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

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Parental Blind Spots Can Be Deadly

Dear Mr. Dad: There are a lot of news items these days about how little parents know about what their kids are up to. Take the Florida girl who committed suicide after being bullied. How could the parents of the bullies be so ignorant?

A: In previous columns, I’ve written about the strange phenomenon of parents not recognizing (or admitting) when their children are obese. That willful blindness makes it impossible for those kids to get the help they need. We’ve also talked about how most parents believe that their children are smarter than they actually are. Why are we so in the dark? I think it’s because we want to see only the best in our children—and we ignore anything that challenges our fantasies. Let me give you a few more examples:

  • Internet dangers. You’d think that with all the coverage of cyberbullied kids who commit suicide and others who use social media to post their intention to shoot up their school, parents would pay more attention to what their children are doing online. Sadly, the parents of those two Florida cyber-murderers (let’s be honest, that’s exactly what they are), are far from alone. A recent study published in the Journal of Computer-Mediated Communication found that parents often have no ideas of what their kids are doing online until it’s too late. For example, while 30% of young people say they’d been cyberbullied, only 10% of parents said they were aware. And while 15% of children admitted that they were the ones actually doing the cyberbullying, fewer than 5% of parents knew.
  • Asthma medication. Most parents of young children who take inhaled asthma medication don’t know what to do to make sure their child takes the medication properly. There are 10 steps parents need to go through. In a recent study of 169 caregivers of children 2-9 who had been hospitalized for asthma and required ongoing asthma treatment, only one knew all of the steps. Out of those 10, five are considered essential, but only four caregivers knew those. Although asthma is quite common, it can be deadly when symptoms are severe enough. And not properly using asthma inhalers means that the child isn’t getting medication he or she needs.
  • Infants must sleep on their back. In 1994, the government’s “Back to Sleep” campaign announced that parents should put their babies to sleep on their back, not on their stomach as the previous conventional wisdom dictated. In the years since, the incidence of Sudden Infant Death Syndrome (SIDS) has dropped by more than 50%.However, more than a quarter of parents are still not putting their babies down on their back. According to Eve Colson, lead author of a recent study tracking baby sleep positions, “African Americans still lag behind caregivers of other races by about 20 percent in following this practice.” One of the most important predictors of whether caregivers will put babies down to sleep on their back is whether he or she got a recommendation from a doctor.
  • Pregnant women shouldn’t smoke. This one seems obvious, but a lot of women still haven’t gotten the message. Smoking during pregnancy has been shown to increase the pregnancy complications, risk of preterm delivery, smaller fetal and infant size, birth defects, and even infant death. Despite all that, the CDC estimates that the percentage of women who smoke during pregnancy has remained at about 13% for quite some time. The percentages vary greatly by state, ranging from a low of 5.1% in Utah and 6.8% in New Jersey, up to 19.7% in Tennessee and 28.7% in West Virginia. Unbelievable.

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