SIDS refers to Sudden Infant Death Syndrome. It happens to infants mostly within the first year of age and maximum from birth to four months. Since it mostly happens when the child is in the cot or in the crib when the baby is asleep, it is also called cot death or crib death.
It is different from other categories of infant-deaths. So far the techniques of investigations of forensic and medical sciences have not been able to contribute anything to establish the reasons behind SIDS. The death under SIDS is sudden and unexplained.
About 2000 infant deaths annually have been recorded in the US due to SIDS, but in India, deaths due to SIDS is quite low, though it is not clear as to why. About 1 in 500 infants can be a victim of SIDS. Many people attribute the knowledge of correct sleeping positions in reducing SIDS deaths worldwide.
One thing has been found that deaths due to SIDS is the highest during sleep especially when the infant is lying on the stomach or sides. The baby could be sleeping in a cot, bed, pram or even in the parents’ arms. Use of tobacco by the mother also increases the risk. The social, cultural and economic conditions do affect the risks. Sleeping with caretaker or parents add to the risk of SIDS. Maternal age below 20 years has higher risk for SIDS than those having age above 20 years. The anomic or any other deficiency condition of the infant might add to the risks.
•Gender: Male infants have been found to be approximately 50% more at risk.
•Temperature: Too hot or too cold is supportive to SIDS. But season wise in summer it is the minimum and the maximum in winter.
•A prematurely born infant especially with very low weight is at higher risk of SIDS.
•African Americans and American Indians have higher risk than Asians.
Although there is no definite cause of death under SIDS, certain preventive actions can be necessarily practiced to reduce the risk:
1.The baby should be put to sleep on back and not on stomach or sides. Always remember the thumb rule – play time tummy, sleep time back. India has witnessed a decline in SIDS deaths since this thumb rule has been prevalent in the country since a log time.
2.The mother should avoid smoking during pregnancy, and if the father smokes or drinks, he should be asked not to sleep with the baby.
3.Put the baby to sleep on firm mattress without pillow, since it has been found that soft quilts etc. increase the risk of SIDS. Similarly sleeping on sofa increases the risk and thus should be avoided.
4.Care should be taken that the head of the baby is not rolled forward too much during sleep as it may cause suffocation.
5.Take care that the nose and mouth of the baby is clear off the caretaker’s body or clothes for breathing freely.
6.Provide a safe sleeping environment to the baby, and try not altering the rooms.
7.In many countries, parents are advised not to share beds with infants, especially if they are smokers or have a drinking habit. Many experts believe that about 81% of SIDS deaths could have been avoided had the bed sharing not been done. Room sharing is recommended over bed sharing with the baby during sleep.
8.Do not overdress your baby, keep the room temperature comfortable.
9.Breastfeed your baby to reduce SIDS risk.
10.Keep the room in which the baby sleeps smoke and odour free.
SIDS has no symptoms or warning signs, and can happen anytime while the baby is put to sleep. The education programs on SIDS by creating awareness on preventive measures have reduced the incidence of SIDS.
Dr Chetan Ginigeri is an experienced Pediatric Intensivist with national and international training. With 15 years of experience, he is one among very few Intensivists in India trained to take care of children who need/had organ transplants. He has been responsible for coordinating the Pediatric Organ Transplant program.Read more.