Sudden infant death syndrome

Overview

Sudden infant death syndrome (SIDS) is the unexplained and sudden death of an apparently healthy infant, usually during sleep, typically occurring before the age of one year. It is sometimes referred to as "crib death" because it often happens when the baby is sleeping in a crib. SIDS is the leading cause of death in infants between one month and one year of age in many countries.

The exact cause of SIDS remains unknown despite extensive research. It is considered a diagnosis of exclusion after a thorough investigation including autopsy and examination of the death scene.

Causes

The causes of SIDS are not fully understood but are believed to be multifactorial, involving a combination of environmental, biological, and developmental factors. These include:

• Brain abnormalities: Some infants may have defects in the brain regions controlling breathing, arousal from sleep, or heart rate.

• Sleep environment: Unsafe sleep practices such as prone (face-down) sleeping position, soft bedding, and overheating increase risk.

• Maternal factors: Smoking during pregnancy, prenatal drug or alcohol exposure, and inadequate prenatal care.

• Genetic predisposition: Some evidence suggests a genetic susceptibility in affected infants.

• Respiratory infections: Minor viral infections may contribute by affecting breathing regulation.

Symptoms

SIDS is typically sudden and unexpected, occurring without warning signs. Because it is a diagnosis after death, no symptoms precede the event. However, some infants may have mild respiratory infections or subtle signs prior to the event, although these are nonspecific.

Diagnosis

Diagnosis of SIDS is made after excluding other possible causes of death. The process includes:

• Complete autopsy: To rule out infections, metabolic disorders, or anatomical abnormalities.

• Examination of the death scene: To assess sleep environment and circumstances.

• Review of medical and family history: To identify potential risk factors or inherited conditions.

• Exclusion of accidental suffocation or abuse: Through thorough investigation.

Treatment

There is no treatment for SIDS as it is a sudden fatal event. However, prevention strategies focus on reducing risk factors:

• Placing infants on their backs to sleep (supine position)

• Using a firm sleep surface without soft bedding or toys

• Avoiding overheating and ensuring a comfortable room temperature

• Promoting breastfeeding and immunizations

• Encouraging smoke-free environments during and after pregnancy

• Using pacifiers during sleep

• Providing education to caregivers on safe sleep practices

Prognosis

Unfortunately, SIDS results in sudden and unexpected death, and prognosis after the event is not applicable. However, public health campaigns promoting safe sleep practices have significantly reduced the incidence of SIDS in many countries.

Families affected by SIDS often require psychological support and counseling to cope with their loss.