2. Outlines
• What is SIDS ?
• Causes of SIDS ?!
• What are the risk factors ?
• Prevention
• Studies
3. Definition
o Sudden infant death syndrome (SIDS) is the
sudden, unexplained death of an infant
younger than one year old.
o Some people call SIDS "crib death" because
many babies who die of SIDS are found in
their cribs.
4. o SIDS is the leading cause of death in children
between one month and one year old.
o Most SIDS deaths occur when babies are between
two months and four months old
o 6000-7000 babies die of SIDS every year in the US
Cont..
5. Infant development
A leading hypothesis is that SIDS may reflect a delay or
abnormality in the development of nerve cells within the
brain that are critical to normal heart and lung function.
Research examinations of the brainstems of infants who
died with a diagnosis of SIDS have revealed a
developmental delay in the formation and function of
several serotonin-binding nerve cell pathways within the
brain.
6. Cont.…
• These pathways are thought to be crucial to regulating
breathing, heart rate, and blood pressure responses
during awakening from sleep
7. Symptoms
o Almost all SIDS deaths happen without any warning or
symptoms
o Death occurs when the infant is thought to be sleeping.
8. Causes of SIDS ?!
A combination of physical and sleep environmental
factors can make an infant more vulnerable to SIDS.
These factors may vary from child to child.
o Brain abnormalities
10. Sleep environmental factors
o Sleeping on the stomach or side. Babies who are
placed on their stomachs or sides to sleep may have more
difficulty breathing than those placed on their backs.
11. o Sleeping on a soft surface. Lying face down on a fluffy
comforter or a waterbed can block an infant's airway.
Draping a blanket over a baby's head also is risky.
12. • Sleeping with parents. While the risk of SIDS is
lowered if an infant sleeps in the same room as his
or her parents, the risk increases if the baby sleeps
in the same bed — partly because there are more
soft surfaces to impair breathing.
13. Risk factors
Although sudden infant death syndrome can strike any
infant, researchers have identified several factors that may
increase a baby's risk. They include:
o Sex..
o Age.
o Race.
o Family history
15. Maternal factors
During pregnancy, the risk of SIDS is also affected by the
mother, especially if she:
• Is younger than 20
• Smokes cigarettes
• Uses drugs or alcohol
• Has inadequate prenatal care
16. Prevention
There's no guaranteed way to prevent SIDS, but you can
help your baby sleep more safely by following these tips:
o Place your baby on their back to sleep, in a cot in the
room with you.
o Don't smoke during pregnancy or let anyone smoke in
the same room as your baby.
o Don't share a bed with your baby if you or your partner
smoke or take drugs, or if you have been drinking
alcohol.
o Never sleep with your baby on a sofa or armchair.
17. Cont.…
• Don't let your baby get too hot or too cold.
• Keep your baby’s head uncovered. Their blanket
should be tucked in no higher than their shoulders.
• Place your baby in the "feet to foot" position (with
their feet touching the end of the cot or pram).
• If possible, breastfeed your baby.
18.
19. Studies in SIDS
Alcohol as a risk factor for sudden infant
death syndrome (SIDS)
(University of California, San Diego
2011)
20. The Aim
To test whether alcohol is a risk factor
for sudden infant death syndrome (SIDS)
21. Cont.…
Participant : All SIDS cases (n = 129,090) and
other infant deaths (n = 295,151) from 1973-2006; all persons
involved in late-night alcohol-related crashes (n = 135,946) from
1994-2008.
Measurement : Three measures were used
• the expected number of deaths on New Year versus the
observed number (expected values were determined using a
locally weighted scatterplot smoothing polynomial)
• the average number of weekend deaths versus the average
number of weekday deaths
• and the SIDS death rate for children of alcohol-consuming
versus non-alcohol-consuming mothers
22. Result
These measures indicate that
• the largest spikes in alcohol consumption and in SIDS
(33%) occur on New Year
• alcohol consumption and SIDS increase significantly on
weekends
• and children of alcohol-consuming mothers are much
more likely to die from SIDS than are children of non-
alcohol-consuming mothers.
23. Sleep environment risk factors
for sudden infant death syndrome: the
German Sudden Infant Death
Syndrome Study.
Institute of Legal Medicine, University of Münster20009)
24. OBJECTIVE:
Our goal was to investigate the risk factors for sudden
infant death syndrome in the infants' sleep environment for
a population in which few infants sleep prone as a result of
education campaigns
Method
this was a population-based sudden infant death
syndrome case-control study over 3 years (1998-2001) in
German
25. Result
There were 333 sudden infant death syndrome cases and 998
matched control
o Although only 4.1% of the infants were placed prone to sleep,
those infants were at a high risk of sudden infant death
syndrome.
o Those who were unaccustomed to sleeping prone were at very
high risk, as were those who turned to prone.
o Bed sharing (especially for infants younger than 13 weeks);
duvets; sleeping prone on a sheepskin; sleeping in the house of a
friend or a relative (compared with sleeping in the parental
home)
o sleeping in the living room (compared with sleeping in the
parental bedroom) increased the risk for sudden infant death
syndrome; pacifier use during the last sleep was associated with
a significantly reduced risk of sudden infant death syndrome
26. Breastfeeding and reduced risk of
sudden infant death syndrome: a
meta-analysis
(Department of Family Medicine, University of Virginia
School of Medicine,2011)
28. METHODS:
We identified 288 studies with data on breastfeeding and SIDS
through a Medline search (1966-2009), review articles, and
meta-analyses. Twenty-four original case-control studies were
identified that provided data on the relationship between
breastfeeding and SIDS risk. Two teams of 2 reviewers evaluated
study quality according to preset criteria; 6 studies were
excluded, which resulted in 18 studies for analysis. Univariable
and multivariable odds ratios were extracted. A summary odds
ratio (SOR) was calculated for the odds ratios by using the fixed-
effect and random-effect inverse-variance methods of meta-
analysis. The Breslow-Day test for heterogeneity was performed
29. RESULTS:
For infants who received any amount of breast milk for any duration,
the univariable SOR was 0.40 (95% confidence interval [CI]: 0.35-
0.44), and the multivariable SOR was 0.55 (95% CI: 0.44-0.69). For
any breastfeeding at 2 months of age or older, the univariable SOR was
0.38 (95% CI: 0.27-0.54). The univariable SOR for exclusive
breastfeeding of any duration was 0.27 (95% CI: 0.24-0.31).
CONCLUSIONS:
Breastfeeding is protective against SIDS, and this effect is stronger
when breastfeeding is exclusive. The recommendation to breastfeed
infants should be included with other SIDS risk-reduction messages to
both reduce the risk of SIDS and promote breastfeeding for its many
other infant and maternal health benefits.
