Sudden infant death syndrome has long been a phenomenon unfathomable to science, killing thousands of infants each year. But now, at least, risk factors can be named and precautions can be taken to reduce the risk of this terrible event. Nevertheless, sudden infant death syndrome is still the most common way infants die before they reach the age of one in Germany, claiming the lives of around 300 babies each year.
What is sudden infant death syndrome?
Sudden infant death syndrome occurs whenever an infant dies completely unexpectedly and unexpectedly without any prior signs of illness or conspicuous behavior, and even an autopsy cannot provide any clues as to the cause of death. Usually, death occurs during the night and, because the soundless and motionless baby is considered by the parents to be asleep, is not noticed until some time later. Sudden infant death syndrome does not include those deaths that occur unexpectedly and suddenly but are medically explainable and detectable, such as heart failure or insidious infection.
Causes
Sudden infant death syndrome has preoccupied the medical community for decades and still raises more questions than it answers. However, a number of theories and conjectures – although not one hundred percent provable – now exist that provide reasons for sudden death. The most recognized of these is that of asphyxiation of the child by an abrupt cessation of the natural breathing reflex. Since this occurs mostly during sleep, babies do not wake up and therefore cannot give any warning signs. However, the exact causes for the cessation of breathing are still based on insufficiently proven theories. For example, sleeping on the stomach is cited as an increased risk for breathing cessation. Involuntary, self-inflicted suffocation by a pillow or blanket is also considered by many physicians as a cause of death, since most cases occur around the 100th day of life and therefore at a stage when infants are increasingly moving at will rather than purely by reflex, which can cause them to become entangled in pillows or blankets.
Symptoms, complaints, and signs
Fatal to sudden infant death syndrome is that it usually occurs without clear symptoms or signs beforehand. Most affected parents find the children unexpectedly dead in bed. Accordingly, sudden infant death syndrome is a diagnosis of exclusion when no other clearly identifiable disease causing the death could be found. Accordingly, there are no clear signs of impending infant death. Nevertheless, experts can now identify some risk factors that make children appear to be potentially at risk. However, the individual case must always be discussed with the pediatrician. Many affected children have died in connection with a respiratory tract infection. Accordingly, parents should insist on careful clarification by a specialist in the event of unclear, persistent or constantly recurring signs of an infection. Furthermore, it has been found that premature infants and those with a generally low birth weight tend to be more affected by infant death. The same applies to children whose mothers smoked during pregnancy or even after birth. If such risk factors apply, parents should definitely discuss them openly with their doctor. If there is any uncertainty or an individually increased risk, the doctor can prescribe a monitor that monitors vital functions during sleep. Since these are recorded and also already give alarm in case of changes, the devices can also help to recognize possible signs and to initiate further examinations.
Diagnosis and disease progression
Since a cause of death cannot be determined in the case of sudden infant death syndrome even during an autopsy, a diagnosis can actually only be made unequivocally by ruling out all other possible causes of death. This means that often several experts, such as the pediatrician, a pathologist, and in some cases also the forensic pathologist, since a crime cannot always be ruled out, have to examine the deceased child for all kinds of possible causes of death.Only after all other possibilities have been ruled out and the baby’s medical history has also been thoroughly reviewed is sudden infant death syndrome listed as the official cause of death.
Complications
Sudden infant death syndrome leaves emotional wounds on the relatives of the deceased child – first and foremost the parents – which can bring complications. For example, the shock reactions and depression that develop not infrequently lead to inability to work, rash acts of overindulgence, or lead to drug addiction or the like if those affected are left alone to deal with their shock. Studies have shown that sudden infant death syndrome increases the risk of self-inflicted death in affected parents. The suicide rate quadruples in mothers within the first few years after the event. Fathers were found to have an increased risk of accidents and an increased propensity to commit suicide. In addition, life expectancy is reduced on average for parents who have experienced sudden infant death syndrome. The risk of various diseases is increased. Among them are cancer and cardiovascular diseases, which are followed by further complications. The fact that the cause of sudden infant death often remains unclear results in a lifelong burden for the parents. If the event is not processed – through psychological measures and therapies – the search for the reason or a supposed meaning of the incident manifests itself psychologically. This can lead to a very limited world of experience as all resources are expended on thoughts surrounding the deceased child. As a result, social fabric, occupation, and personal interests are neglected.
Prevention
Since, in addition to the infant’s prone position at night and entanglement in pillows and blankets, smoking during pregnancy increases the risk of sudden infant death syndrome many times over, according to studies, experts strictly advise against it. To avoid prone position of the child, care should be taken that he falls asleep in the evening lying on his back. However, the child should not be completely trained not to lie on his stomach, but on the contrary, should be practiced to lie on his stomach correctly, because otherwise involuntary rotation on the stomach can lead to complications. In addition, the use of a special sleeping bag for infants is recommended, which is completely free of pillows and blankets lying around. Furthermore, breastfeeding also has a positive effect on the baby and can also slightly reduce the risk of sudden infant death syndrome. Thanks to the newly gained knowledge from research and empirical studies, many risk factors for sudden infant death syndrome can already be recognized today and minimized through correct behavior. Nevertheless, education, especially of young mothers, about such risks and methods of prevention in Germany still leaves much to be desired.
Aftercare
A first point of contact after sudden infant death syndrome is emergency counseling. In conversation with a trained counselor, relatives receive support and advice regarding support groups and further measures. As part of the aftercare, the doctor in charge asks whether care is necessary. Many relatives want to say goodbye to the child in person. Religious parents often attach importance to the blessing of the child. An emergency baptism can be performed by all baptized Christians, provided the child has not been deceased for a long time. Siblings of the deceased child must be informed in a manner appropriate for the child. For this, parents are best advised to contact the local doctor, who will find the right words based on his or her experience. In the long term, marriage counseling may also be useful for the child’s parents. Often, after the death of the child, the marriage faces a serious crisis. Working through the grief is an important aspect of processing. Relatives who feel left alone with their grief turn to a therapist or a support group. If the mother becomes pregnant again after some time, questions regarding the cause of the child’s death should also be clearly clarified to ease the parents’ fears of another incident.
When should you go to the doctor?
If sudden infant death syndrome occurs, no doctor can save the infant anymore. This is because the baby’s death is usually not detected immediately, but when the parents next check on him – even a few minutes is enough and no medical help can still save the baby.In such cases, a doctor must intervene immediately after breathing and heartbeat stop. Therefore, the only option is to closely monitor babies at increased risk of sudden infant death syndrome. At best, they stay in the hospital until the risk is almost non-existent. This way, they can be connected to medical monitoring devices that immediately sound the alarm if the baby shows critical signs. In addition, pediatricians are present here at all times and can initiate resuscitation in the event of an emergency. Once a baby at increased risk is allowed to return home, the best prevention is to monitor him or her here as well and instruct parents on what to do if an emergency occurs. Furthermore, the baby should see the pediatrician regularly until the risky period is over so that health problems can be detected and treated in time. The doctor cannot reverse sudden infant death syndrome that is noticed too late, but he or she can help prevent it. Affected parents should seek psychological or pastoral help.
What you can do yourself
Sudden infant death syndrome often strikes families completely unexpectedly. Since sudden infant death syndrome is a diagnosis of exclusion, this means that no other illnesses that could have caused the death could be detected in the child. Accordingly, in the field of self-help in everyday life, no measures that could provide absolute certainty are possible. This is because to date it has not been conclusively determined what specifically may have caused the child’s death. Even if there is still no scientific clarity about the exact causes, over the years studies have produced some indications that may be able to prevent sudden infant death syndrome. For example, the supine position is still considered much safer than the prone position. As long as parents can influence the sleeping position of the child, sleeping on the baby’s back is probably safer in everyday life. Parents should also avoid covering their child too warmly in bed or even putting blankets, scarves or cuddly toys in bed that the child could consciously or unconsciously pull over its head or into the nose area. Studies have shown that children with low birth weight and children of smokers tend to die more often from sudden infant death syndrome. So such known risks should be discussed openly with the pediatrician. If necessary, he or she will prescribe a special monitor for daily use at home to monitor the child’s vocal functions during his or her bedtime.
