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Sudden Infant Death Syndrome (SIDS)

Nearly 3,000 seemingly healthy babies die of Sudden Infant Death Syndrome, or SIDS, each year in the United States, making it the leading cause of death among infants who are between 1 month and 1 year old. The cause of SIDS remains a mystery, although recent scientific breakthroughs hold the hope of prevention.

Sudden Infant Death Syndrome is the sudden and unexplained death of an infant younger than one year old. It rarely occurs in babies younger than two weeks or older than six months - most deaths occur in infants between two and four months - and the incidence of SIDS is greatest during cold weather, according to the National Institute of Child Health and Human Development (NICHD). Often referred to as "crib death," SIDS is usually associated with sleeping and the infants often show no signs of trauma or suffering. African-American infants are two times more likely to die of SIDS than white infants, Native Americans are about three times more likely than whites, and more boys than girls fall victim to SIDS. Other potential risk factors include:

• smoking, drinking, or drug use during pregnancy

• poor prenatal care

• premature birth or low birth weight (less than 4.4 pounds)

• mother is younger than 20

• infant's exposure to smoke

• putting the infant to sleep on his stomach

• a sibling of the infant's died of SIDS

Many researchers believe that the cause of SIDS may be a combination of several factors, including vomiting or choking, birth defects, suffocation, infection, metabolic abnormalities, and abnormalities in the area of the brain that controls breathing. Researchers at Children's Hospital in Boston recently linked abnormalities in the brain's serotonin system - which regulates breathing, blood pressure, body heat, sensitivity to carbon dioxide, and arousal - to SIDS. The scientists now believe that serotonin acts like an alarm if a baby's oxygen supply is compromised during sleep, such as when the baby sleeps face down or if their face is covered by bedding. In these situations, the baby is in danger of rebreathing their own exhaled carbon dioxide and in a normal baby, serotonin would stimulate the baby to wake up, turn his head and breathe faster to restore oxygen levels. However, in SIDS babies, that alarm is never triggered.

Babies who are put to sleep on their stomachs are 12.9 times more likely to die from SIDS than babies who sleep on their backs. A soft mattress or lots of bedding can create a small enclosure around the baby's face, trapping her low-oxygen, exhaled air, which could eventually contribute to SIDS.

Some people also believe that SIDS is related to immunizations because most vaccinations are administered during the same period of time that most babies die of SIDS: between 2 and 4 months. However, there is no evidence of a link between SIDS and common childhood immunizations. Recent research reported by the Centers for Disease Control (CDC) states that any appearance of a connection between the two is merely a coincidence.

SIDS is diagnosed by a process of elimination; it is determined to be the cause of death only after all other possible causes of death have been ruled out through an autopsy, examination of the death scene, and a complete review of the infant's medical history. This helps distinguish SIDS deaths from those resulting from accidents, abuse, and previously undiagnosed conditions, such as cardiac or metabolic disorders.

You can decrease the likelihood that your baby will fall victim to SIDS by avoiding the risk factors mentioned above and following these tips:

• Put your baby to sleep on his back, even though he may sleep more soundly on his stomach. Infants who sleep on their stomachs and sides have a higher rate of SIDS than infants who sleep on their backs.

• Use a firm mattress in your baby's crib and keep the crib clear of coverings-including sheets and blankets-pillows, bumper pads, and toys. Soft mattresses and heavy bedding are associated with SIDS.

• Do not over-dress your baby for bed and keep the room at a temperature that is comfortable for you. Excess clothing and overheating may increase the risk for SIDS.

• Breastfeed your baby if possible. Breast milk decreases the incidence of respiratory and gastrointestinal infections. Studies show that breastfed babies have a lower SIDS rate than formula-fed babies.

• Avoid exposing your baby to people with respiratory infections. Carefully clean anything that comes in contact with your baby. Have people wash their hands before holding or playing with your baby. SIDS often occurs in association with relatively minor respiratory and gastrointestinal infections (vomiting and diarrhea).

• Consider using home monitoring systems (apnea/bradycardia monitors) if you have a high-risk infant.

• Visit the American SIDS Organization Website

• Connect with other parents who have lost a child to SIDS