Tuesday, April 2, 2013

SIDS: How to minimize your infant's risk

Sudden infant death syndrome (SIDS) is defined as the "sudden death of an infant younger than one year of age, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history."

SIDS is the leading cause of death for infants between 1 month and 12 months of age and is most common between 1 to 4 months old, with 90% of cases occurring before 6 months old.

Fortunately, the SIDS rate in the United States has dropped significantly over the last 30 years. The greatest reduction occurred in the first 10 years after the American Academy of Pediatrics (AAP) started the "Back to Sleep" campaign to reduce the risk of SIDS which recommends placing infants in a supine position (on the back) for sleep. Between 1992 and 2001, the SIDS rate in the United States fell from 0.12% to 0.06%, while the proportion of infants sleeping in the supine position increased from 13% to 72%.

More than 95% of SIDS cases are associated with one or more risk factors, and in many cases, the risk factors are modifiable (usually sleeping position, sleep environment, or parental co-sleeping).

Major Pre-natal SIDS Risk Factors:
-Young maternal age (less than 20 years old)
-Maternal smoking during pregnancy
-Late or no prenatal care
-Preterm birth and/or low birth weight

MajorPost-natal SIDS Risk Factors
-Sleeping on stomach
-Sleeping on a soft surface and/or with bedding accessories such as loose blankets and pillows
-Bed-sharing (sleeping in parents’ bed)

SIDS Risk Reducers
The following factors are somewhat protective against SIDS. However, these effects are outweighed by the modifiable risk factors described above:
-Breastfeeding (36% lower risk of SIDS, if BF lasts more than 1 mo)
-Room-sharing without bed-sharing
-Pacifier use that does not interfere with the establishment of breastfeeding.
-Fan use

In summary, infants whose mothers received appropriate prenatal care and who sleep on their backs in an appropriate sleep environment (see first link below for picture), are breastfed beyond 1 month old, and have never been exposed prenatally or postnatally to tobacco smoke are at the lowest risk for SIDS.

Take a look at the following links for more information:





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5/7/13 Addendum

Here is a link to the recent FDA warning to NOT use infant sleep positioners because of the risk of death by suffocation.