Sudden Infant Death Syndrome

S.I.D.S.

Definition of SIDS

The sudden and unexplained death of an infant under one year of age. – Leading cause of death in infants under 12 months

Outline

Historical Perspective Proposed Causes and Symptoms Treatment Prevention

Historical Perspective

“And this woman child died in the night; because she has over laid it” 1 Kings 3:19-20

1291 a German poster forbid mothers from taking their infants under 3 years of age to bed with them.

Late 1800’s SIDS was first defined “Sudden and Unexplained Death in Children”

Proposed Causes (External/Internal)

Tiny hemorrhages Asphyxiation Immune System

Disorders Apnea Hypothesis

Sleep position Temperature Smoke/Narcotics Bedding

Sleep Position

The baby is in the prone position (Lying on its stomach)

Temperature

The temperature of the environment would determine how warmly the infant is dressed or how tightly a blanket is wrapped around the infant.

Smoke/Narcotics

The presence of smoke during pregnancy increases the infants chance 3 times for having SIDS.

The use of narcotics during pregnancy increases the infants chance 10 times for having SIDS.

Bedding

Improper bedding such as a too soft mattress or a big fluffy blanket could cause the infant to inhale stale air during the night.

Tiny Hemorrhages

Autopsy’s revealed that tiny hemorrhages inside of the babies chest could be responsible for congestion in the lungs during the night.

Asphyxiation

Asphyxiation by carbon dioxide is associated with soft bedding because the infant only breathes in stale air (containing mostly carbon dioxide) throughout the night, and does not receive the proper amount of oxygen.

Immune System Disorders

Infants who have an immune system disorder are at higher risk than those who do not, because it is likely to cause a change in heart rate during the night.

*Apnea Hypothesis

The cessation of airflow to the nose and mouth (central apnea)– The pause is called central and usually last for

about 15 seconds

Most widely accepted hypothesis

Sleep Apnea Hypothesis

There is an abnormality in the regulation of the breathing activity that leads to prolonged central apnea, hypoxia which leads to coma, death

Treatment

Because SIDS has no known cause and happens randomly there is no treatment available.

Prevention

Lying the infant on its back during sleep Proper bedding Controlled environment temperature Good prenatal care Avoidance of smoke and narcotics Monitors Co-sleeping with parents

Co-Sleeping

Co-sleeping is widely believed to be a prevention of SIDS

Case Study

In Zimbabwe SIDS practically does not exist. English pediatrician Duncan Keely found that

infants almost always sleep with their mothers, at least until 6 months of age.

What does Co-sleeping do?

Allows for the mother and infant to interact their breathing patterns.

Exchange sensory stimuli such as sound, movement, touch, vision, gas, and temperature.

Infants spend less time in the deep stages of sleep. Allows the baby to be near the mother for breast

feeding during the night.

Teddy Bear Experiment

A special teddy bear was developed to reflect the babies breathing pattern

Babies showed quieter sleeping patterns The teddy bear apparently facilitates

neurobehavioral development.

Breast feeding

Human milk provides less calories than formula, which indicates the need for more frequent feedings.– More frequent contact with mother

Natural Selection and SIDS

When an infant is separated from its caregiver, its natural instinct is to protest (cry).

Natural selection probably favored the infants who protested.

Case Study (parent-infant separation)

When monkey infants were separated from their caregivers for as short as 3 hours, they experienced significant effects such as:– Decrease in body temp.– Release of stress hormones– Sleep disturbances– Compromises to the immune system– Cardiac arrhythmias

Case Study (cont’)

Compared to monkeys, human infants are less neurologically developed.– The symptoms of the monkeys are less likely to

occur in human infants.

Cultural Risks

Culture plays a big part in the occurrence of SIDS

Cultural Risks

Culture Rates (per 1000 births)

Asian .50

Whites 1.3

Latinos 1.7

Blacks 2.9

Indians 5.9

Case Study (England)

A study in Birmingham found that on average 22% of Asian babies are put to sleep on their backs, and only 3% of white babies.

Study (cont’)

98% of Asian babies slept in the same room as their parents for the 1st year.

34% in the same bed.

65% of White babies slept in the same room.

Summary

There is no known cause or treatment for SIDS. Although there is action that can be taken for the prevention of SIDS. Co-sleeping and breast feeding, under proper conditions, are the two most significant prevention techniques.

Cultural practices have relevance to the occurrence of SIDS.

Conclusion

Education of the parents makes all the difference.