Brief overview
- Causes and risk factors: cause not conclusively understood; genetic risk factors, problems during pregnancy and birth, external risk factors such as the sleep environment
- Symptoms: SIDS infants are usually found dead. The “apparently life-threatening event” announces itself with respiratory arrest, flaccid muscles and pale skin.
- Diagnosis: After death, autopsy of the body.
- Treatment: Possible attempt at resuscitation measures
- Course and prognosis: Increased risk for siblings after SIDS
- Prevention: Eliminate risk factors, sleep in sleeping bag, cool room temperature, no objects in bed, smoke-free environment, sleep in own bed near parents, etc.
What is sudden infant death syndrome?
Sudden infant death syndrome means that a child dies suddenly and unexpectedly. In this tragic death of a seemingly healthy infant or toddler, doctors also refer to it as Sudden Infant Death Syndrome, or SIDS. SIDS is colloquially known as “crib death” or “sudden infant death syndrome”. Causes cannot be determined with certainty.
By definition, sudden infant death syndrome occurs when a child dies unexpectedly before 365 days of life, i.e., within the first year of life. Most deaths occur during the first two days of life and between the second and fifth months of life. About 80 percent of deaths occur before six months of life. After that, the risk of SIDS decreases. Boys are affected more often than girls.
Sudden infant death syndrome: causes and risk factors
To date, the cause of sudden infant death syndrome has not been conclusively determined. Experts assume that there is an interaction of several factors. On the one hand, these relate to the course of pregnancy and the physical condition and health of the child (endogenous risk factors).
Secondly, environmental factors, i.e. external influences, play a decisive role in sudden infant death syndrome (exogenous risk factors).
Disturbances of life-sustaining functions
Even an infant already has these life-sustaining reflexes, but they must first mature. In sudden infant death syndrome, experts assume that these control functions fail. A reduced O2 or increased CO2 level during sleep is no longer compensated for – the child dies.
Genes as a risk factor
Researchers have found that twins and siblings of SIDS children have a six-fold increased risk of also dying from sudden infant death syndrome. They therefore suspect that changes in the genetic makeup play a role. These affect the metabolism of messenger substances and the control of vital functions – the risk of sudden infant death syndrome increases.
Problem birth as a risk factor
Various studies have investigated the connection between the birth process and sudden infant death syndrome. According to these studies, premature babies have an increased risk of SIDS. This also applies to children from multiple births. Newborns who have breathing problems during or after birth are also at risk for sudden infant death syndrome.
Risk factors prone position and overheating
Most infants die in their sleep in the early morning hours. The majority are found by their parents in the prone position. SIDS infants are often drenched in sweat and lie with their heads under the covers. When babies sleep on their stomachs, the risk of SIDS is significantly increased: The prone position is considered the greatest risk factor for sudden infant death syndrome.
The risk of SIDS is even higher if the bedding is very soft or if there are additional pillows, stuffed animals, cloths and blankets in the bed. These things may impede breathing. The child re-breathes too much carbon dioxide, while at the same time the breathing air contains less and less oxygen. The child is neither able to compensate for this deficiency nor to free itself with purposeful movements. Sudden infant death is imminent.
At the same time, heat accumulates in the infant’s body. It is assumed that this overheating additionally impairs the physical functions. If the cardiovascular regulation then fails, this may lead to sudden infant death.
Risk factor infections
The infant’s body reacts to their toxins with fever, which in turn stresses the circulation and leads to increased fluid loss. All these things threaten the child’s central regulatory mechanisms and increase the risk of sudden infant death syndrome.
Risk factor stress and social status
More and more people feel burdened by stress. Unconsciously, they transfer some of it to their children. Studies show that parental stress increases the risk of sudden infant death syndrome, especially for infants and young children.
A young maternal age (under 20) and closely spaced pregnancies also appear to increase the risk of SIDS. Other factors include low family financial and social status.
Risk factors smoking, drugs, alcohol.
Studies show: When mothers smoke or use drugs during pregnancy, it not only leads to developmental disorders or malformations of the embryo or fetus in many cases. It also increases the risk of sudden infant death syndrome.
Are there signs that herald sudden infant death syndrome?
Most parents of SIDS children find their babies already dead in bed. Often, just a few hours before, everything was normal, the child was doing well, kicking and laughing – which makes this event as unexpected as it is painful.
Differentiated from sudden infant death syndrome is the so-called “apparently life-threatening event” (ALE). In this case, the affected infants breathe only very weakly – or even not at all – all of a sudden and without any apparent cause. The muscles go limp. The skin becomes pale or bluish. In addition, there are sometimes signs of choking or suffocation.
ALE occurs both when the child is asleep and awake. Parents who notice it still have a chance to resuscitate their child.
How is sudden infant death syndrome diagnosed?
The infant who died of sudden infant death syndrome is then autopsied. This means that forensic doctors or pathologists examine the child’s body. They determine whether internal causes or external causes brought about the child’s death.
The diagnosis “Sudden Infant Death Syndrome” (or “SIDS”) is therefore a diagnosis of exclusion, made when no other cause of death can be identified.
What to do in an emergency?
Treatment often comes too late – SIDS infants die unnoticed in their sleep. If parents or other adults recognize a respiratory and circulatory arrest, the emergency physician must be called immediately. In the time until the emergency physician arrives, you can save the child’s life by performing resuscitation. Resuscitation in an infant includes chest compressions and rescue breathing, just as in an adult:
Lay the baby flat on his or her back with the head in a neutral position (not hyperextended). Give 5 breaths once at the beginning, followed by 30 chest compressions and then 2 breaths. After that, always alternate in a 30:2 pattern. This means: press 30 times, breathe 2 times.
What is the prognosis after sudden infant death syndrome?
Losing a baby to sudden infant death syndrome is a heavy blow for the entire family. But it usually does not mean the end: many have another child after the loss. However, if parents have already lost one child to sudden infant death syndrome, the risk of having a subsequent sibling is increased. Doctors recommend that they avoid known risk factors and thereby minimize the risk of SIDS.
For the “apparently life-threatening event”, after a single occurrence, the risk for another as well as for sudden infant death syndrome is increased.
How can sudden infant death syndrome be prevented?
Experts recommend some measures to reduce the risk of SIDS. They are oriented towards eliminating the external risk factors that are often found in affected children.
The prevention measures seem to work very effectively, as can be seen from the statistics. Various safe sleep environment campaigns for infants significantly reduced the number of SIDS cases in recent decades.
- Supine position for sleeping
- Proper bed
- Smoke free environment
Put your baby on his back to sleep
The most effective measure against sudden infant death syndrome is not to put the baby on its stomach to sleep. Place it on its back for free breathing.
The less bedding, the better
Do not put extra sheets, pillows, stuffed animals or animal skins in the bed. This reduces the risk of the child overheating or putting something in front of the airway. Make sure the sleeping surface is firm so that the baby does not sink in.
Use a sleeping bag
Place your child in a sleeping bag of an age-appropriate size for sleeping. It ensures a constant temperature. Most importantly, it prevents turning into the prone position, which promotes sudden infant death syndrome. If you don’t have a sleeping bag, cover the child with a flat blanket and tuck it in tightly. That way, the child won’t roll into the bedding as easily and risk slipping his head under the covers.
Avoid too much heat
Leave your baby in his bed, but not alone.
This point has been discussed in the past as a SIDS risk factor. Some scientists believe that co-sleeping the young child in the parental bed reduces the risk of sudden infant death syndrome. However, one study says that newborns are probably even more affected by sudden infant death syndrome when so-called co-sleeping.
Therefore, put your child in a separate bed of his or her own and place that next to your parent’s bed. This will enable you to act in time in an emergency and prevent sudden infant death syndrome.
Attend the preventive check-ups
The regular check-ups are important to detect possible diseases or developmental disorders in the infant at an early stage. In addition, the pediatrician has useful advice on how to prevent sudden infant death syndrome. Take symptoms of illness seriously and do not hesitate to see the pediatrician. Because infections increase the risk of SIDS.
Breastfeeding and pacifier protect
Several studies have shown that pacifiers reduce the risk of sudden infant death syndrome on average. Doctors explain the benefit by the fact that sucking on a pacifier trains and expands the upper airways. It also makes babies sleep less deeply. Parents are therefore advised to offer babies a pacifier, but not to force it on them.
Sudden infant death syndrome medical guidelines also recommend that mothers breastfeed their infant during the first year of life, if possible. In the past, it was thought that a pacifier reduced breastfeeding success. Today it is clear that both measures together, pacifier and breastfeeding, reduce the risk of sudden infant death syndrome.
Smoke-free environment!
Smoking increases the risk of sudden infant death syndrome. So do not smoke during, or after pregnancy. This also applies to the father, relatives and friends who are near the infant or pregnant woman. A smoke-free environment effectively protects your child and reduces the likelihood of sudden infant death syndrome.
