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Sudden Infant Death Syndrome
Is Your Grandchild at Risk? By Dr. David Fay
Back to Sleep
31 Center Dr.
M5C2425, Room 2A32
Bethesda, MD 20892-2425
Telephone: 800-505-CRIB
The SIDS Network
9 Gonch Farm Rd.
Ledyard, CT 06339
Telephone: 800-560-1454; fax: 860-887-7309
E-mail: sidsnet@sids-network.org
http://sids-network.org
In the past it was felt that SIDS had a familial tendency, tending to strike some families more than once. This is now disputed, and family history may no longer be a risk factor. In one study in the United Kingdom in 1997, infants who had been reported to stop breathing at home were hospitalized and secretly videotaped. The results were startling: The parents of 39 infants were observed in the act of attempted infanticide. While experts estimate that less than five percent of presumed SIDS deaths are actually due to infanticide, this shocking and sensational finding, along with some recent high-profile cases of SIDS later found to be infanticide, have brought to light a darker side of the phenomenon of unexplained infant deaths. For this reason, it is now recommended that all infants who die of SIDS have an autopsy.
One issue which remains controversial is parent-child co-sleeping. While there appears to be little risk of suffocation by a responsible parent, it is clear that adult bedding is risky for the infant, and confers a higher risk of SIDS. Parents should never co-sleep with their babies if they are on medication or have been drinking alcohol, and babies should never be allowed to sleep with older siblings. Studies are currently ongoing to assess the risk versus benefit of this sleeping arrangement.
Apnea monitors have been used extensively in infants thought to be at risk for SIDS. Unfortunately, this has not proven to be beneficial, possibly because a large percentage of SIDS victims have no known health problems.
While it is not clear what causes SIDS, it is clear that changing certain behaviors reduces the risks. Specifically, parents should be advised to 1) place infants down to sleep in the supine position (on their backs); 2) avoid cigarette exposure, both before and after the birth of the baby; 3) use firm bedding without heavy, soft blankets and bedclothes; and 4) if at all possible, breastfeed rather than bottle-feed. It should be emphasized that the supine position is only for sleep; awake infants can and should spend time in the prone position.
