What Is SIDS and How Can I Protect My Baby?

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One of the most devastating things parents (and pediatricians) have to go through is losing a baby to SIDS (sudden infant death syndrome). To do everything we can to prevent this, we at Westchester Health Pediatrics offer this information to educate parents about SIDS so that we can lower, and hopefully eliminate completely, the risk of this happening to any baby.

What causes SIDS?

Lauren Adler, MD, FAAP

Sudden infant death syndrome (SIDS) is the unexplained death, usually during sleep, of a seemingly healthy baby less than a year old. SIDS is sometimes called “crib death” because the infants often die in their cribs. What makes SIDS so frightening is that it strikes babies who seem to have nothing wrong with them, typically without warning.

Most SIDS deaths occur between 2-4 months of age, and they increase during cold weather. African-American infants are twice as likely and Native American infants are three times as likely to die of SIDS as Caucasian infants. Also, more boys than girls die of SIDS.

As far as what causes SIDS, many experts blame stomach sleeping. Numerous studies have found a higher incidence of SIDS among babies put to sleep on their stomachs compared to those put to sleep on their backs or sides. Researchers think that stomach sleeping puts pressure on a baby’s jaw, thereby narrowing the airway and impeding breathing, which leads to death.

Another theory is that stomach sleeping can increase an infant’s risk of “rebreathing” his/her own exhaled air, particularly if the infant is sleeping on a soft mattress or with bedding, stuffed toys or a pillow near the face. The conclusion is that the soft surface creates a small enclosure around the baby’s mouth that traps exhaled air. As the baby breathes this “stale” air, the oxygen level in his/her body drops and carbon dioxide accumulates. Eventually, this lack of oxygen could contribute to SIDS.

And yet another hypothesis is that infants who succumb to SIDS may have an abnormality in the part of their brain that helps control breathing and waking during sleep. If a baby is breathing stale air and not getting enough oxygen, the brain usually triggers him/her to wake up and cry, which reverses the lack of oxygen. A problem in the brain, however, could negate this involuntary reaction and put such a baby at greater risk for SIDS.

How to know if your baby is at risk of SIDS

At Westchester Health Pediatrics, what we tell parents who are concerned about SIDS is that there is no single risk factor that causes it. Instead, a combination of several risk factors may cause an at-risk infant to die of SIDS.

Physical factors that can make an infant more vulnerable to SIDS:

  1. Brain abnormalities. Some infants are born with problems that make them more likely to die of SIDS. It is believed that the portion of the brain that controls breathing and arousal from sleep does not work properly.
  2. Low birth weight. Premature birth or being part of a multiple birth increases the likelihood that a baby’s brain doesn’t mature completely, resulting in less control over such automatic processes as breathing and heart rate.
  3. Respiratory infection. Many infants who died of SIDS had recently had a cold, which may contribute to breathing problems.
  4. Boys are more likely to die of SIDS.
  5. Infants are most vulnerable during the 2nd and 3rd months of life.
  6. For reasons we don’t understand, African-American, American Indian and Alaska Native infants are more likely to develop SIDS.
  7. Family history. Babies who’ve had siblings or cousins die of SIDS are at higher risk themselves.
  8. Secondhand smoke. Babies who live with smokers have a higher risk of SIDS.

Environmental factors that can increase an infant’s risk of SIDS:

  1. Sleeping on stomach or side. Babies who are placed on their stomachs or sides to sleep may have more difficulty breathing than those placed on their backs.
  2. Sleeping on a soft surface. Lying face down on a fluffy comforter or a waterbed can block an infant’s airway. Draping a blanket over a baby’s head also is risky.
  3. Sleeping with parents. While the risk of SIDS is lowered if an infant sleeps in the same room as his or her parents, the risk increases if the baby sleeps in the same bed, partly because there are more soft surfaces to impair breathing.

Maternal risk factors that can increase an infant’s risk of SIDS:

During pregnancy, the risk of SIDS increases if the mother:

  1. Is younger than 20
  2. Smokes cigarettes
  3. Uses drugs or alcohol
  4. Has inadequate prenatal care

10 things you can do to reduce the likelihood of your baby dying from SIDS

  1. Place your baby to sleep on his/her back, every time. Babies up to 1 year of age should always be placed on their backs to sleep during naps and at night. However, if your baby has rolled from his back to his side or stomach on his own, he can be left in that position if he is already able to roll from tummy to back and back to tummy. If your baby falls asleep in a car safety seat, stroller, swing, infant carrier or infant sling he/she should be moved to a firm sleep surface as soon as possible.
  2. Place your baby to sleep on a firm sleep surface. Your crib, bassinet, portable crib or play yard should meet current safety standards. Check to make sure the product has not been recalled. Do not use a crib that is broken or missing parts, or that has drop-side rails. Cover the mattress that comes with the product with a fitted sheet. Do not put blankets or pillows between the mattress and the fitted sheet. Most important: Never put your baby to sleep on a chair, sofa, water bed, cushion or sheepskin. For more information about crib safety standards, visit the Consumer Product Safety Commission website at www.cpsc.gov.
  3. Keep soft objects, loose bedding or any objects that could increase the risk of entrapment, suffocation or strangulation out of the crib. Pillows, quilts, comforters, sheepskins, bumper pads and stuffed toys can cause your baby to suffocate so keep them out of the crib.
  4. Place your baby to sleep in the same room where you sleep but not the same bed. Babies who sleep in the same bed as their parents are at greater risk of SIDS, suffocation or strangulation. Parents can roll onto babies during sleep or babies can get tangled in the sheets or blankets.
  5. Breastfeed as much and for as long as you can. Studies show that breastfeeding your baby can help reduce the risk of SIDS.
  6. Keep up with all well-baby visits. Your baby needs important immunizations and other crucial health checks at regularly scheduled well-baby visits.
  7. Don’t smoke around your baby and keep him/her away from smokers and places where people smoke. If you smoke, quit. Plus, don’t allow anyone to smoke near your baby, even if he/she is outside.
  8. Don’t let your baby get too hot. Keep the room where your baby sleeps at a comfortable temperature. In general, dress your baby in no more than one extra layer than you would wear. If you are worried that your baby is cold, dress him/her in clothing designed to keep babies warm but that doesn’t cover their heads.
  9. Offer a pacifier at naptime and bedtime. Studies show that this helps reduce the risk of SIDS.
  10. Do not use products that claim to reduce the risk of SIDS. Products such as wedges, positioners, special mattresses and specialized sleep surfaces have not been shown to reduce the risk of SIDS. In addition, some infants have suffocated while using these products.

Make sure your baby has lots of “tummy time”

At Westchester Health Pediatrics, we tell all our parents to give their babies plenty of tummy time when they are awake. This helps strengthen the neck muscles and avoids flat spots on the head. However, always stay with your baby during tummy time and make sure he/she is awake. If your baby falls asleep on his/her tummy, gently roll him/her over onto his/her back.

If you are worried about SIDS, come see us.

At Westchester Health Pediatrics, one of our most important goals is to do everything we can to prevent SIDS. Also, we want to give our parents peace of mind during the first crucial months of their baby’s life. If you’re concerned about the possibility of SIDS, please come in and meet with us. We have lots of advice, guidance and support from our years of experience with all kinds of babies, and we want to help you with yours. Whenever, wherever you need us, we’re here for you.

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By Lauren Adler, MD, FAAP, pediatrician with Westchester Health Pediatrics, member of Northwell Health Physician Partners

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About the Author: ML Ball