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Sudden infant death syndrome

Sudden infant death syndrome (SIDS) is any sudden and unexplained death of an apparently healthy infant aged one month to one year. The term cot death is sometimes used in the United Kingdom, and crib death in the United States. more...

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Diagnosis

SIDS is a definition of exclusion and only applies to an infant whose death remains unexplained after the performance of an adequate postmortem investigation including (1) an autopsy, (2) investigation of the scene and circumstances of the death and (3) exploration of the medical history of the infant and family. Generally, but not always, the infant is found dead after having been put to sleep and exhibits no signs of having suffered.

The inexplicability of the death often leaves parents with a deep sense of guilt in addition to their grief.

Statistics

SIDS is responsible for roughly 50 deaths per 100,000 births in the US. It is responsible for far fewer deaths than congenital disorders and disorders related to short gestation; though it becomes the leading cause of death in otherwise healthy babies after one month of age.

The frequency of SIDS appears to be a strong function of the age, race, education, and socio-economic status of the parents.

Risk factors

Very little is known about the possible causes of SIDS; there is no method for absolute prevention. However, several risk factors are associated with increased probability of the syndrome.

Prenatal risks

  • inadequate prenatal care
  • inadequate prenatal nutrition
  • tobacco smoking
  • use of cocaine or heroin
  • teenage pregnancy
  • less than a one year interval between subsequent births

Post-natal risks

  • low birth weight (especially less than 1.5 kg)
  • exposure to tobacco smoke
  • laying an infant to sleep on his or her stomach (see positional plagiocephaly)
  • failure to breastfeed
  • excess clothing and overheating
  • excess bedding, soft sleep surface and stuffed animals
  • sex (60% of deaths occur in males)
  • age (incidence is higher between 2-4 months)

In addition, research indicates a reduced risk of SIDS in conjunction with a safe co-sleeping arrangement. Though findings are still preliminary, the proximity of a parent's respiration is thought to stimulate proper respiratory development in the infant.

(The use of baby monitors, particularly those with motion sensors, can allow the parents to remotely keep track of their child.)

SIDS and child abuse

Controversial British pediatrician Roy Meadow believes that many cases diagnosed as SIDS are really the result of child abuse on the part of a parent suffering from Munchausen Syndrome by Proxy (a condition which he himself identified). During the 1990s and early 2000s, a great many mothers of multiple apparent SIDS victims were convicted of murder on the basis of Meadow's opinion. However, in 2003 a number of high-profile acquittals brought Sir Roy's theories into disrepute, and many now doubt their credibility. Several hundred murder convictions are now under review.

Read more at Wikipedia.org


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New study looks at sudden infant death syndrome
From AORN Journal, 3/1/05

Researchers at Washington University School of Medicine in St Louis have found that babies who never steep on their stomachs do not learn behaviors that may reduce their risk of sudden infant death syndrome (SIDS), according to a Dec 7, 2004, news release from the university. Researchers still caution that infants always should be placed on their backs to steep, however.

Researchers studied 38 healthy infants aged three weeks to 37 weeks. Half of the babies usually slept prone (ie, on their stomachs) or had a history of turning prone during steep. The other babies had never slept prone. The researchers placed a moderately asphyxiating surface--a comforter over a foam rubber mattress with a two-inch-deep, circular depression--directly beneath the babies' faces. When babies steep face down on such a surface, they rebreathe air they have exhaled, which can contain high amounts of carbon dioxide. A catheter taped under the babies' noses allowed monitoring of carbon dioxide levels.

After four to five minutes of steeping face down on this surface, all 38 babies awoke and sought fresher air. The babies with experience steeping prone generally lifted and turned their heads to the side when they sensed the air was stale, increasing their supply of oxygen-rich air. Conversely, the inexperienced infants nuzzled the bedding or briefly rifted their heads and then resumed steeping face down. Overall, babies inexperienced with steeping prone spent more time fully face down than did babies who had slept prone.

Nuzzling produced only a brief reduction of carbon dioxide levers at the nose, whereas complete head turns resulted in larger, sustained decreases in carbon dioxide. Head tiffs also reduced carbon dioxide levels, but only as tong as the baby's head was raised.

The researchers suggest that babies Learn from experience which head movements decrease the discomfort associated with breathing high carbon dioxide levels; therefore, babies with experience steeping prone are better able to avoid conditions that may trigger SIDS. The research results support the theory that SIDS may result from insufficiently learned airway protective responses.

SIDS Risk Linked to Lack of Experience With Tummy-Sleeping (news release, St Louis: Washington University in St Louis School of Medicine, Dec 7, 2004) http://med news.wustl.edu/news/page/normal/441-6.html (accessed 9 Dec 2004).

COPYRIGHT 2005 Association of Operating Room Nurses, Inc.
COPYRIGHT 2005 Gale Group

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