New Parents' Guide to Understanding SIDs

The infant death syndrome which occurs suddenly or SIDS as it is better known is defined as the sudden and unexplained death of any infant who was either well or almost well prior to death and whose death remains unexplained even after a through autopsy. It is also known as crib deaths.

Death usually occurs between the age of two and four months. It strikes boys somewhat more often than girls. It is more common in low birth babies and among children whose mothers smoke or are drug addicted. The reason is often not known. The incidence is about three fold among twins.

People have come up with various theories regarding the sudden death syndrome. You must take few easy steps which can prevent your baby from SIDS. The baby must sleep on her or his back. This is one thing which can definitely prevent SIDS.

Researchers have come up with a long list of all the possible causes. These include vomiting, infection, suffocation, metabolic abnormalities and birth defects.

Any one factor can not give rise to SIDS alone. The child may be already having some biological problem (like a heart defect) and when that combines with stress like stomach sleeping, SIDS can occur.

Critical developmental period, outside stressor and vulnerability together form what is known as a triple risk model. The critical development of the child usually takes place within the first 6 months of life and it is this period when the child is at risk of SIDS. The syndrome occurs rarely after the age of 6 months.

Various research works is being done on SIDS all over the world. Some researchers have suggested that the division of the brain controlling arousal and breathing may have a role in this syndrome. Some people concentrate on the breathing patterns of the child especially when there is low oxygen (hypoxia). Some also focus on the way the heart functions.

QT syndrome is commonly associated with SIDS. Electrical disturbances in the heart are common in QT syndrome. This leads to rapid heart rates. The QT syndrome is determined genetically and one in every 10 baby dying of SIDS had this syndrome. You must take your child to the doctor if you have positive family history of SIDS. The doctors can determine whether your child has the long QT syndrome or not with the help of an ECG (electrocardiogram).

Immunization has no role to play in the occurrence of SIDS. The incidence of SIDS neither increases nor decreases with the use of vaccines.

Predisposing factors

Though the exact reason of SIDS is not known, yet there are several factors which make your child more prone to it. They are:

• Sex of the child: SIDS is more common in male babies.
• Age of the child: most common between the second and fourth month of life.
• Low birth weight babies: premature and low birth babies are more vulnerable.
• Race: the incidence rate of SIDS is different for American Indian and Black babies. Cultural practices may also affect the occurrence of this syndrome.
• Sleeping habits: babies who rest on their backs are at low risk. Sleeping on their stomachs make the babies more prone to SIDS. Changing the position suddenly from back sleeping to stomach sleeping can be quite dangerous. Such babies are at highest risk. It is true that babies sleep more comfortably in stomach sleeping and that is why doctors used to recommend it earlier on. However now no one recommends it. Back sleeping is preferred by one and all.
• Mothers who smoke: a child is more prone to SIDS, if his or her mother smokes during pregnancy. If you consume drugs like heroin, methadone or cocaine during your pregnancy, your child is more likely to suffer from the syndrome.
• Weather: SIDS is common in winters so babies born during that time have higher risk.
• Exposure to environmental smoke: the smoke of the tobacco in the environment affects the babies and makes them more prone.
• Maternal problems: babies whose mother have such problems become more vulnerable to SIDS

• placental abnormalities like placenta previa (in this condition the placenta is abnormally situated in the lower segment of the uterus)
• When the total gain in weight during pregnancy is way below the normal.
• Younger mothers (below 20 years)
• Inappropriate diet and care during the prenatal period.

How to prevent your child from SIDS?

There is no effective medication by which you can prevent SIDS. However few preventive measures are recommended by the American Pediatrics Academy. These are:

v Babies should be put to rest on their backs. Stomach sleeping should be avoided. However this is only important when the baby is sleeping and not for other times.

v If you are leaving you child in a day care or with your relatives, make sure that he is sleeping on her or his back before you leave. You should not think that others will do that for you. Before going out, tell your relatives not to adjust the child's position.

v Smoking in injurious to health and for your baby too if you are pregnant. So don't smoke so that you can have a healthy child. Babies whose mothers smoke are more prone to SIDS.

v To avoid suffocation, you have to be careful with the baby bedding. Firm mattress should be preferred. Beanbag, water bed, thick quick must be avoided. Your baby may suffocate if her or his face presses against these. Stuffed or fluffy toys should be kept away from the crib.

v A sleep sack can be used instead of blankets. However in case you are using a blanket to keep the child warm; make sure that it is not too heavy. The blanket should cover the baby only till the shoulders and it should be tucked in properly at the foot crib.

v Cribs are safer than beds for babies. So they must always be placed in them. The baby can suffocate to death in case a parent when sleeping rolls over her or him. You can prevent such accidents by keeping your child in cribs.

v You and your baby should have a common room to sleep. You must keep the crib close to you.

v Pacifiers can be used to prevent your child from SIDS. However in case you are breast feeding, pacifier must be given only after the child is more than one month in age. You should not force your child to use the pacifier and you must also not put it back in the mouth if it falls out during sleep.

v The temperature in the room should be optimum. It should not be too hot inside. If you baby is sweating excessively, consult a doctor. The child may be having fever or some other illness.

Drawbacks of back sleeping

Sleeping on the back also has few drawbacks. The head of the baby is flexible and soft and it may become flat due to back sleeping. However flattening of the head causes no harm and it can be corrected easily. If you notice it early, just change the head position, and it will be corrected automatically. You may also need to use an open helmet to correct the shape.

These steps can prevent the head of your baby from being flat:

• Keep your baby in erect posture, when she or he is awake.
• The baby can play on her or his tummy. This should only be done when your child is fully awake. You should be close to the child during this time and should be also be fully alert.
• You can keep on changing the head direction from time to time when your child is sleeping. If you have positioned the baby's head on one side, you can change it to the other side of the crib after some time.

The toys hanging in the crib can also be moved from their position. This way the child will be able to look in all directions. All this will help in making her or his head round.