SIDS-Risk Factors and Prevention

30 Jan

What is SIDS?

  • Short for sudden infant death syndrome
  • Death in a child under 1 year of age that is not explained after a thorough investigation
  • Most common cause of death in children 1 month-1 year age
  • Terrifying
  • Devastating

I cannot imagine the despair that would be associated with living through something so difficult.

What are the risk factors for SIDS?

Mommy factors:

  • Young maternal age
  • Maternal smoking during pregnancy

Baby factors:

  • Preterm birth or low birth weight
  • Face-down sleeping position
  • Sleeping on a soft surface with bedding accessories such as loose blankets and pillows
  • Bed-sharing
  • Overheating

What can we do about SIDS?

Obviously, there are some factors for SIDS that cannot be controlled and some that can. Below I’ve listed several factors that are the most controllable in the prevention of SIDS.

If you are pregnant and under 20, that does increase your child’s risk.

Smoking while pregnant and exposure to environmental smoke after the baby is born both increase the risk of SIDS.  If you can’t find a reason to quit smoking for yourself, please stop for you baby…it not only protects from SIDS but also decreases respiratory illness and has effects on asthma.

Whether or not your baby is premature is also another factor that, for the most part, cannot be controlled. However, a premature baby is protected even more by sleeping on its back.

The Back to Sleep campaign has been one of the most successful public health initiatives I know about.  It dramatically reduced the incidence of SIDS with something so simple.  Parents often ask me about side sleeping and sleep positioners.  I usually tell them that I don’t know if they are safe or not and thus choose not to use them.

The bed environment is another safety measure that people are becoming more aware of as a potential risk factor for infant death.

Babies should sleep on an approved firm mattress intended for use with babies.  Softer sleeping surfaces have consistently been shown to increase the risk of SIDS, especially when babies are placed face-down on these softer surfaces.

Loose beddings, such as  blankets or quilts, have also been shown to increase SIDS.  In this category I also typically add the big soft crib bumpers because they have also been shown to be a suffocation hazard.  So, take the pictures of the nursery (crib bumpers and all) put them up on Facebook and then take the bumpers down and put them in the closet until the child is over 1 year.

Overheating has also been shown to be a risk factor for SIDS.  I often see my little babies in multiple onesies with the swaddling blanket and a big heavy blanket.  This is probably too much.  Get the house comfortable for you and put the child in one extra layer than what you have and they should be comfortable at that temperature.

I have seen arguments for co-sleeping as a means for improving bonding and facilitating breastfeeding. One thing I can say for certain regarding co-sleeping is that co-sleeping does significantly increase the incidence of suffocation.  The risk of suffocation is 3x higher in infants who co-sleep and 10x higher in those infants who co-sleep under 3 months of age.  You can check an abstract from a large study on the topic here (Bed sharing and the risk of SIDS: can we resolve the debate?).  Parents may choose to co-sleep despite this risk and there are some defined/well-studied biological and psychological benefits but I feel that parents should be made aware of this when making their decision.

Room sharing, by contrast, has been shown to decrease the risk of SIDS and is also proven to benefit breastfeeding and bonding.

Pacifier use has also been shown to decrease the incidence of SIDS and I support the use of pacifiers in all families who chose to use them after breastfeeding (latch, etc) have been well established.

Breastfeeding has been inconsistent in evidence about its effect but the best study done on the subject did show a modest decrease in risk by breastfeeding.

Special monitors that monitor breathing, etc have not been shown to protect babies against SIDS.

So, as you can see there are many controllable risk factors that can be used to help protect your baby against SIDS.  In my experience, if families are aware of these factors and do their best to take care of these issues, it significantly reduces their anxiety about SIDS.

Sorry, there was less humor in this post…stay tuned for more light-hearted stuff soon…

Advertisements

One Response to “SIDS-Risk Factors and Prevention”

Trackbacks/Pingbacks

  1. What I learned as a {pediatric resident}’s wife: Bed Sharing | Doc J Smitty's Wife - September 13, 2013

    […] sleepers. Just beds, but in our room, as that’s what’s called for to reduce the risk of SIDS. Not sleeping with our babies is the rule in our house, because of the following story (which was […]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: