Accompanying affected parents
The death of one’s own child represents a very large, burdensome loss for the parents. In addition, it can lead to great self-reproach and blame when sudden infant death occurs in the family. The police investigations to exclude a infanticide contribute to the feeling of the own guilt considerably.
For this reason, it is important to accompany and inform the parents. It has been proven to be very helpful for the parents to talk to the autopsy doctor to find out the exact reasons for infant death. Furthermore, close relatives must be involved in the mourning process.
Couples who have suffered a severe loss often withdraw and isolate themselves. Therefore, family support is extremely important. Not least also for the partnership.
This can be broken by the death of the child, but there are also couples who grow closer together through such a fate. There are also self-help groups to support them. In these communities, people talk about what they have experienced so that they can deal with the loss.
More than two thirds of all sudden child deaths occur within the first 6 months of life. The frequency peak lies – depending on the study – between the 2nd and 4th or between the 3rd and 4th month of life. Sudden infant death occurs rather rarely in newborns and in older children from 1 year of age.
Most cases occur during the winter months. The earlier known winter summit disappears however gradually. The frequency of sudden infant death has decreased from 1-3% to less than 0.5% in European countries due to targeted prevention measures.
Boys are generally affected slightly more frequently than girls. About 2-6% of unexplained child deaths occur after the first year of life. However, Sudden Infant Death Syndrome (SIDS) is by definition the death of an infant due to an unexplained cause of death.
An infant is defined as a child until the age of 1 year. No.Sudden infant death is an event that by definition occurs after the child is born. It describes the death of an infant with an unexplained cause and usually occurs within the first year of life.
Of course, it also occurs unfortunately that unborn children die in the womb. This is not called sudden infant death and can have various causes. For the sudden infant death there is so far no secured cause.
Therefore, the multifactorial hypothesis is currently considered the most probable. This hypothesis states that children who are exposed to endogenous (internal) and exogenous (external) risks can decompensate during sleep under oxygen deficiency. 90% of children die in sleep.
The following risk factors were observed more frequently in children who died of SIDS than in control children. The individual risk factors can have different degrees of influence on sudden infant death. While the endogenous risk factors can hardly be influenced, the exogenous risk factors can in part be circumvented very well.
It is important to know that the individual factors do not yet represent a risk, but only several of the following points must occur. Even then, however, this does not mean that sudden infant death can certainly occur. Since the cause has not yet been explained in detail, this is a summary of all the factors that have been associated with SIDS.
Among the endogenous risk factors are premature babies or deficient babies, especially if the lungs are malformed. Also infants who suffered from a severe form of respiratory depression and circulatory weakness after birth. Siblings of SIDS deaths and infants who have already suffered a death attack and have received timely treatment are at increased risk.
Furthermore, children of drug-addicted mothers or children with proven respiratory failure during sleep are considered at risk. In addition, the following autonomic regulatory weaknesses are also at risk: changes in the heart‘s electrical conduction, increased sweat production, reflux disease, impaired coordination of sucking and swallowing, conspicuous lack of movement and shrill crying. Even children who are difficult to wake up can have an increased risk.
The exogenous factors are much better controllable, and accordingly important for the parents. It is noticeable that the clear majority of children were found in prone position. In addition, overheating during sleep and soft bedding as well as Niktoin exposure during and after pregnancy can be problematic.
Frequent infections of the children, both viral and bacterial, can also lead to respiratory pauses or heat stress. The sleeping situation is also very important. For example, twisting into the bedspread, getting trapped or covering up can be a danger.
Also sleeping of the child in close physical contact with alcoholic parents can be dangerous. Psychosocial factors such as the child’s increased stress, lack of attention, neglected care and a poor socio-economic status can have an influence on sudden infant death. It is not yet clear whether a lack of breastfeeding has an influence.
In addition to these rather vague causes, there are also some pathological causes of sudden infant death. These include cerebral diseases such as bleeding, tumors and malformations. Respiratory diseases, such as pneumonia or malformations, as well as cardiac diseases or sepsis can also lead to sudden death.
Congenital metabolic disorders and gastrointestinal diseases can also be explainable causes. Furthermore, accidents during sleep, e.g. strangulation and suffocation or wilful infanticide by suffocation or poisoning are also possible. In order to reduce the mass of possible causes to an individual diagnosis, an autopsy is necessary.
Besides smoking, the prone position of the child serves as one of the main risk factors for sudden infant death. Sleeping in the prone position should increase the risk by a factor of 9 to 13. But also the lateral position means, in contrast to the supine position, a risk that is 2 to 3 times higher.
Probably most likely because children can roll from the rather unstable lateral position onto their stomachs relatively quickly during sleep. In the past, sleeping in the supine position was considered a risk for the development of cranial deformities. However, this has now been disproved.
In addition, parents can put their children on their stomachs during waking hours to avoid a constant supine position. This is because the prone position is only dangerous during the sleeping phases. The use of baby pillows, the so-called sleep positioners, to avoid the prone position is not recommended, they are rather considered dangerous.
Sudden infant death is still the subject of research and studies.It is still not clear what is the cause for the sudden death of apparently healthy children. However, there are certain risk factors that increase the probability of sudden infant death. Among other things the cigarette consumption of the nut/mother during the pregnancy counts to it.
According to current studies the risk for the sudden infant death rises clearly starting from a consumption of 10 cigarettes per day. Starting from 10 cigarettes per day the risk for a sudden infant death is to be increased by the 8-fold to 10-fold. 10 years ago almost every 5th pregnant woman smoked.
This shows what a significant influence this risk factor has. A study from the year 2007 found out that smoking is one of the most important risk factors at all. Without nicotine consumption 60% of the cases of sudden infant death could be prevented according to this study.
Also the passive inhalation of cigarette smoke, also called passive smoking, increases the risk of sudden infant death. This is about 2 to 3 times higher. Current data on factors that can promote the occurrence of sudden infant death include cigarette smoke, but not chimney smoke.
According to current study situation there is agreement over the fact that cigarettes (both in passive form with the baby and in active form by smoking of the pregnant nut/mother) are one of the main risk factors for sudden infant death and should be avoided therefore absolutely. There are no data on the influence of chimney smoke so far. With a chimney, which – as everywhere usual – was examined and removed by a chimney sweep, the smoke developing when lighting should pull upward by the draft and thus no endangerment represent.
Many vaccination opponents discuss vaccinations as a possible trigger or risk factor for sudden infant death. In particular the six-fold inoculation which can be administered starting from the second life month and should be repeated twice, stands here in the focus. However, there are no studies that indicate that vaccinations could increase the risk of sudden infant death.
On the contrary: Studies show that control children (not deceased) are vaccinated significantly more often than children who have died of sudden infant death. According to expert opinion, the idea that vaccinations could increase the risk of cot death came about only because the peak of the disease coincides with the time when most children receive their first vaccinations. In 2002, 334 children in Germany died of sudden infant death.
The diagnosis was the cause of almost 22% of deaths in children between the 8th day of life and the completed first year of life. In 2008 there were still 215 cases. In 2014, 119 children died of sudden infant death.
About 80% of these unexplained deaths occur before the 6th month of life. Sudden infant death most frequently occurs between the 2nd and 4th month of life. About one and a half times as many small boys as girls are affected.
Sudden infant death is still the most common cause of death during the first year of life. Sudden infant death is a rare but all the more devastating event when it occurs. Parents can avoid many potential dangers for the child by taking preventive measures, such as proper sleeping arrangements, and thus significantly reduce the risk for their own child.
It is particularly important to avoid the prone position for sleeping children. If sudden infant death occurs, resuscitation measures must be started immediately if the child cannot be awakened. Depending on the period of respiratory arrest until the first attempts at resuscitation, successful resuscitation may be very unlikely.
If death has occurred, a police investigation is always followed up in such cases, as a voluntary infanticide must be ruled out. This also means an autopsy in which other causes of death are sought. If these cannot be found, but there are indications of a lack of oxygen, the diagnosis of sudden infant death is made. After such a great loss, the grief processing of the parents with medical and psychological accompaniment should be in the foreground.
