Sudden Infant Death Syndrome is caused by a combination of factors. According to the Triple Risk hypothesis, SIDS is likely to occur when three risk factors intersect. An environmental stressor, a critical developmental period, and underlying physical vulnerability are examples of these.
What Is the Difference Between SIDS and SIUDS?
Sudden Infant Death Syndrome (SIDS), also referred to as crib death, refers to the sudden death of an infant younger than 1 year of age without any known cause even after a full investigation has been performed. SIDS is a subset of SUID.
Sudden unexpected infant death (SUID) is a term used to describe the sudden and unexpected death of a baby less than 1 year old in which the cause was not obvious before investigation. Investigations might lead to diagnoses such as SIDS, Accidental Suffocation and Strangulation in Bed (ASSB), Infection, Metabolic diseases, or Trauma among others.
Who’s at Risk?
In 2020, there were about 1,389 deaths attributable to SIDS in the US. According to the CDC, SIDS is the leading cause of death among infants aged one month to one year. SIDS is most common in babies aged one to four months, and it is more likely to affect boys than girls.
SIDS will typically happen when the baby is sleeping but may occur while they are awake. Additionally, colder months tend to have a slightly higher number of SIDS occurrences than hotter ones.
What Are the Possible Causes Of SIDS?
There are no known causes of SIDS. That said, researchers believe that three factors have to occur simultaneously for a baby to die from SIDS. These factors include the infant’s physical vulnerabilities, outside stressors, and stage in the critical developmental period. This model is aptly named the Triple-Risk Model.
Critical Development Period
The Critical Development Period refers to the first year of a baby’s life, particularly the first six months, during which they experience rapid growth and development. Changes in sleeping/waking patterns and variations in blood pressure, breathing, and heart rate during this phase may disrupt the baby’s internal systems temporarily or on a regular basis, making them more vulnerable to SIDS.
According to the Centers for Disease Control and Prevention (CDC), SIDS is most common among infants aged 1-4 months, with 90% of SIDS cases occurring before the baby reaches 6 months of age. This is a critical period during which the risk of SIDS is highest.
Vulnerable Infant
Infants with certain underlying vulnerabilities or risk factors may be more susceptible to SIDS. These risk factors may include:
- Prematurity or low birth weight: Infants born prematurely or with a low birth weight are at a higher risk of SIDS than full-term babies. According to a study published in Pediatrics, infants weighing less than 2500 grams (5.5 pounds) at birth are at a six times greater risk of SIDS than those weighing 2500 grams or more.
- Brain abnormalities: Certain abnormalities in the brainstem or other parts of the brain may increase the risk of SIDS. According to the American Academy of Pediatrics (AAP), about 5-10% of SIDS cases may be linked to underlying brain abnormalities.
- Respiratory infections: Infants with respiratory infections or illnesses, such as bronchiolitis or pneumonia, may be at an increased risk of SIDS. According to a study published in the Archives of Pediatrics & Adolescent Medicine, respiratory infections were identified as a risk factor in 55% of SIDS cases.
Exogenous Stressors
Exogenous stressors are external factors that can trigger SIDS. These stressors may include:
- Prone sleep position: Placing infants on their stomachs to sleep increases the risk of SIDS. According to the AAP, placing infants on their backs to sleep has been shown to reduce the risk of SIDS by over 50%.
- Soft bedding: Soft objects or loose bedding in the sleep environment may increase the risk of SIDS. According to a study published in Pediatrics, the presence of soft bedding was identified as a risk factor in 72% of SIDS cases.
- Bed-sharing: Sleeping in the same bed with an infant may increase the risk of SIDS. According to the AAP, bed-sharing is associated with an increased risk of SIDS, particularly when combined with other risk factors.
Prevention of Sudden Infant Death Syndrome
Sudden Infant Death Syndrome (SIDS) is a heartbreaking event that can leave families devastated. Unfortunately, there is no surefire way to prevent SIDS, but there are ways to reduce the risk. Here are some things that parents and caregivers can do to help protect infants:
Reduce the Risk of Sudden Infant Death Syndrome:
There are some steps that parents and caregivers can take to reduce the risk of SIDS:
- Back to Sleep: The American Academy of Pediatrics (AAP) recommends that all infants be placed on their back to sleep until they are at least one year old. This is the most effective way to reduce the risk of SIDS.
- Use a Firm Sleep Surface: Infants should be placed on a firm and flat sleep surface, such as a crib mattress that meets safety standards. Soft surfaces, such as couches, sofas, or waterbeds, can increase the risk of SIDS.
- Avoid Bed-Sharing: The AAP recommends that infants sleep in the same room as their parents, but not in the same bed. Bed-sharing can increase the risk of SIDS.
- Avoid Overheating: Infants should be dressed in light clothing and not be overheated. The ideal room temperature for a baby is between 68 and 72 degrees Fahrenheit.
- Avoid Exposure to Smoke: Infants should not be exposed to cigarette smoke, either before or after birth. Smoking during pregnancy increases the risk of SIDS, and exposure to secondhand smoke can also increase the risk.
Safe Sleep Practices to Prevent SIDS:
The AAP recommends the following safe sleep practices to prevent SIDS:
- Always place babies on their backs to sleep for naps and at night.
- Use a firm sleep surface, such as a crib mattress covered with a fitted sheet.
- Keep soft objects, loose bedding, and any other items that could increase the risk of suffocation out of the crib.
- Do not allow babies to sleep on soft surfaces, such as adult beds, couches, or chairs.
- Do not use bumper pads in cribs.
Can Infants Lay on Their Side?
The safest sleep position for infants is on their back. The side position is not safe because it increases the risk of SIDS. While it was once thought that placing infants on their side to sleep might reduce the risk of SIDS, research has shown that it actually increases the risk. The back-to-sleep position is the only safe sleep position for infants.
Summary
In conclusion, while there is no surefire way to prevent SIDS, there are things that parents and caregivers can do to reduce the risk. Following the recommendations of the American Academy of Pediatrics, including placing infants on their backs to sleep, using a firm sleep surface, avoiding bed-sharing, avoiding overheating and exposure to smoke, and following safe sleep practices can help reduce the risk of SIDS.