Sudden infant death syndrome (SIDS) is the sudden, unexpected death of an infant or young child. The cause of death cannot be determined by a subsequent autopsy.
Signs of sudden infant death
Unfortunately, there are no signs that directly indicate the approach of a sudden infant death. There are, however, risk factors whose importance has been established by numerous studies in recent years. These include, above all, maternal smoking during pregnancy and the prone position of the child during sleep.
In addition, overheating of the child in the sleep, too strong covering of the head and missing satisfying are considered as factors of risk. Even if no safe reference signs on approaching sudden infant death, there are nevertheless indications, which can mean a particularly high risk for the general occurrence of sudden infant death. These include breathing pauses of the child (apnoea phases), very heavy sweating of the child during sleep, unusually pale skin of the child during sleep or bruises or blue tarnishing of the arms and legs during sleep.
If any of these signs occur, the child should consult the pediatrician and be informed. Children who have already gone through a similar experience are also considered at particular risk of sudden infant death. The same applies to children whose siblings have died of sudden infant death.
Measures in case of suspected respiratory arrest
The first thing to try is to wake up the child. This must not be shaken under any circumstances, as this can cause cerebral haemorrhages. If it does not succeed to wake up the child, resuscitation measures should be initiated until the emergency doctor arrives. The child is directly ventilated twice by mouth-to-mouth resuscitation and then a cardiac massage is performed 30 times. This change is carried out continuously until an emergency doctor arrives or the child shows functioning vital functions again.
Diagnostics
First of all, the exact history should be collected and the “death scene”, i.e. the sleeping situation, should be considered. However, an autopsy according to standardized guidelines is necessary to ensure the exact diagnosis of sudden infant death. The first step is to rule out other causes for the child’s death.
If an exact diagnosis cannot be secured here either, there are some clues, such as bleeding on the pleura and thymus, as well as changes in the brain and the comparison with previously collected data, which indicate sudden infant death. These changes indicate an earlier lack of oxygen, but this could not be proven by anamnestic evidence. Sudden infant death itself, however, cannot be reliably proven even by an autopsy.
In principle, some of the exogenous risks can be avoided by the parents. These include in particular the fact that infants should not sleep on their stomachs. This is the most important and effective preventive measure.
Furthermore, overheating of the child should be avoided. Soft sheepskins should also be avoided, as should niktoin exposure of the child in the sense of passive smoking. Infants should also not sleep alone in the room, but rather in their parents’ room, but in their own bed.
Regular check-ups and breastfeeding are also important for the children, as is early treatment of infections. However, it is especially important to educate parents so that they do not make simple mistakes with potentially devastating consequences. Children with endogenous risk factors should be regularly presented to a pediatrician.
Here, great attention should be paid to care and health measures. For children at high risk, a home monitor can be provided for sleep monitoring. However, this is only indicated for children with a tendency to respiratory arrest, premature babies with malformed lungs and infants after a previous event.
However, the preventive effect of these monitors is not certain. Parents must be trained in the correct handling of the device and learn appropriate resuscitation measures. For this reason, commercially available monitors are not suitable for preventing sudden infant death, but only give the appearance of increased safety.
Monitoring without medical supervision is therefore not reasonable. The best preventive measure that parents can take on their own are sleeping bags in the right size for children. They should also sleep on their back or side.
The sleeping bag prevents wrapping in the blanket, keeps the temperature constant and leaves the arms free. Pillows, cuddly toys or blankets can also be potential dangers for the child and should be avoided.There are children who have a particularly high risk of sudden infant death. For example, children in whom a sibling has died of SIDS or children with respiratory disorders.
For these infants there are certain monitoring devices for so-called home monitoring. Here, especially the respiration is monitored. However, only children who have an increased risk of sudden infant death are prescribed a home monitor.
Numerous parents of completely healthy and not increasingly endangered children are also very concerned about the well-being of their babies night after night. Therefore, surveillance systems have been developed that do not require a medical prescription and can be purchased privately. These are mattresses that measure the breathing movements of the child.
They are also known as sensor mats, baby monitors or motion detectors. The best known manufacturers of these mattresses are Angelcare® and Babysense. Usually these monitoring systems are additionally combined with a baby monitor to provide additional auditory or visual monitoring.
The sensor mat is placed under the actual mattress of the bed. It registers the breathing movements of the child. As soon as there is no movement for a certain period of time, i.e. when the mattress takes a breathing break, an alarm is triggered.
The time from which an alarm is triggered is usually 20 seconds without breathing movement or less than 10 breathing cycles per minute. There are sensor mats of the mark Angelcare® for example in on-line trade starting from 85 euro to acquire. Some studies have shown that sleeping with a pacifier could reduce the risk of sudden infant death.
However, the data on this is sometimes inconsistent. So far it is above all clear that breastfeeding is intended to provide protection against sudden infant death. Why, is not yet clear.
It has been investigated whether it has a protective effect on children who are not (or cannot) be breastfed if they sleep with a pacifier. This hypothesis has been proven in several studies. However, this does not mean that a soother should be forced on the child.
All in all, the following therefore applies: A pacifier could have a protective effect especially on children who cannot be breastfed. This applies however only to the times, at which the child sleeps and not to the waking hours. This possibly protective effect does not mean that the child should get the pacifier in every case. If the child does not want it or loses it while sleeping, it should not be offered any further. For children who are (can be) breastfed, the importance of the pacifier as protection against sudden infant death is not yet sufficiently clear.
