What exactly is SIDS?
Sudden infant death syndrome (SIDS) refers to the sudden and unexplained death of an infant less than one year of age. Diagnosis requires that the death remain unexplained even after a thorough autopsy and detailed death scene investigation. SIDS usually occurs during sleep, between 0:00 and 9:00, and there is typically no evidence of struggle or noise before death.
The scientific community has not yet found the exact cause of SIDS. Currently, Risk factors for SIDS can be divided into extrinsic and intrinsic categories. Intrinsic risk factors can be subdivided into developmental factors, such as prematurity, and putative genetic factors, such as familial SIDS (i.e., a recurrence of SIDS in subsequent siblings), male sex (by a 2:1 ratio), and race or ethnic group. According to statistics, SIDS rates decrease with increasing maternal age, with teenage mothers at the greatest risk. And about 10% to 20% of SIDS cases are believed to be due to ion channelopathy, a genetic defect in ion channels that play an essential role in cardiac contraction.
Extrinsic risk factors are physical stressors that put vulnerable infants at risk of asphyxia or other disturbances in homeostasis. These external factors include prone and side-sleeping positions, overheating, and exposure to tobacco smoke. In addition to this, sharing a bed with parents is also a risk factor. Approximately 50% of sudden infant deaths occur when infants are sharing a bed, sofa, or sofa chair with another person.
Why does SIDS peak at 2-4 months?
SIDS has a four-parameter lognormal age distribution that spares infants shortly after birth — the time of maximal risk for almost all other causes of non-trauma infant death. SIDS is most common in infants between one month and one year. Approximately 90% of cases were found before six months, with the peak incidence occurring when the infant is two to four months old. This is considered a critical period because the baby's ability to rouse from sleep and the cardiopulmonary function has not yet matured. Infants during this period lack experience in the prone sleeping position and have not yet fully learned the effective protective behaviors of raising their heads and turning around. So once the baby has apnea, it isn't easy to adjust himself to resuscitate breathing.
When to stop worrying about SIDS?
SIDS plagues parents and kills more than a thousand American babies yearly (1,600 in 2016). SIDS usually occurs in infants between the ages of one month and one year, and the incidence of SIDS decreases dramatically after six months. But this does not mean that infants' sleep is safe, and babies after six months are more likely to experience other types of sleep deaths, such as accidental suffocation. These accidents involve mobility, and most babies start swinging, rolling, crawling, and moving after six months. Therefore, parents can reduce the probability of infant asphyxia during sleep by avoiding all potential risk factors, whether during the high incidence of SIDS or after the infant's age of one year.
How to prevent SIDS?
Several measures prevent SIDS, including changing the sleeping position to supine, breastfeeding, limiting soft bedding, immunizing the infant, and using pacifiers. But can electronic monitoring equipment be used as a preventative strategy? Why does a fan reduce SIDS? Does swaddling prevent SIDS? There is not enough evidence to substantiate these issues.
(1) Sleeping on the back can reduce the risk of SIDS. Although babies may sleep lightly in this position, it is not harmful. And sharing the same room with parents but in different beds may reduce the risk of SIDS in half.
(2) Smoking during pregnancy is a significant risk factor for SIDS. About 22% of SIDS in the United States is related to maternal smoking, so smoking cessation in pregnant women can reduce the risk of SIDS. Of course, second-hand smoke around babies also increases the chances of SIDS, so don't let anyone smoke around the baby.
(3) Statistics show that breastfeeding can reduce the risk of SIDS so that mothers can breastfeed babies as long as possible. Pacifiers may also reduce the risk of SIDS, but the exact cause is unknown. And pacifiers do not affect breastfeeding in the first four months, but mothers must consider using them according to their baby's needs.
(4) Product safety experts advise against sleeping with pillows, overly soft mattresses, sleep positioners, bumper pads (crib bumpers), stuffed animals, or fluffy bedding in the crib, and recommend instead dressing the baby warmly and keeping the crib "naked." The American Academy of Pediatrics recommends that parents let their babies sleep in a sleeping bag to keep them warm but not overheated or deprived of oxygen by covering the head with a quilt. And the sleeping bag can keep babies sleeping on the back to prevent babies from suffocating on side-sleeping and prone.
(5) SIDS may also occur with some diseases, such as medium-chain acyl-coenzyme A dehydrogenase deficiency (MCAD deficiency), infant botulism, Helicobacter pylori bacterial infections, etc. Many studies have confirmed that infant vaccinations were associated with halving the risk of SIDS.
Why does room sharing prevent SIDS?
Research has found that sharing rooms is associated with a lower risk of SIDS. And the American Academy of Pediatrics revised its guidelines for safe sleep in 2016, recommending that babies sleep in the same room as their parents but not in the same bed for the first six months. When a baby sleeps in the same room as the parent, but in a different bed, the sound of the parent's actions can prevent the baby from a deep sleep, which keeps the baby safe. Also, room sharing is convenient for mothers to breastfeed, which may prevent SIDS. Of course, room sharing can interfere with babies' sleep and interfere with good sleep habits. But everyone also understands the desire to see these deaths stop, and no one wants to take risks.