby on their back to sleep even for naps.
- Let the baby sleep in the crib placed in the same room (room-sharing) where parents or caregivers sleep. However, do not share a bed with the baby.
- Choose firm sleeping surfaces, like a firm mattress with an attached cover or sheet. A firm surface should be gentle yet hard enough to not indent.
- Avoid keeping blankets, stuffed animals, dangling toys, pillows, or any other items in the baby’s crib.
- If the baby falls asleep in a stroller, car seat, or infant carrier, then move them to their crib or a firm sleeping surface as soon as possible.
- Maintain normal room temperature. If you want to keep the baby warm or the weather is warm, dress the baby appropriately.
- Avoid smoking, alcohol use, and illicit drugs during pregnancy. Ensure proper prenatal care.
- Avoid smoking around the baby, and try to quit the habit. Discourage others at home from smoking.
- Breast feed for at least the first six months. Breastfed infants tend to have a lower risk of SIDS.
- Offer a pacifier without string or strap after your baby is settled into a nursing routine by three to four weeks. Do not force the baby to use pacifiers or keep it back in their mouth if it falls while they are asleep.
- Immunize according to the schedule to minimize the risk of infections. There is no scientific evidence that vaccination could cause SIDS.
- Avoid the use of baby monitors and other devices that claim to prevent SIDS.
There is no definitive method to prevent SIDS since it does not have a precise cause. However, observing the above-mentioned precautions can substantially reduce the risk of SIDS.
Diagnosis And Treatment Of SIDS
SIDS does not have any preceding symptoms, thus there is no prior diagnosis. SIDS is diagnosed as a cause of an infant’s death only when all the possible causes are excluded through a review of medical history and autopsy.
There is no specific treatment of SIDS. Observing precautions is the best way to minimize the risk. If your baby has any medical condition, then timely treatment may help reduce the risk of SIDS. Immunization and precautions can further safeguard the baby.
Frequently Asked Questions
1. Are there warning signs of SIDS?
SIDS presents no warning signs or symptoms. Babies who succumb to SIDS seem healthy when placed in a bed. No signs of struggle are noticeable, and they are often found to be in the same position as when put to bed (6).
2. Can SIDS happen while awake?
SIDS usually occurs when a baby is asleep. However, in rare cases, it may happen while they are awake (7).
3. Does swaddling reduce SIDS?
Some studies have shown swaddling to increase the risk of SIDs. However, the risk is more if swaddled babies are laid on their sides or their stomachs. Proper swaddling before they begin to roll over and always laying them on their back can help you get the benefits of swaddling and reduce the risk of SIDS (8).
4. Why does a pacifier help prevent SIDS?
Pacifiers have been found to help reduce SIDS risk. It is thought that sucking on a pacifier keeps the tongue forward, which helps to maintain an open airway. A baby soothed by a pacifier may move less during sleep and is less likely to get covered by blankets. They may also act as a mechanical barrier and prevent the baby from rolling over and get positioned on their stomach. Pacifiers may also reduce reflux of stomach contents and apnea (9).
5. Does SIDS occur during the day?
Yes, SIDS may happen anytime during the day and is not a nighttime phenomenon (10).
6. Why is breastfeeding good for SIDS?
Possible reasons why breastfeeding may lower the risk of SIDS are:
- Breastfed babies wake from sleep more easily compared to formula-fed babies. Arousability may help prevent SIDS-related death.
- Respiratory infections and diarrhea may make babies more susceptible to SIDs. Breastfeeding provides the baby with antibodies and micronutrients that protect against infectious diseases (11).
7. Is SIDS just suffocation?
SIDS is not synonymous with suffocation and is also not caused due to suffocation (12).
Newborns below 4 months are at high risk of being affected by sudden infant death syndrome (SIDS). Therefore, do not neglect or delay vaccinations and medical attention if your baby has any health issues after birth. Though SIDS is a serious condition, following certain preventive strategies can help minimize its risk. For example, lay babies on their backs to sleep in the same room as their caregivers. Fortunately, as babies grow old, their bodies will develop, and they will be more equipped to deal with the adversities and risk factors of SIDS. If you lost a baby due to SIDS, seek support from counselors, healthcare practitioners, or support groups to help you cope with your loss.
- The exact cause of sudden infant death syndrome (SIDS) is not yet known.
- The inability of the brain to detect low oxygen levels in blood and arousal from sleep is a suggested reason for SIDS in babies.
- Sleeping on tummy, soft sleeping surfaces, and sharing bed with parents may increase the risk.
- Scroll down to learn about the diagnosis and treatment for this condition.
2. Sudden infant death syndrome; U.S. National Library of Medicine
3. Sudden infant death syndrome (SIDS); St. Clair Hospital
4. How to Keep Your Sleeping Baby Safe: AAP Policy Explained; American Academy of Pediatrics
5. How can I reduce the risk of SIDS?;The Eunice Kennedy Shriver National Institute of Child Health and Human Development
6. Sudden infant death syndrome (SIDS); St. Clair Hospital
7. Sudden infant death syndrome (SIDS); NHS
8. Safe swaddling and sleeping practices for babies; Ut Southwestern Medical center
9. Recommendations for the use of pacifiers; National Library of Medicine
10. P S Blair et al. Sudden Infant Death Syndrome and the time of death: factors associated with night-time and day-time deaths; NCBI
11. SIDS & Breastfeeding: A Mini-Lit Review; School of Public Health, University of Washington
12. SIDS Is Not; NIH