SIDS: Every New Parent’s Greatest Fear

healthy babyDear Mr. Dad: A few years ago, my sister’s three-month old infant died from Sudden Infant Death Syndrome. My baby is now the same age, and I’m in a panic worrying that the same thing will happen to him. I’m not even sure I understand what SIDS is and what the risk factors are. More importantly, is there anything my wife and I can do keep my son from suffocating to death?

A: In the U.S., around 4,000 babies die from Sudden Infant Death Syndrome every year—that’s about one death per thousand births. That makes SIDS the most common cause of death of children between one week and one year old. Before we get to risk factors and how to reduce them, we need to clear up a big misconception: SIDS is not “suffocating to death.” According to First Candle (firstcandle.org), SIDS is “the sudden, unexpected death of an apparently healthy baby under one year of age,” whose death remains unexplained even after an autopsy.

Unfortunately, despite millions of dollars spent on research, there’s no consensus on what causes SIDS. However, many experts believe that the most likely culprit is the baby’s failure to wake up when a breathing problem (such as sleep apnea) happens during sleep. There aren’t any medical tests than can reliably identify high-risk babies. But here are some of the known risk factors.

  • Certain types of brain abnormalities increase SIDS risk.
  • SIDS is most common in babies two to four months old. Ninety percent of deaths happen to babies under six months.
  • SIDS takes more boys than girls. Multiple-birth babies and preemies are also at higher risk.
  • African American and American Indian babies are more likely than white babies to die of SIDS.
  • It’s more common in cold weather when respiratory infections are more likely.
  • It’s more common in families where one or both parents smoke, share a bed with their baby, put the baby to sleep on his or her stomach, overdress the baby, or cover him or her with fluffy bedding.

Despite all those risk factors, SIDS remains unexplained, which means that most babies who succumb to it don’t fall into any of the above categories. There’s no surefire way to prevent SIDS. But there are a number of proven ways to reduce the risks.

  • Put your baby to sleep on his back. Until about 1994, doctors thought that babies who slept on their back would choke on their vomit if they spit up. It turns out that babies are smart enough to turn their heads. SIDS deaths are more than 40% lower now than before the recommendations changed.
  • Don’t smoke and don’t let anyone who does near your baby. Babies exposed to cigarette smoke (even before birth) are at high risk for SIDS. According to the CDC, chemicals in cigarette smoke may interfere with babies’ ability to regulate their breathing.
  • Don’t overdress the baby. A number of studies show that overheated babies can fall into a deep sleep that’s hard to wake from.
  • Put the baby to sleep on a firm mattress: no pillows, fluffy blankets, plush sofas, waterbeds, shag carpets, or beanbags.
  • Give your baby a pacifier at bedtime. A number of studies show that pacifier use greatly reduces SIDS risk. That may be because it helps keep airways open or because pacifier-sucking babies may sleep less deeply. But does it really matter why?
  • Encourage your wife to breastfeed. Research shows that breastfed babies are 60% less likely than formula-fed ones to die from SIDS. They also tend to be lighter sleepers. Plus, breastmilk strengthens the baby’s immune system, which is always a good thing.
  • Don’t panic. SIDS is a devastating, horrible experience for any parent, but try to remember that 999 out of 1,000 babies don’t die of it.

Photo credit: Unsplash.com/Giu Vicente

Bed-Sharing Remains Greatest Risk Factor For Sleep-Related Infant Deaths

Sudden infant death syndrome (SIDS) and other sleep-related causes of infant mortality have several known risk factors, but little is known if these factors change for different age groups. In a new study in the August 2014 Pediatrics, “Sleep Environment Risks for Younger and Older Infants,” published online July 14, researchers studied sleep-related infant deaths from 24 states from 2004-2012 in the case reporting system of the National Center for the Review and Prevention of Child Deaths. Cases were divided by younger (0-3 months) and older (4 months to one year) infants. In a total of 8,207 deaths analyzed, majority of the infants (69 percent) were bed-sharing at the time of death. Fifty-eight percent were male, and most deaths occurred in non-Hispanic whites. Younger infants were more likely bed-sharing (73.8 percent vs. 58.9 percent), sleeping on an adult bed or on/near a person, while older infants were more likely found prone with objects, such as blankets or stuffed animals in the sleep area. Researchers conclude that sleep-related infant deaths risk factors are different for younger and older infants. Parents should follow the American Academy of Pediatrics (AAP) recommendations for a safe sleep environment and understand that different factors reflect risk at different developmental stages.

Co-sleeping/bed sharing

Dear Mr. Dad: My wife and I are looking into “co-sleeping” with our new baby girl. When I told a neighbor of mine, she shook her head and said it was too risky and would “spoil” her, causing later behavior problems. What are the risks, the benefits, and what should we do?

A: Co-sleeping, or sleeping with an infant in your adult bed, is one of the many parenting ideas that has passionate advocates and just-as-passionate detractors. The two sides are usually framed in extremes, as if you’re evil if you do it – or evil if you don’t. Obviously, it’s not that simple. As you noted, it’s best to learn the risks and benefits so you can make an informed decision.

Although it has only recently re-entered the conversation in North America, co-sleeping is not some newfangled idea. Outside of the English-speaking world it’s the norm, and before the 20th century it was standard pretty much everywhere (although it’s worth mentioning that in many countries, people share a bed with their children because the entire family lives in a single room).
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