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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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Bed sharing increases sudden infant death syndrome risk - Brief Article
From AORN Journal, 6/1/03

Sharing a bed with other children, sleeping on soft bedding, and sleeping on the stomach all increase infants' risk of sudden infant death syndrome (SIDS), according to a May 5, 2003, news release from the National Institutes of Health. Researchers studied the 260 SIDS deaths of infants from birth to one year of age that occurred in Chicago between November 1993 and April 1996. The infants were predominantly African American. Information about each infant who died from SIDS was compared to information for a live infant of comparable age, birth weight, and racial or ethnic group.

Infants who died of SIDS were 5.4 times more likely to have shared a bed with other children. Sleeping with a mother alone or with a mother and father also were associated with risk for SIDS, but the results were not statistically significant.

Two known risk factors for SIDS--sleeping on soft bedding and sleeping on the stomach--were found to pose a much greater risk if they occurred together. Soft bedding poses five times the risk of firm bedding, and sleeping on the stomach increases the risk 2.4 times compared to sleeping on the back. Infants who slept both on soft bedding and on their stomachs, however, had 21 times the risk of those who slept on firm bedding and on their backs. Fifteen of the SIDS deaths occurred after a child was put to sleep on a sofa. The researchers do not know why sleeping on a sofa increases the risk for SIDS; however, they warned that this practice appears to be dangerous.

Bed Sharing with Siblings, Soft Bedding, Increase SIDS Risk (news release, Bethesda, Md: Notional Institutes of Health, May 5, 2003) http://www.nih.gov/news/pr/may 2003/nichd-05.htm (accessed 7 May 2003).

COPYRIGHT 2003 Association of Operating Room Nurses, Inc.
COPYRIGHT 2003 Gale Group

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