PATCHS PROGRAM PUBLIC HEALTH NURSING ADVOCATES TEACHING CHILD HEALTH AND SAFETY HEALTH CARE PROGRAM FOR CHILDREN IN FOSTER CARE (HCPCFC)
Volume 1, Issue 21		JULY 2005

Medical Information Fact Sheet

Sudden Infant Death Syndrome (SIDS):

Every year, nearly 2300 seemingly healthy babies die of sudden infant death syndrome, a condition also known as SIDS or crib death.

SIDS strikes suddenly and silently, usually during sleep. Typically, a peacefully sleeping baby simply never wakes up. The cause or causes of SIDS is not known. The condition rarely occurs before 2 weeks, with 90% of deaths by 6 months of age. Most deaths occur in babies that are between 2 and 4 months of age.

Although the cause of SIDS is not known, researchers have discovered a number of factors that may put babies at risk. The researchers have also identified some simple measures parents can take to reduce the risk to their children. The most important of these is placing babies on their backs to sleep as opposed to their stomachs.

Causes:

Exactly why SIDS occurs remains elusive. Over the years, researchers have investigated a number of possible causes, including suffocation, vomiting or choking, birth defects, metabolic abnormalities, infection and altered development in the parts of the brain that control breathing. New research has focused on the way babies breathe while they are asleep― especially their response to low blood oxygen levels (hypoxia).
Researchers have also looked at what is referred to as the long QT syndrome. This is a subtle electrical disturbance in the heart that causes sudden, extremely rapid heart rates.
It is suspected that some SIDS babies may carry this gene. However, most deaths from long QT syndrome occur during exercise, rather than during sleep as SIDS deaths do. And if long QT syndrome were the cause of SIDS, it does not explain why back sleeping reduces the risk or why only very young infants are affected.
Still if there is a history of SIDS in the family then a doctor may want to check for the presence of long QT syndrome which can be done by an electrocardiogram (ECG) and confirmed, if necessary, by genetic studies.

Some factors that probably do not cause crib death include:

• A toxin or poison in the baby’s environment. The notable exception to this is cigarette smoke. Babies exposed to cigarette smoke have a harder time waking up or being awakened from sleep, which researchers believe increases the risk of SIDS.
• Immunizations or lack of immunizations. Some people believe that the number of vaccinations American infants receives plays a role in SIDS. However a report issued in March of 2003 by the Institute of Medicine found no link between any childhood immunization and SIDS.

At the same time, there is no evidence that children who aren’t vaccinated are at an increased risk.

• Exposure to electrical or magnetic fields or to household pets. In addition, SIDS does not seem to be caused by allergies or allergic reactions.

In the long run, it may be that SIDS does not have a single cause but rather occurs because of a complex interaction among many factors, including the way infants develop, their physiological responses to stress and exposure to environmental stressors.

Risk Factors:

Although SIDS can strike any infant, researchers have identified several factors that may increase a baby’s risk. At higher risk are babies who are:

• Male
• Between 2 weeks and 6 months of life. Infants are most vulnerable in the 2nd and 3rd months of life.
• Premature or low birth weight infants. A baby that is premature or weighs 4.4 pounds or less at birth is at an increased risk.
• Black or American Indian. For reasons that are not understood, race appears to play a part in SIDS. A higher incidence of metabolic conditions may put some children at greater risk. Cultural differences in child care practices ― such as whether babies are placed on their backs ― are likely a factor.
• Placed to sleep on their stomachs.
• Born to mothers who smoke or use drugs.
• Exposed to tobacco smoke.

Reducing the Risk

At present, it is not possible to prevent SIDS, but these steps can help to reduce the risk for your baby:

• Place baby on his or her back to sleep. Place the baby to sleep on his or her back rather than on the stomach. This is not necessary if the baby is awake.
• Be sure your baby is placed to sleep on his or her back when staying with relatives or at child care.
• Do not smoke. Infant whose mothers smoke during and after pregnancy are more likely to die of SIDS than are infants of nonsmoking mothers.
• Select bedding carefully. Use a firm mattress. Avoid placing baby on thick, fluffy padding, such as lambskin or thick quilt. These may interfere with breathing if your baby’s face presses against them. Don’t leave fluffy toys or stuffed animals in the crib. Instead, tuck in a lightweight blanket securely at the foot of the crib, with just enough length to cover the baby’s shoulders. Then place the baby in the crib, near the foot, covered loosely with the blanket. If the baby sleeps in a kimono or sleep sack, they may not need a blanket unless the room is cool or next to a window in cold weather.
• Place baby to sleep in a crib rather than in your bed. A baby may become trapped and suffocate, between the headboard slats, the space between the mattress and the bed frame, or the space between the mattress and the wall or if the parent rolls on top of the baby. Sofa beds seem to be particular dangerous for infants.
• Moderate room temperature. Keep the temperature in the baby’s room at a level that is comfortable for you, not warmer than normal. If the baby is sweating around the neck or face, it probably means the infant is too warm or has a fever or illness. When this happens, use fewer covers, not more.

Coping skills:

Facing the death of a child can be overwhelming. Parents are often torn by guilt as well as grief. But SIDS can occur no matter how much you love and protect your baby. Right now, SIDS remains a mystery.

At this time, the emotional support of others is especially important. You may find it comforting to talk to other SIDS parents. If so, your doctor may be able to recommend a support group in your area, or you can visit an online SIDS chat room. But support groups aren’t for everyone. For some people, talking to a trusted friend or counselor may be more helpful. Finally, having time to grieve is important.

Public health nurses are also available through county agencies to help with the grieving families. The public health nurses can also help the families with support and available community resources.

 

Mayo Clinic. (2005, June 14). Sudden Infant Death Syndrome (SIDS). Retrieved on July 10, 2005 from the World Wide Web:  http://www.mayoclinic.com/invoke.cfm?id=DS00145

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HCPCFC PROGRAM UPDATES and ANNOUNCEMENTS!!! We would like to Congratulate Nicole Boyd on her promotion to Assistant Nurse Manager of the Health Care Program for Children in Foster Care (HCPCFC). Congratulations!!!

 

Editor: Kristen Thompson, PHN
Contributors: Nicole Boyd, PHN, Judy Earp, MHA, Director of Public Health Nursing.