Sudden Infant Death Syndrome

Once your newborn comes home, you may find a new concern permeating the nursery— fear of Sudden Infant Death Syndrome (SIDS). SIDS is the death of an apparently healthy infant under 12 months for which no cause can be determined. It usually occurs during sleep and is also known as crib death.

SIDS occurs more often in babies under six months of age and is more common in boys than girls. African-American and Native American babies have a two to three times greater risk of SIDS than the average.

Recent studies have found different possible causes for SIDS. Much like cancer or colic, the definitive cause is not known, and there are probably several different conditions that can lead to the sudden unexpected death of an infant. Causes as varied as positional suffocation, central respiratory defects, viruses, aspiration (choking on regurgitated food), cardiac arrhythmias (irregular heart beat), birth defects, and even homicide have been implicated as possible causes of SIDS.

There are some things a parent can do to decrease the likelihood of SIDS. In 2005 The American Academy of Pediatrics compiled a list of preventative measures known as “back to sleep” because of its emphasis of placing babies on their back when they sleep. Other suggestions from the AAP include:

·         Don't place pillows, soft bedding, comforters, quilts or stuffed toys in your baby's crib.

·         Don't put a baby to sleep on a soft surface, such as a waterbed, sofa, or soft mattress. The best sleeping surface is a firm crib mattress with a snug-fitting sheet.

·         Keep the temperature cool in the room where your baby sleeps; the temperature should be comfortable for a lightly clothed adult. Don't swaddle your baby, and don't cover him with a heavy blanket or quilt. If you use a thin blanket, place your baby toward the foot of the crib, and tuck the blanket around the mattress so that it only reaches up to your baby's chest.

·         Don't smoke in your home or car. Minimize your baby's exposure to secondhand smoke in other environments.

·         Use caution if your baby sleeps in your bed. Adult beds often have soft bedding, such as pillows and quilts that are not recommended for infants. In addition, adult beds do not meet crib safety standards and may be dangerous for small children. For example, a baby could become trapped between the mattress and a wall, or in headboard or footboard openings. Also, there have been cases where babies were suffocated when adults rolled on to them.

·         Consider offering a pacifier at naps and bedtime. Use the pacifier when you're placing the baby down to sleep, but there is no need to put it back in the mouth once the baby falls asleep. If the infant refuses the pacifier, do not force it.

·         Breast-feed your baby if possible. Breast milk contains infection-fighting substances and nutrients to keep your baby healthy.

·         Encourage "tummy time." Make sure your baby spends some time on his stomach while awake to help keep the back of the head from becoming flat and to aid neck and shoulder muscle development.

There is no evidence that devices that monitor a baby's breathing and heart rate help to prevent SIDS. However, home monitoring may be useful for some infants with certain conditions. Discuss any concerns you may have with your doctor.

One of the unintended consequences of the “back to sleep” program is a condition called “plagiocephaly,” which is a molding of the head. Babies who are on their backs all the time may develop a flat head in the back. By giving the baby time on her stomach when awake, the flattening may be helped. Otherwise, the head will gradually remodel once the baby is up and about.

While SIDS is frightening to all parents, the rate of SIDS has been declining in the United States since the “back to sleep” program began. If you follow the AAP recommendations and focus on those things that you can control (as opposed to congenital defects), you can push fear of SIDS down the worry list.

How much is SIDS on your mind? What other worries do you have as a new parent?

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

Family Health Guide
To take advantage of the latest medical advances, and to deal with the often-confusing world of health care, you need information that is clear, accurate, easily understandable, and accessible. The Harvard Medical School Family Health Guide brings you the information you need to keep your and your family healthy and to cope with illness when it does strike. 170 faculty members of Harvard Medical School, physicians who care for patients every day, developed this comprehensive guide.

Do you have a baby? Connect with others with similar health concerns and issues. Click here to join the group.