Sudden Infant Death Syndrome

Sudden infant death syndrome (more commonly called just SIDS) is the sudden unexplained death of a child of less than one year of age. It used to be called cot death and is a tragic occurrence. It typically occurs during sleep and there is no warning and no evidence of anything untoward that might have caused the death. It is more common in boys than girls and is more common in most of the non-European ethnic groups. It is the main cause of infant mortality in Western countries and there is some evidence that it was increasing in incidence. The exact cause is not known. SIDS is thought to occur when the infant has an underlying biological vulnerability and is at a critical development age and then is exposed to some sort of external environmental trigger. There are a number of risk factors that make some infants more susceptible to SIDS. These factors include a genetic predisposition, sleeping on the stomach, overheating, parental alcohol use, being exposed to tobacco smoke, co-sleeping with a parent and being born before 39 weeks gestation. Anemia has also been shown to be involved in some cases. In rare cases child abuse in the form of intentional suffocation could be misdiagnosed as SIDS and this is why every case needs to be thoroughly investigated.

There have been and continue to be public health campaigns that are believed can reduce the incidence of SIDS by up to 80%. One of the most effective methods of reducing the risk of SIDS is putting a child less than one year old on their back to sleep. In addition to that other strategies include a firmer mattress, sleeping in a separate bed to caregivers, no loose bedding, using pacifiers, a relatively cooler sleeping environment and avoiding exposure to tobacco smoke. Breastfeeding and immunization are to be also preventive. There is good evidence that infants up to date with their recommended vaccines are less likely to affected, despite propaganda from anti-vaccination conspiracy theorists claiming otherwise. The use of baby monitors has been shown to not reduce the incidence. In the media, infants are often seen in a non-recommended sleeping position which is often criticized by pediatric organizations.

The support for families affected by Sids is important with grief counseling as the death of the infant is sudden and there is no warning. There is also an associated forensic investigation that does need to rule out anything suspicious in the death of the infant that can be quite traumatic for the family. The diagnosis of Sids does need to be confirmed by an autopsy, which can also be distressing. Due to the tragic circumstances surrounding SIDS and that many of the risk factors are easily modified there needs to be continued community education and public health campaigns to educate parents of newborn infants, especially in the at risk and vulnerable groups on the strategies to reduce those risk factors and also the availability of services in the community when a sudden death does occur.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.