What is SIDS? The American SIDS Institute (ASI) defines Sudden Infant Death Syndrome or SIDS as “the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.” (Willinger et al, 1991).
This is the leading cause of death of infants less than a year old usually between two and four months. It continues to be unpredictable despite years of research. Not knowing is part of what makes it so terrifying. Formerly known as “crib death”, it is linked to sleep in most cases. A combination of several risk factors may make a baby high-risk for SIDS and not just because of one particular factor.
Major risk factors for SIDS
Tobacco and/or drug use during and after pregnancy
Second-hand smoke exposure before and after birth
Short intervals between pregnancies
Poor prenatal and/or postnatal care
Thermal stress or overheating (dressed too warmly)
Unsafe sleeping environment
How to reduce the risk There’s really no fail-safe way of preventing SIDS, but there are ways of reducing the risk.
Before the baby comes
Take every precaution in prenatal (and postnatal) care. Eat healthy. These reduce the risk of premature birth.
Do not smoke, drink alcohol, or use drugs.
Do not get pregnant during the teenage years. The SIDS rate goes down for babies born to older mothers.
At least one-year-child spacing between children
When the baby comes
Always let baby sleep on her back. Never on her stomach (though they may sleep more soundly) or on her sides with the risk of rolling over while sleeping. Stomach sleeping may narrow baby’s airway for breathing, and may decrease oxygen levels in the body due to “re-breathing’ of carbon dioxide exhaled.
Pediatrician Dr. Abigail Laurel-Suntay stresses, “Putting infants on their backs for sleep is a safer position in relation to SIDS. The exact reason for this is unknown but it may be related to the stomach-positioned infant getting less oxygen or eliminating less carbon dioxide because she is ‘re-breathing’ air from a small pocket of bedding pulled up around the nose. Although sleep position is probably not the only reason for SIDS, it seemed to be so strongly related that Pediatric societies felt obligated to make this recommendation.”
Always use a firm mattress for baby to sleep on. Never on an adult bed, sofa, waterbed, or chair. No comforters, pillows, positioning devices, or toys.
Babies younger than six months should sleep close to their parents.
Breastfeed as much as possible. According to ASI, “breast milk decreases the occurrence of respiratory and gastrointestinal infections. Studies show that breast-fed babies have a lower SIDS rate than formula-fed babies do.”
Pediatrician Dr. William Sears says, “Anything that improves the overall health of baby and sensitivity of its mother should lower the risk of SIDS.” If co-sleeping does not work for you, keep baby’s crib in your room close to you. There are two opposing thoughts on the correlation of the risk of SIDS and co-sleeping.
Baby shouldn’t be dressed too warmly for sleeping. Keep the room and baby at a comfortable temperature.
A smoke-free environment for baby.
Make sure baby goes to regular well-baby checkups.
Practice cleanliness with diligence. Avoid crowds and exposing baby to people with respiratory infections. ASI states that “SIDS often occurs in association with relatively minor respiratory (mild cold) and gastrointestinal infections (vomiting and diarrhea).
Immediately inform your pediatrician if baby has periods of not breathing, going limp or turning blue, or gags excessively after spit-ups.
Dr. Abigail Laurel-Suntay holds clinics at Asian Hospital and Medical Center, Southwoods Multi-Specialty Clinic, and Tokyo Healthlink Inc., Medical and Diagnostic Center-Alabang.