Sudden Infant Death Syndrome (SIDS, Crib Death)
When an apparently healthy infant dies and a medical investigation fails to uncover an explanation, cause of death is attributed to sudden infant death
syndrome (SIDS). This syndrome, or crib death, claims about 8,000 infants in the United States each year, making it one of the most common causes of death in babies under one year.
The cause of SIDS is unknown, but researchers believe that it probably involves abnormalities in the mechanisms that control breathing and heart rate. Specific contributing factors may include a narrowed and inflamed airway, chronic oxygen deficiency, and irregular breathing, all of which may predispose an infant to spasm of the trachea, or windpipe, and death.
About 5 percent of babies who die of SIDS have had prior episodes of apnea, a condition in which breathing stops, usually during sleep. In most instances, the apnea is brief and the baby resumes breathing without incident. During a prolonged breathing lapse, however, the brain and heart become starved for oxygen, and this situation may result in a life-threatening cardiac arrhythmia. Death usually occurs rapidly, and most babies do not cry or struggle. Even a person in the same room may hear nothing. There have been cases in which an apparently healthy baby died silently in a car seat or a parent's arms.
Babies born to women who smoke have a markedly increased risk of SIDS, as do those who had a sibling die unexpectedly. Other possible predisposing factors include prematurity, low birth weight, and slower than normal growth. Racial, social, and economic factors may also play a role; SIDS occurs most often among Native Americans, followed in order by African-Americans, Caucasians, and Asian-Americans.
SIDS is most common during the winter and sometimes follows a cold. However, most SIDS babies were completely well before they died. They may even have seen a doctor recently and been pronounced healthy.
Diagnostic Studies and Procedures
In most cases, there are no symptoms before SIDS occurs to give any indication that the baby is in any danger. Therefore, after a death, an autopsy should be performed immediately to look for a possible cause, such as an undiagnosed congenital defect.
Medical Treatments
There is no medical treatment for SIDS, but in some cases, a baby who has had repeated episodes of apnea may be hospitalized for monitoring.
Alternative Therapies
Nutrition Therapy. There are many theories about what to feed or not feed a baby to prevent SIDS. Although some nutritionists have attributed SIDS to food allergies and bottle-feeding, this has not been proven. While experts agree that breast-feeding provides the best nutrition for young babies, SIDS occurs with equal frequency among breast-fed and bottle-fed infants.
Psychotherapy. The sudden loss of a baby is one of life's hardest blows. Psychological counseling can be very beneficial to (he surviving family members, who invariably need help in coming to terms with this death. Siblings, for example, may develop a fear of falling asleep, especially if they have been told that the dead baby has "gone to sleep." They may also feel guilty, thinking that the baby died because they secretly wished it would go away. Parents, too, may feel guilty or blame each other, even when assured that they were not at fault.
Different forms of psychotherapy are available, including family counseling or individual sessions with a therapist, social worker, or another professional trained in helping people to cope with a death in the family. There are also support groups of parents who have lost children to SIDS.
Self-Treatment
Electronic monitoring is sometimes recommended for a high-risk baby. Such a monitor, placed in the crib, will sound an alarm if the baby ceases breathing for more than a few seconds.
A baby's sleeping position may have something to do with the risk of SIDS. Several studies here and abroad have found an increased incidence of SIDS among babies who slept on their stomachs rather than their sides or backs. This has led many pediatricians to recommend that infants be placed on their backs, but this advice is somewhat controversial. Some doctors maintain that babies who are prone to spitting up should be placed on their stomachs to prevent possible choking. Increasingly, however, pediatricians are advising that infants be placed on their backs.
Regardless of his sleeping position, a child should be placed on a firm, smooth mattress that is covered with a light-fitting sheet. Pillows should not be used, nor should the baby be swaddled snugly. Instead, loosely cover him with a light blanket. Also, avoid overheating the bedroom.
Parents and others should not smoke around infants, as secondhand smoke can damage their vulnerable respiratory systems and may contribute to SIDS.
Other Causes of Sadden Death in Babies
Autopsies sometimes reveal that sudden death is due to a brain hemorrhage, often the result of a fall or child abuse.
Other causes of infant death may include myocarditis, an inflammation of the heart muscle; and meningitis, an infection of the membranes that cover the brain and spinal cord. Unlike SIDS, these usually produce prior symptoms.