Sudden Infant Death Syndrome (SIDS) is the leading cause of death in healthy infants under age 1 year. It is the terms used to describe the sudden death of an infant under one year of age when a cause cannot be found when a thorough postmortem examination is performed. 20% of all episodes of SIDS occur when a child is being cared for by someone other than the parent. This is the time when protective strategies such as the “Back to Sleep” position is not used and the infant is placed on their tummy to fall asleep. Infants is accustomed to sleeping on their backs are 18 times more likely to die from SIDS if they are placed to sleep on their tummies. SIDS is not caused by immunizations, vomiting or choking and the risk can be limited by maintaining safe sleep practices and a safe sleep environment.
The peak age range is from 1-4 months and males infants are at greater risk than females. Premature or low birth weight infants and those infants with a history of apnea are at greatest risk. Other risk factors include infants born to mothers who smoke or use drugs, African Americans or those with Native American or Native Alaskan heritage. The fall and winter months are the highest risk periods and siblings of a baby who died from SIDS are at greater risk.
The use of a “Back to Sleep” position and the avoidance of soft bedding will alleviate some of the risk as will the avoidance of an excessively warm room or being over swaddled. Do not let your infant get too hot. If you notice your infant has damp hair, is flushed or has been sweating then dress your infant lighter. Set the room temperature in a range that is comfortable for a lightly clothed adult. Babies do not need warm rooms. Environmental tobacco smoke must also be avoided. The rate of SIDS decreased by more than 50% after the “Back to Sleep” campaign was started. One of the new risk factors, especially for infants under age 2 months, is bed-sharing or sleeping in an adult bed with soft bedding or a soft mattress. Side sleeping is not as safe as back sleeping and should be avoided. Infants can easily roll over to a face down position and the use of special equipment to position your infant on the side is unsafe. Keep all quilts, pillows, and stuffed animals out of cribs.
Tummy time is important for your infant but should be used when your infant is supervised and awake. It should be integrated into your daily activities. Tummy time helps to build strong neck and shoulder muscles. This position allows your infant to develop new skills which will allow a proper progression of developmental milestones.
Parents often raise the question of home apnea monitors to prevent SIDS. Home apnea monitors are not prescribed to prevent SIDS. They are used for infants who are at risk for apnea or bradycardia due to an underlying condition. Apnea is the name given to a pause in breathing and bradycardia is a slowing of the heart rate below a normal level for your infant. Apnea and bradycardia may be associated with cyanosis. Cyanosis is the name given to a bluish hue to your child’s lips or skin. Possible physical causes for apnea include prematurity, anemia, gastroesophageal reflux (GER), bronchospasm, lung disease and seizures. Infants with these conditions may be treated with medication and discharged home on a home apnea monitor. They also may have a a sleep study performed. It is called polysomnography or a pneumogram and it monitors your infant’s breathing and heart rate over a 12 or 24 hour period. If your infant is prescribed a home apnea monitor then you will be instructed in its use. You will want to use it whenever your baby is sleeping and when you are busy and not directly with your infant. During alert periods or when you are with your baby or when you are in an active play activity or bathing your infant the monitor is not needed.