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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:

1- 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 routine sleep.

4- Room sharing in separate beds is recommended, but bed sharing, including twins, is not.

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.

8- Exclusive 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 pediatrician.


Newborn SIDS: (Sudden Infant Death Syndrome) Risk
By Loraine Stern M.D.

Newborn SIDSSIDS (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 over. The newborn video will discuss even more ways to reduce the risk of SIDS.


No Sleep Positioners!

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 the crib.

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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