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...
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.
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