The American Academy of Pediatrics modified its recommendations for preventing SIDS and sleep-related newborn fatalities in 2016. Despite the ongoing communication efforts, there appears to be a gap between public health recommendations to prevent SIDS.
What can you read in this article?
- What is Sudden Infant Death Syndrome (SIDS)?
- Causes of SIDS
- Can SIDS be prevented?
Promote safe sleeping environments, and what parents actually practice with regard to infant sleeping environments, as evidenced by the continued infant mortality statistics.
Around 196 babies or a rate of 0.28 deaths per 1,000 live births still die every year to SIDS in the United Kingdom in 2019, the Office for National Statistics in the UK said.
Also in 2019, about 170 or a rate of 0.27 per 1,000 live births unexplained infant deaths occurred in England and Wales. This, however, showed a decrease from 0.32 deaths per 1,000 live births in 2018.
Meanwhile, boys are more at risk of SIDS than girls with 55.3 percent or 0.29 per 1,000 live births happened in 2019. In the same year, the SIDS was highest for mothers aged under 20 with 0.96 deaths per 1,000 live births.
A statistic from The Center for Disease Control and Prevention in 2019 showed that there were about 1,250 deaths due to SIDS, about 1,180 deaths due to unknown causes, and about 960 deaths due to accidental suffocation and strangulation in bed in the United States.
In the Philippines, SIDS is not a commonly discussed topic, but it’s important to know what measures families can take to help reduce their baby’s risks.
What is Sudden Infant Death Syndrome (SIDS)?
Sudden Infant Death Syndrome or SIDS is part of a larger classification of unexpected infant deaths called Sudden Unexpected Death in Infancy.
SIDS, also known as crib or cot death, is the sudden and unexplained death of a baby between 1 and 12 months old. This usually happens while the baby is asleep. It is also considered one of the leading causes of death among infants.
What Causes SIDS?
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Although Sudden Infant Death Syndrome has been heavily studied by experts, the exact cause of SIDS is still unidentified. The lack of findings on immediate causes or warning signs of SIDS is what makes it so frightening and devastating.
No one knows for sure what causes SIDS. What we do know, however, is that SIDS victims stop breathing and lack the ability to alert themselves to start breathing again.
Many researchers and clinicians affirm that SIDS might be associated with abnormalities in the part of the infant’s brain. That is responsible for regulating breathing and sleep-wake function. However, this claim has yet been proven beyond doubt.
In 1994, Filiano and Kinney proposed the Triple-risk model for SIDS to explain how it occurs. The model poses that SIDS happens when these three conditions exist at the same time:
- The infant is exposed to exogenous stressors. Such as prone sleeping position, soft and loses bedding, exposure to secondhand smoke, or an upper respiratory infection;
- the baby has an underlying abnormality. Such as defects in the part of the brain that controls cardiac function and respiration;
- These conditions prevail during a vulnerable stage in the child’s development, especially during the first six months of life.
Does SIDS have symptoms?
Even with years of research given to find more about SIDS, there are still no easy answers when it comes to clearly identify symptoms. Although the exact cause of SIDS is unknown, certain risk factors have been identified:
Parental risk factors
- Babies who receive poor prenatal care
- Whose mothers smoked, drank alcohol, and consumed drugs during their pregnancy
- Babies born to mothers who are under the age of 20
Environmental and Physical risk factors
- Babies born prematurely or at very low birth weight.
- Babies exposed to certain stressors (such as sleeping tummy-down or on too soft bedding)
- Infants who become too hot or too cold while asleep.
- Babies with prolonged tobacco smoke exposure even after birth
- Who had an apparent life-threatening event (e.g. babies who have turned pale and required resuscitation)
- Babies who recently suffered from respiratory infections might experience breathing problems.
- SIDS is most prevalent in babies between the ages of two and four months, but there are more than a few cases each year in babies up to one year of age.
- Sex may be a factor as 3 out of 5 victims are boys.
- Babies born with underlying vulnerabilities and abnormalities (like brain and heart abnormalities and respiratory infections)
- Babies who have siblings or blood relatives who died from SIDS.
Can SIDS be prevented? Here are various ways to lower the risk of SIDS
The incidence of SIDS varies among countries and ethnic groups, and Asia has been reported to have very low incidence rates.
In the United States, SIDS is the leading cause of infant death in the developed world, with 1500 reported cases in 2013 alone, according to the CDC.
Also known as “crib death,” SIDS happens mostly during sleep. Infants who die of SIDS show no signs of suffering. SIDS isn’t an illness or disease, however. When the exact cause of an infant’s death cannot be determined by autopsy or investigation, SIDS is the diagnosis given.
While there’s no clear way to prevent SIDS from happening, there are a number of practical precautions parents can take to lower the risk of SIDS:
Put your baby to sleep on his back
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Babies placed on their stomachs or sides to sleep may have more difficulty breathing than those placed on their backs. This is because when infants sleep tummy-down, they’re more likely to overheat, breathe incorrectly, and re-breathe carbon dioxide air they’ve exhaled, which lacks oxygen.
If you’re worried about your baby developing a flat spot on his head after too much back time, you can always give your baby adequate amounts of tummy time while she’s awake and under your watchful eye.
So the next time yaya or lola insists on having the baby sleep on his tummy, gently take charge and say “No,” and tell them to wait until your baby is older and has more control over his body.
By the time your baby can roll over both ways, they may not stay on their back. Don’t worry! That’s normal for babies around 6 months. It’s okay to let them determine their own sleeping position once they are able to roll over.
Choose your bedding wisely
When buying baby bedding, go with the basics: a firm mattress, a fitted sheet, and as little blankets, quilts, and fluffy padding as possible. Choosing appropriate bedding for infants will prevent smothering or suffocation.
Make sure to clear the crib of any linens, pillows, or stuffed toys that can accidentally move and block the baby’s airways during sleep. Should you give your baby a blanket, make sure it’s breathable, in case your baby wiggles under it or pulls it over his head.
Remove the bumper pad
And most importantly, avoid using bumper pads in cribs. Doing so will decrease the risk of strangulation and entrapment, increase airflow into the crib, and let you see your baby without any obstruction.
Co-sleep with your baby
There has been a lot of debate with co-sleeping and SIDS, but recent studies show that the rate of SIDS is lowest in cultures, such as in Asia, that traditionally share sleep. Not only does co-sleeping strengthen the bond between parents and babies, but it also helps babies sleep better and more soundly.
Make sure your mattress is firm, that there’s enough space for you and your, and that there’s nothing that will obstruct your baby’s breathing.
If you’re not ready to co-sleep, just move the baby bassinet or crib closer to your bed. Always remember to trust your parental awareness – your bodies are so attuned to your newborn that you’ll wake up with even the slightest bit of uneasiness in your child.
Don’t overheat your baby
In a tropical country like ours where it’s hot every day of the year, there’s really a risk of overheating a newborn, especially when we alternate between air-conditioned and non-air-conditioned rooms. It’s best to watch for signs of overheating like sweating and damp hair.
Make sure your baby’s room is cool, and not too warm or stuffy. Hot stuffy air makes it more difficult to breathe.
Unless your baby’s a premie, don’t over-layer baby clothing and swaddles. Dress your baby in comfortable and light clothes for sleeping.
You may use onesies or pajamas to cover arms, legs, hands, and feet if your concern is about keeping your baby warm. Instead of using a regular blanket, place them in a sleep sack or a wearable blanket.
Don’t cover your baby’s head. And to be sure, take your baby’s temperature now and again and make sure their body heat stays at a constant 36 degrees Celsius.
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Breastfeed, breastfeed, breastfeed
You all know about the benefits of breastfeeding, and reducing the risk of SIDS is actually one of them. The protective effect is strongest if you breastfeed your baby exclusively for six months.
But even some breastfeeding is better than none – exclusively breastfeeding until 1 month of age already cuts the risk of SIDS in half.
Combining all these precautions with proper immunizations, infant care, regular pedia visits, and a good, clean environment (free of tobacco smoke, alcohol, and drugs) will give you the upper hand when it comes to avoiding Sudden Infant Death Syndrome. In SIDS’ case, prevention is definitely key.
Offer a pacifier
Let your baby use a pacifier to soothe themselves to sleep. The sucking reflex aids in consistent breathing.
For breastfeeding mothers, wait until the infant is regularly breastfed (not less than 1 month old) before using a pacifier. Your baby might experience nipple confusion if you introduce a pacifier too soon. Your child then would rather have the pacifier’s nipple instead of your own.
You may put the pacifier on the infant’s mouth when you put them to sleep. After they fall asleep, it is best not to put it back in their mouth.
Make sure that you keep the pacifier clean by sterilizing it. Buy a new one if it is already damaged. Avoid putting any coating in the pacifier. Don’t compel your baby to use a pacifier if they don’t like it.
Common concerns related to SIDS
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Flat head syndrome (positional plagiocephaly)
Some parents might worry if their babies would develop a flat spot on the back of their heads because of spending too much time lying on their backs.
However, this can be treated easily. You can change your baby’s position and allow more supervised “tummy time” while your baby is awake.
Spitting up or vomiting
Spitting up or vomiting while babies are sleeping on their backs is one of the things that parents also worry about. Take comfort in knowing that there is no increased risk for choking for healthy infants who sleep on their backs.
The same goes even for most babies with gastroesophageal reflux (GER). On the other hand, experts suggest that babies experiencing some types of rare airway problems sleep on their stomachs.
Take note of these life-saving interventions. Spread the word to other parents so they can also protect their babies from the risk of SIDS. Hopefully one day, we will know a definite cause for this tragic disease, which will lead to a definite cure.
It happens in the best of circumstances
While it is important for you to follow the safety guidelines for the prevention of SIDS, the fact is that some babies who die from SIDS die in spite of their parents doing everything right.
This silent epidemic takes away the lives of thousands of infants every year which leaves behind grief-stricken parents. Tormenting questions such as “why did this happen?” or “what did I do wrong?” haunts every parent who encounters SIDS.
You may think that SIDS may be one of the worst nightmares of a parent. Maybe you have encountered a relative or a friend unprepared for the tragedy. And now you are wondering how you can be of great help to that friend or relative during these difficult times.
They are in dire need of support not only during the days after the death of their baby but for at least several months. The length of time of having social support will help them get through their grief and be free from guilt feelings. This might involve home visitations, and talking to counselors or lay ministers.
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