Update on SIDS
It has been almost 20 years since the introduction of promoting a safe
sleeping environment for newborns and babies. Death form SIDS (Sudden
Infant Death Syndrome), which is diagnosed when a newborn or infant's
death cannot be explained by other factors, declined dramatically since
the "Back to Sleep" campaign was introduced. This was the recommendation
to place babies on their backs for sleep instead of on their stomachs.
The number of SIDS deaths dropped by 50 percent in the decade following
this health campaign.
SIDS is still the leading cause of death in the United States among
babies 4 weeks to 12 months.
A study examining the SIDS deaths in San Diego County from 1991 to 2008
revealed that almost 1/3 were newborns/infants that were put to sleep on
their stomachs. Co-sleeping and being in an adult bed by itself were
also strong risk factors. Mattresses and bedding on adult beds are
usually softer than an approved crib mattress and can compress inward,
contributing to suffocation risk.
There are some risk factors that parents cannot control. The risk is
greatest during the second and third month of life, boys are more likely
than girls, familial history of SIDS, and prematurity of your newborn
all increase the risk.
Here are the latest recommendations from the American Academy of
Pediatrics, which are all associated with decreasing the risk of SIDS:
All infants/newborns should be placed on their backs to sleep.
2- Place the baby to
sleep on a firm, flat mattress with only a fitted sheet.
3- Car safety seats,
strollers, swings, infant carriers and slings should not be used for
4- Room sharing in
separate beds is recommended, but bed sharing, including twins, is
5- Keep all loose
bedding and soft objects such as pillows, comforters, bumper pads
out of cribs.
6- Receiving regular
prenatal care before the arrival of your newborn.
7- Avoid smoke
exposure, alcohol and other illicit drugs during and after birth.
breastfeeding, if possible for the first six months.
9- Offering a pacifier
to infants at sleep time once breastfeeding has been established.
10- Not to overdress
the baby for sleep to avoid overheating.
11- Make sure infants
are up to date on immunizations.
12- Do not use devices
such as wedges, positioners, special sleep surfaces that are
advertised to protect against SIDS.
13- Supervised tummy
time every day while awake.
There might be specific exceptions to these recommendations based on the
health of your newborn/baby and would be determined by your own
SIDS: (Sudden Infant Death Syndrome) Risk
(Sudden Infant Death Syndrome) is the tragic, unexpected death of
healthy babies 12 months or younger. SIDS is the leading cause of death
for children under one year and the peak age is 2-4 months.
Although SIDS occurs
during periods of sleep, whether it is during deep sleep, during the
period between waking and sleeping or between sleep periods is not
known. What is also not known is the cause. Perhaps it has to do with
mechanisms for arousal in the brain stem or respiratory control.. At
this time there is no way to predict which infants are at risk.
What we do know that
immunizations or choking does NOT cause SIDS.
There are ways you can
reduce the risk. The most important is to always put your baby down to
sleep on his back. Since the “Back to Sleep” campaign in 2003, SIDS
deaths have been cut in half. Nevertheless, in 2005, 2200 infants in the
US died of SIDS.
About 1 out of 5 SIDS
deaths occur when in the care of someone who is not a parent – a baby
sitter, a child care center or a relative. Make sure that these people
always put your baby down on her back.
The risk is higher for
infants whose mothers smoked during pregnancy and who are exposed to
second hand smoke after birth. SIDS is more common in the winter months,
perhaps because overheating is another risk factor. Having blankets,
bumper pads and stuffed animals in the crib also increases the risk.
If your newborn startles
and does not sleep as well on his/her back, try swaddling her with a
light blanket but reduce the layers she is wearing to avoid overheating.
Do not use positioning devices, which the American Academy of Pediatrics
does not recommend. If you are worried about your newborn getting a flat
head, be sure that there is generous tummy time when your little one is
awake and being observed by an adult. And most flat heads round out
after the first few months. After all, how many flat heads do you see in
a kindergarten class? Tummy time is also important for development of
upper body strength and coordination.
When your newborn can turn
over, that is the time to let him/her assume any position he or she
wants. If you do not, you will be up and down all night turning him/her
newborn video will discuss even more ways to reduce the risk of
Both the FDA and the
Consumer Product Safety Commission (CPSC) warned
against the use of sleep positioners for newborns
and babies. The agencies reported 12 deaths babies 1
to 4 months old that suffocated in their positioners
or got trapped between a positioner and the side of
Some manufacturers of
these products claim that the positioners reduce the
incidence of SIDS by keeping the newborns and babies
on their backs during sleep. The FDA stated that it
was unaware of any scientific studies that showed
the positioners decrease the incidence of SIDS or
other life-threatening harm and has asked for the
manufacturers to submit scientific data.
There should not be
anything in your newborn / baby’s crib other than
your baby and what he is wearing to sleep. A swaddle
blanket for a newborn or infant is fine. Never put
extra blankets, quilts, pillows, stuffed toys or
positioners in the crib.
Breastfeeding and SIDS
An analysis of 18 different studies from multiple countries representing
newborns from mixed populations examined the relationship of breast
feeding and Sudden Infant Death Syndrome (SIDS). The data showed that
newborns who received breast milk for any duration had a decreased
incidence of SIDS. The decrease in SIDS was even greater for newborns
who were breastfed exclusively. This data further illustrates the
importance of breastfeeding your newborn by adding SIDS risk reduction
to its long list of maternal and infant health benefits.
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