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Sudden infant death syndrome (SIDS) is any sudden and unexplained death of an apparently healthy infant aged one month to one year. The term cot death is often used in the United Kingdom, and crib death in North America. more...
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Diagnosis
SIDS is a definition of exclusion and should only apply to an infant whose death is sudden and unexpected, and remains unexplained after the performance of an adequate postmortem investigation including:
an autopsy,;
investigation of the scene and circumstances of the death, and;
exploration of the medical history of the infant and family.;
Generally, but not always, the infant is found dead after having been put to sleep and exhibits no signs of having suffered.
The inexplicability of SIDS often leaves the parents with a deep sense of guilt in addition to their grief.
Statistics
SIDS is responsible for roughly 50 deaths per 100,000 births in the U.S. It is responsible for far fewer deaths than congenital disorders and disorders related to short gestation; though it becomes the leading cause of death in otherwise healthy babies after one month of age.
The frequency of SIDS appears to be a strong function of infant sex (61% male) and the age, race, education, and socio-economic status of the parents.
Risk factors
Very little is known for sure about the possible causes of SIDS; there is no proven method for complete prevention. Listed below are several factors associated with increased probability of the syndrome.
Prenatal risks
inadequate prenatal care;
inadequate prenatal nutrition;
tobacco smoking;
use of heroin;
teenage pregnancy;
less than a one year interval between subsequent births;
Post-natal risks
low birth weight (especially less than 1.5 kg (~3.3 lb);
exposure to tobacco smoke;
laying an infant to sleep on his or her stomach (see positional plagiocephaly);
failure to breastfeed;
excess clothing and overheating;
excess bedding, soft sleep surface and stuffed animals;
gender (61% of SIDS occur in males);
age (incidence rises from zero at birth, is highest between 2-4 months and goes towards zero at one year);
Research on co-sleeping indicates an excess risk with an adjusted Odds-Ratio of 2.71 (Vennemann et al., Acta Paediatr. 2005 Jun;94(6):655–60.) There is a good deal of debate and discussion in the medical literature about this (see below). For example, though findings are still preliminary and unpublished, the proximity of a parent's respiration is thought by some to stimulate proper respiratory development in the infant. It is interesting to note that the first epidemiologic investigation of sudden unexpected infant deaths by Templeman in Dundee in 1892 were shown to be probably from suffocation by overlaying (Williams et al., Sudden unexpected infant deaths in Dundee, 1882-1891: overlying or SIDS? Scott Med J. 2001 Apr;46(2):43–7).
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