Sudden Infant Death Syndrome Sudden Infant Death Syndrome Sudden Infant Death Syndrome (SIDS) is defined as “an unspecified medical entity: the sudden and unexpected death of a reasonably healthy child, whose passing away remains uncertain following the performance of an adequate assessment of medical history, autopsy, and death scene examination”(Valdes-Dapena,1979). SIDS is one of the predominately-unsolved problems of infancy. The number of infants who die each year of SIDS is greater than the number of children who die of pneumonia, child abuse, AIDS, cancer, heart disease, cystic fibrosis, and muscular dystrophy combined (Mayo Foundation for Medical Education and Research, 2007). Even though SIDS is not predictable or 100% preventable, there are prevention tips, guidance, and support for those that have been affected by this tragedy. The tragic loss of a child to SIDS weighs heavily on the minds of all parents. One thought that offers a little comfort to parents who have suffered such a loss is that there appears to be no suffering. In most SIDS cases, death occurs rapidly and during sleep. According to the National Center for Health Statistics (NCHS), “SIDS is the prevalent cause of death during the first year of life with a rate of roughly two per every thousand births.” SIDS could possibly have more than one cause, though the final process appears to be associated in the majority of cases. Though it is unknown what causes SIDS, it is known what SIDS is not. SIDS is not contagious or caused by suffocation, or entrapment. Slight illnesses such as infections and colds, choking or vomiting are also not causes of SIDS. Research has shown that diphtheria, pertussus, and tetanus (DPT) vaccines, or further immunizations do not cause SIDS (Walker et al., 1987). Having a child properly immunized will help maintain the health of an infant and may help reduce the risk of SIDS. The National SIDS Alliance Group believes the only way to help prevent SIDS is with careful management of children in the particular age range that is affected. Researchers associated with the National SIDS Alliance Group review information surrounding babies who die of SIDS to see how these babies differ from babies who do not die from SIDS. This information includes the family’s medical history, autopsy findings, and death scene examination. The differences uncovered between deaths are referred to as risk factors. Risk factors are not causes of SIDS however, they may provide clues to what causes SIDS and why some infants are more susceptible (The SIDS Network, 2008). The National SIDS Research Center’s (NSRC) recent research shows that babies who pass away from SIDS are born under one or more circumstances, which predisposes him or her to stresses that may appear in the typical life of a child, including internal and external influences that affect the care of an infant. SIDS is more common in families where cigarette smoke is present in the home on a regular basis. Infants whose mothers smoke throughout pregnancy are more prone to become victims of SIDS. SIDS is indifferent to race or social and economic level, occurs in all types of families, and affects females more than males with a ratio of 60 to 40% (NSRC, 2006. In addition, SIDS deaths do reappear in families; the rate among siblings of babies who pass away of SIDS is four to seven times greater than that for the general population (Valdes-Dapena, 1999). Additionally, researchers associated with the National SIDS Alliance Group believe there are things parents and caregivers can do to help hinder SIDS from occurring. Parents are encouraged not to smoke during pregnancy or around infants and babies. Smoking while pregnant may lead to low birth weight and underdevelopment of the infants vital organs placing the baby at a higher risk for SIDS. Not allowing anyone else to smoke around an infant is also important because secondhand smoke increases a baby’s risk of SIDS (Walker et al, 2003). Parents and caregivers are encouraged to take a CPR course. Parents should take their babies to a healthcare provider for standard check-ups and regular immunizations. Babies should be placed on their back to sleep instead of being placed face down. Placing babies face down may lead to suffocation or positional asphyxia. It has been known for some time now that the incidence of SIDS can be greatly reduced by placing the baby in the supine sleeping position (on its back). For this reason, in 1994, the National Back to Sleep Campaign was initiated in the United States. This was a joint endeavor of the American Academy of Pediatrics (AAP), the US Public Health Services, the Association of SIDS and Infant Mortality Program, and SIDS Alliance to raise awareness regarding this important prevention tip. According to data collected after the launch of the National Back to Sleep Campaign, since 2000 the number of children sleeping on their stomachs has decreased from 70% to 20% (US infants). This has resulted in a reduction of 43% in the number of deaths since 1992. Additionally, parents and caregivers should not allow an infant to become too cold or to warm. Allowing an infant to become too cold or over heated may cause the heart to beat irregularly, causing arrhythmias or cardiac arrest (Williams, 1999). Recent studies performed by the National Institute of Child Health and Human Development (NICHD), show that in parts of the world where there are larger seasonal temperature changes are persistent, more incident take place during the winter than the summer. However, in subtropical and moderate climates, there is a minute variation in the rate of unsolved deaths taking place during the summer and winter months. Experts think the higher incidence of SIDS in the colder months may be attributable to the greater risk of infection infant’s face during this time or the "over bundling" and "overheating" of infants (NICHD 2008). With several recent studies initiated by the American Sudden Infant Death Syndrome Institute, researchers hope to gain knowledge of why and how Sudden Infant Death Syndrome occurs. Contributing to these studies are scientists Goyco and Beckerman who are exploring the function and development of the hears, the brain, the nervous system, breathing, sleeping patterns, autopsy findings, body chemical balances, and environmental factors. Researchers at Harvard and Dartmouth have isolated a neuro-chemical deficiency in a section of the brain in SIDS fatalities that controls the infant's protective responses to changes in carbon dioxide and oxygen levels. This research suggests that SIDS may be caused by some slight developmental impediment, an anatomical deficiency, or functional failure. SIDS, like other medical disorders, may eventually have more than one explanation and more than one means of prevention. (The SIDS network, 1997) This may shed light on why the distinctiveness of SIDS babies seems so wide-ranging. The sudden passing away of a baby is appalling and this emotion may carry on for an extensive amount of time. Even though death is considerably distressing for any family, when an outwardly well child is found deceased in his or her crib, it is particularly hard to handle. Parents may be extremely broken and it is hard for the majority of them to escape experiencing some level of blame. Therefore, parents require constant assurance that they are not to blame and that suffocation and any noticeable illnesses were not the reason for the infant’s death. Concern and emotional support from health team members is vital for parents whose children have died from SIDS. For this reason, all over the United States and other countries, organizations and groups have been established by parents who have had children die in this manner, to support each other during the period of bereavement and to inform the public about the problem of Sudden Infant Death Syndrome. These organizations of parents supply help through the sharing of experiences and acknowledge that SIDS deaths are not unique. The Sudden Infant Death Syndrome Network, Inc. is a nonprofit, voluntary health agency whose goals are to put an end to SIDS through the support of SIDS research projects, raise public awareness of the issue, and to offer support to people who have been affected by SIDS (The SIDS Network, 2006). First Candle provides a state-by-state register of grief resources available to those that have been affected by an infant death, during pregnancy of after childbirth. Sudden Infant Death Syndrome is one of the most complicated and disheartening events a parent may encounter. SIDS is an alarming and valid fear of all doctors and parents. Although some infants are more susceptible to SIDS, it strikes families of all races and ethnic backgrounds with no forewarning. Neither doctors nor parents can predict which baby will die. The first 12 months of a baby’s life is a time of rapid development and growth when any baby is thought to be the most susceptible to SIDS. Undoubtedly, public knowledge of this heartbreaking event needs to be improved. The future of SIDS research focuses heavily on predisposing factors and cause identification. Public awareness is vital to the continuity of SIDS research with the hope that one day a cause will be identified and a method of prevention implemented.
References
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