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>FAQ
WHAT IS SUDDEN INFANT DEATH SYNDROM (SIDS)?
SIDS is the diagnosis given for the sudden death of an infant under one year of age that remains unexplained after a complete investigation, which includes an autopsy, examination of the death scene(Center for Disease Control and Prevention guidelines), and review of the symptoms or illnesses the infant had prior to dying and any other pertinent medical and family history. Because most babies sleep in cribs, and therefore, most cases of SIDS occur when a baby is in a crib sleeping, SIDS is sometimes called "crib death." Cribs do not cause SIDS, however, other aspects of an infant's sleep environment have been associated with increasing the risks for SIDS.
WHAT CAUSES SIDS? There is mounting evidence that suggests some SIDS babaies are born with brain abnormalities that make them vulnerable to sudden death during infancy. Studies of SIDS victims reveal that many SIDS infants have abnormalities in the "arcuate nucleus", a portion of the brain that is involved in control of breathing and waking during sleep. Babies born with defects in other portions of the brain or body may also be more prone to a sudden death. These abnormalities may stem from prenatal exposure to a toxic substance, or lack of a vital compound in the prenatal environment, such as sufficient oxygen.
WHEN IS SIDS MOST LIKELY TO OCCUR?
SIDS is the leading cause of death in infants between one to 12 months old. Most SIDS deaths occur when a baby is between 2 and 4 months of age. THe risk of SIDS then diminishes during the first year of life. Currently, the diagnosis of SIDS is not used after 1 year of age.
IF THERE ANYTHING WE CAN DO TO PREVENT SIDS?
At this time, there is no way of predicting which newborns will succumb to SIDS. However, there are a few measures parents can take to lower the risk of their child dying from SIDS in order to give their infant the best possible chance to thrive.
BACK SLEEPING.
Placing babies on their backs to sleep is the single most important step that parents and other caregivers can take to reduce the risk of SIDS. Infants who fall asleep on their stomachs should be gently turned onto their backs. Studies have shown that countries where caregivers have switched from placing babies on their stomachs to sleep to placing babies on their backs to sleep have reduced their total SIDS deaths by as much as 50 percent. 2,000 fewer infants die of SIDS in the U.S. each year due to this simple measure.
BEDDING.
Parents should make sure their baby sleeps on a firm, flat mattress in a crib that meets current safety standards. Caregivers should also avoid using loose, fluffy blankets or coverings and should not use pillows, sheepskins or comforters under the baby. Consider using a sleeper or other sleep clothing as an alternative to blankets, with no other covering. Infants under 1 year of age should not be placed to sleep on a waterbed, sofa or with stuffed toys or pillows.
HEAD COVERING.
Make sure your baby's head remains uncovered during sleep. Babies are at an increased risk for SIDS if their head becomes covered during sleep. Avoid using a blanket or other covering over your baby's face as a sun or weather screen, or to block out distractions or sounds while your baby is sleeping. Bedding that bunches up or contours around your baby's face can obstruct the mouth and nose, causing potentially dangerous rebreathing of stale air.
BEDSHARING/SOFA-SHARING.
In additon to the recognized hazards presented by pillows and comforters in the family bed, there are risks associated with infants who sleep with parents whose instincts are impaired by exhaustion, drug or alcohol abuse, or who are smokers. There are also dangers connected with infants sharing a bed with brothers, sisters, or relatives other than the baby's mother. Sofas and chairs are particularly dangerous environments for shared sleep. Bedsharing has not been found to be protective against SIDS, though studies suggest that room-sharing may be protective. Keeping the baby next to the adult bed in his/her own secure crib or bassinet provides greater safety for the infant and proximity for parents seeking to facilitate breastfeeding and share closeness with their baby.
SMOKING
Mothers who smoke during pregnancy are three times more likely to have a SIDS baby and exposure to passive smoke from smoking by mothers, fathers, and others in the household after pregnancy doubles a baby's risk of SIDS. Parents should be sure to keep their babies in a smoke-free environment. Studies have found that the risk of SIDS rises with each additonal smoker in the household, the numbers of cigarettes smoked a day, and the length of the infant's exposure to cigarette smoke. Components of smoke are believed to interfere with an infant's developing lungs and nervous system, and to disrupt a baby's ability to wake from sleep.
ROOM TEMPERATURE.
Babies should be kept warm, but they should not be allowed to get too warm. An overheated baby is more likely to go into a deep sleep from which it is difficult to arouse. Keep temperature in the baby's room at a level that feels comfortable to an adult and avoid overdressing the baby.
PRENATAL CARE.
Good prenatal care - including proper nutrition, abstinence from alcohol, drugs, and smoking, and frequent medical checkups beginning early in pregnancy - might help prevent a baby from developing an abnormality that could put him or her at risk for sudden death.
REGULAR HEALTH CARE.
Parents should take their babies to their health care provider for regular well baby checkups, and should make sure that their babies receive their immunizations on schedule.
CHILD CARE.
Babies who routinely sleep on their backs and are unaccustomed to sleeping on their stomachs are at an 18 times higher risk of SIDS when placed prone by a well-intentioned but ill-informed relative or caregiver. Be sure to communicate Back to Sleep advisories to baby sitters, daycare providers, grandparents and everyone else who cares for your infant. Parents cannot assume that everyone knows about Back to Sleep and other ways to reduce SIDS risk.
WHAT IS THE BACK TO SLEEP CAMPAIGN?
Back to Sleep is aptly named for its main recommendation to place healthy infants on their backs to sleep to reduce the risk of SIDS. The National Institute of Child Health and Human Development (NICHD) leads the campaign, along with the Maternal and Child Health Bureau and other Federal agencies such as the Centers for Disease Control and the Census Bureau. The American Academy of Pediatrics (AAP) is the major private sponsor, along with the SIDS Alliance and the Association of SIDS and Infant Mortality Programs. Based on a recommendation made by the AAP in 1992, the campaign was launched in 1994 with an effort to reach every newborn nursery in the country. A toll-free number was established for ordering Back to Sleep pamphlets, posters and videos. In March 1997, Tipper Gore became national campaign spokesperson.
IS THE CAMPAIGN SUCCESSFUL?
This campaign has been increasingly successful in reaching parents and other caregivers of infants. We have seen a change from 70 percent of babies placed on their stomachs to sleep in 1992 to 21 percent in 1998. The death rate from SIDS declined by 42% between 1992 and 1998, the first significant decrease in SIDS deaths in the U.S.
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