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Sudden Infant Death Syndrome (SIDS) |
One of the most devastating tragedies that can befall young parents is the sudden death of their infant. When the death is unexplained by history or a thorough examination, including an autopsy, it is defined as Sudden Infant Death Syndrome (SIDS). SIDS is the leading cause of death in infants between the ages of one month and 12 months or even beyond. This translates into one-third to half of all deaths in the one month to one year age group. Here is a detailed note for parents and care-givers to look out for this danger and adopt simple ways to avoid the hurt and anguish of losing a new born.
 Description of Sudden Infant Death Syndrome (SIDS)
The peak age for SIDS is two to four months, and it most often occurs during sleep. More cases happen during winter months, but SIDS can occur any time of year. Certain groups of infants are at a somewhat higher risk, including premature infants, boys, and infants born to substance-abusing mothers. Other risk factors are exposure to tobacco smoke and prone sleeping position (face down). There are currently no diagnostic tests to identify individual infants at risk.
There is often little or no warning for the shocked parents, with less than 10 percent of SIDS victims having had a history of apparent life threatening events (ALTEs). ALTEs are characterized by some combination of apnea (cessation of breathing), colour change (usually pale or blue/gray), and choking or gagging, and are understandably frightening to the observer, who may fear that the infant has died. Previous terms to describe these incidents as "aborted crib death" or "near death" wrongly imply a close association between ALTEs and SIDS. In fact, most infants with an ALTE do not subsequently have SIDS.
Causes
The cause of SIDS is unknown. In fact, it is likely that SIDS is the end result of many different processes and this is what makes prevention of all SIDS a difficult task. Some possible causes are:
| 1. |
The underlying mechanism for these cases of SIDS appears to be an abnormal response to stressors such as changes in blood levels of oxygen or carbon dioxide. This may explain the high frequency in the first half year of life that subsequently declines with increasing developmental maturity. If parts of the baby's brain that regulate breathing remain immature (possibly due to delayed development) it is likely that the baby may suffer shorter bouts of oxygen resulting in shortage. |
| 2. |
Strain on the body and SIDS may also result in the following ways:
- If the body becomes overheated due to faulty body temperature control. Over-swaddling or heavy bedding may make the body work too hard to keep down body temperature.
- If the baby is overweight at birth, slow to gain weight or premature - or have lung disorders
- If the baby has serious apnea (temporary breathing stoppage or a flaw in breathing control.) with signs of "blue spells" |
| 3. |
Specific heart dysrhythmia called prolonged QT syndrome. Although this can be screened for, it is unclear what the exact risk is and if treatment would be successful. |
| 4. |
Metabolic defects may also lead to SIDS. |
| 5. |
Smoking by either parent as well as secondhand smoke are clearly linked with SIDS. |
| 6. |
Unfortunately, some cases of SIDS are due to infanticide- or willful killing of infants and in our country predominantly, baby girls. This is a crime and makes a thorough examination of each case all the more important. |
| 7. |
New evidence suggests that a subtle form of suffocation may be the true culprit in one-quarter to one-half of all suspected SIDS cases. There is strong evidence that the prone position in which babies sleep (face down) is associated with SIDS. |
Tips for parents
Let the baby fuss on his or her back (for no more than a few minutes) during the first few months of life before calming him down and trying again. If you try for 20 to 30 minutes three nights in a row and the baby still will not go to sleep on his back, let him fall asleep on the stomach and then turn him onto his back or wait a few days and try positioning her/him again. Parents can place special soft wedges on the baby's sides that help maintain the baby's position on the back or side. Furthermore, babies should not be placed asleep on any blankets or with any pillows or stuffed animals. The goal is to not have any objects that can block the baby's face and hinder breathing.
Home monitoring has long been utilized as a preventive measure in higher risk children and those who have already experienced an ALTE. However, there is almost no evidence to suggest that home monitoring is effective for this purpose.
Precautions to reduce the chance of SIDS
| 1. |
Ensure good medical care and adequate nutrition during pregnancy. |
| 2. |
Keep the baby in smoke-free surroundings. |
| 3. |
Put the baby to sleep on a firm mattress. |
| 4. |
Breastfeed, as far as possible. |
| 5. |
If "blue spells" (disolouration of any part of the body, especially face) are noticed in the infant, get prompt medical advice. |
| 6. |
Try not to let the baby get too hot (don't over-swaddle). |
| 7. |
Never have the infant's face covered by bedclothes. |
| 8. |
Avoid thick blankets, pillows or soft toys in the sleeping area or crib. |
| 9. |
Try not to let the infant sleep on the stomach. |
| 10. |
Put the baby to sleep on the side or back. A rolled-up towel along the back will help to keep the baby in the same position. |
Babies seem to be at above-SIDS risk where the following conditions are present:
| 1. |
Winter-time |
| 2. |
Mothers, fathers and care-givers do not smoke cigarettes or beedi during and after pregnancy |
| 3. |
Mothers, fathers and care-givers are not drug addicts |
| 4. |
Mothers receive sufficient health care while pregnant (including good uterine care) |
| 5. |
Breast-feeding rather than bottle-feeding |
Keep watch over movements
| Head support, followed by crawling, and a baby's first few steps should be followed by chiropractic checkups. If neglected, the bumps and falls during this period of rapid growth may lead to serious spinal deformities later in life. This can set the stage for scoliosis, "growing pains," and a weakened immune system. |
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