SIDS [Sudden Infant Death Syndrome] is the sudden unexplained death of an apparently healthy infant one year of age or under. SIDS is the major cause of death in infants from 1 month to 1 year of age.
Most deaths occur in the period between 2-4 months of age. Research indicates that risk can be reduced by placing the baby on his / her back to sleep on a firm surface, by maintaining a smoke free environment, by keeping baby from being overheated, by the use of a fan in a room that is above 70 degrees F, by preventing re-breathing [as when the baby has cover over the face and re-breathes the carbon dioxide he has just expelled], by using a pacifier, which is believed to both prevent re-breathing and keep the infant from the deepest levels of sleep, and by identifying infants with autonomic dysfunction.
Risk factors include maternal, behavioral and environmental influences that cause ill health such as cigarette smoking during pregnancy; maternal age less than twenty years; poor prenatal care; low weight gain; anemia; use of illegal drugs; history of STDs [Sexually transmitted diseases] or urinary tract infection. Environmental factors include but are not limited to improper air control, pollutants, excessive bedding, placing baby on stomach to sleep, soft toys in sleeping space.
Higher risk groups include males [twice as often], children of color and Native Americans [three times], low income / single parent families, but SIDS can happen anywhere, anytime, to anyone. Recent research implicates various genetic problems and brain stem irregularities, all of which impact the autonomic nervous system’s functioning. [See Research Findings]
There is a striking disconnect between research findings and conclusions, and their implementation in clinical practice. Autonomic dysfunction is implicated in SIDS, and there are simple, low-cost bedside tests, such as heart rate variability [pulse] and orthostatic blood pressure, which can identify risk of sudden death; however, they are not regularly and uniformly implemented.
Parents can reduce the risks by ensuring that any autonomic dysfunction is identified and ameliorated by proper treatment and a healthcare maintenance program for the condition. Bedside screening can develop additional need for specific testing at higher levels, such as genetic testing for deletion, 22q11DS, chromosome 15q duplication syndrome, PHOX2 genotype; electrocardiograms, and neuro investigations by the appropriate specialists. [See Research Findings]