David Perlstein, MD, MBA, FAAP
Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
In this Article
- Sudden infant death syndrome (SIDS) facts
- What is sudden infant death syndrome (SIDS)?
- What is the cause of SIDS?
- What are the risk factors for SIDS?
- How is SIDS diagnosed?
- Can SIDS be prevented?
- Does the supine (back) sleep position cause any problems for infants?
- What support is available to parents who are coping with an infant loss due to SIDS?
- Where can people get more information about sudden infant death syndrome (SIDS)?
Can SIDS be prevented?
There is currently no way to predict which infants are at risk for SIDS. SIDS has been linked to certain infant-specific and sleep-environment factors. Therefore, observing the following precautions has reduced the risk of SIDS for many infants.
- Sleep position and the local sleep environment: Educate babysitters, day-care providers, grandparents, and everyone who cares for your baby about SIDS risk and the importance of observing the latest advice related to safe infant sleep offered in the original "Back to Sleep" campaign and updated in the recent "Safe to Sleep" initiative. Safe to Sleep (http://www.nichd.nih.gov/SIDS/Pages/sids.aspx) messages highlight the importance of the back sleep position with emphasis on safety surrounding the infant sleep environment and safe sleep conditions:
- Back to sleep: You should place your baby on his or her back to sleep at night and nap time.
- You should avoid fluffy, loose bedding in your baby's sleep area.
- Keep your baby's face clear of coverings.
- Be careful not to overheat your baby by overdressing or adding unnecessary covers.
- You may offer your baby a pacifier when placed for sleep. If it falls out there is no need to replace it.
- Don't allow anyone to smoke around your baby.
- Use a firm mattress in a safety-approved crib with a tight fitting sheet. Commercial products, including "breathable mattresses" and infant positioning devices marketed to "reduce SIDS risk" should be avoided. Many of these products have intuitive designs, but have not been scientifically validated to reduce SIDS risk. The use of infant positioners has been linked to deaths due to suffocation in a recently released report from the Consumer Product Safety Commission.
- Do not use a car seat, carrier, swing, or similar product as your baby's everyday sleep area. Never place your baby to sleep on soft surfaces, such as on a couch or sofa, pillows, quilts, sheepskins, or blankets.
- Do not allow your baby to sleep alongside another person. The risk of unintentional smothering is too great.
- Your baby's crib may be placed in your room. Room sharing (but not bed-sharing) has been shown to be protective against SIDS and other sleep-related causes of infant death. If you bring your baby into bed with you to breastfeed, make sure you return your baby to their crib or bassinet when they have completed their feeding.
- Keep all "well-child" appointments, including immunizations.
- Home monitoring: The use of home cardiorespiratory monitors for infants perceived to be at risk of SIDS is still controversial. Doctor-prescribed monitors are available that sound an alarm if the baby's breathing or heartbeat stops. These monitors use three electrodes to detect movements of the chest wall and monitor respiratory rate and heart rate. In case of breathing irregularities or decreased heart activity, the device gives off an audible and/or visual alarm. The choice of electronic monitor may measure heart rate, respiratory rate, and pulse oximetry (blood oxygen saturation). The information recorded can be downloaded and periodically and examined by a doctor.
- Current studies still echo the National Institutes of Health (NIH) Consensus Report on SIDS. To date, no reports scientifically demonstrate the effectiveness of home monitoring for siblings of SIDS victims (babies born after a family has had a child die of SIDS).
- Currently, certain guidelines exist for use of home cardiorespiratory monitoring:
- Infants with one or more life-threatening episodes in which the baby turned blue or became limp requiring mouth-to-mouth resuscitation or vigorous stimulation and during hospitalization are identified as having abnormal control of heart or lung function.
- Symptomatic preterm infants with apnea of prematurity
- Infants with certain diseases or conditions that include central (brain related) breathing irregularities
- If families have questions related to the use of home monitors, they should seek assistance from their child's primary medical care provider.
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