What is SIDS “Sudden Infant Death Syndrome?

SIDS “Sudden Infant Death Syndrome”

What is SIDS “Sudden Infant Death Syndrome?

– SIDS “Sudden Infant Death Syndrome” is defined as a sudden unexplained death before 1 year of age. The death usually occurs in a previously healthy infant, and the cause of death remains unexplained despite a thorough investigation , including a complete autopsy, death scene investigation, and review of the clinical history.

In May of 2022 a news article was published with the tag “We have found the Cause of SIDS”. Sadly, this was a little premature as the researches enter the preliminary stages of their testing and data.

The study in question, published May 6 in the journal EBioMedicine, was fairly straightforward. Carmel Harrington, a sleep medicine specialist at the Children’s Hospital in Westmead, Australia, tested for levels of the enzyme butyrylcholinesterase in the blood. She and two co-authors thought the enzyme might play a role in SIDS. Sure enough, in dried blood spots that had been taken in the first day or two of life, they found that in 67 infants who later died of SIDS, levels of the enzyme were on average only 73 percent as high as in children who died of other causes.

The finding makes sense because the enzyme plays an important role in regulating the autonomic nervous system, which controls breathing, heart rate and other basic bodily functions. Infants who die of SIDS are believed to have a dysfunctional autonomous nervous system: When their blood-oxygen level dips during sleep, they remain still, rather than gasping, crying, arching their backs and otherwise making sure they get enough air.

But the study was small, and the finding on low butyrylcholinesterase levels in SIDS was the first time such an observation has been made. Doctors say, therefore, that it has to be replicated in a larger group before they will take it seriously.

Additionally, researchers say, while the lower level of the enzyme in SIDS infants was statistically significant by one measure, it was not significant by another, more common statistical test, so the association could be due purely to chance.

“I would love for this to be true,” said Jose Javier Otero, MD, PhD, associate professor and director of neuropathology at Ohio State University’s College of Medicine, where he researches potential biomarkers for SIDS. “It’s what everybody would like to have: something simple you can test in the blood. That’s why it’s exciting. But whether or not it’s true is very much up in the air.”

But…. Don’t discourage yourself after reading this update, there is a strong correlation in SIDS and “low butyrylcholinesterase levels”, the research will continue and the research teams believe that they are now looking in the right direction for answers. With some more funding, research and public attention the research team believes that they may have more within this year to back their findings.

  • “Here is what we know to be Scientific Research so far on SIDS”

What causes SIDS?

Unfortunately “Doctors do not know what causes SIDS”. It seems to happen more often in premature and low-birth-weight babies however. It also is seen more often in babies who’s mothers didn’t get medical care during the pregnancy and in babies who’s mothers smoke. SIDS may also be more likely in babies who were part of a multiple pregnancy “twins for example” or who’s mothers are younger than 20.

SIDS has also been associated with a sleep period but is unpredictable. It is often referred to as a “diagnosis of exclusion” because it is determined only after ruling out other causes of death, including suffocation, infection, or other illnesses.

SIDS is also “not” the cause of every sudden infant death. Each year in North America thousands of infants tragically die suddenly of no immediate or obvious cause. These deaths are classified as SUID.

SUID “Sudden Unexplained Infant Death” includes all unexpected deaths. These deaths without a clear cause, such as SIDS, and those from a known cause, such as accidental suffocation. Many unexpected infant deaths are accidents, but a disease or another external factor, such as poisoning or neglect, can also cause an infant to die unexpectedly. One-half of SUID cases are SIDS.

Sleep-Related causes of infant death” – These deaths are not SIDS – These causes are linked to how or where a baby sleeps or slept, accidental suffocation, entrapment “trapped between two objects ie: Mattress / Wall” , strangulation or when something presses on or wraps around the baby’s neck blocking the baby’s airway.

Risk Factors:

Age: “Birth 0 – 6 Months”

SIDS has “NO” symptoms or warning signs, babies who die from SIDS seem healthy before being put to bed, they will show “NO” signs of struggle and are often found in the same position as when they were placed in bed.

While the cause of SIDS is unknown, many physicians and researchers believe that SIDS is associated with problems in the ability of the Baby to arouse from sleep, to detect low levels of Oxygen or a build-up of carbon dioxide in the blood. When babies sleep face down, they may re-breathe exhaled carbon dioxide. Normally, rising carbon dioxide levels activates nerve cells in the brain stem, which stimulate the brain’s respiratory and arousal centers “Provoking a movement response to clear the airway”, a Baby will “wake up” turn its head and breath faster to get more oxygen. SIDS may cause the baby to fail to wake.

  • Babies who sleep on their stomach or their sides rather than their back.
  • Overheating while sleeping “Febrile Seizures, Coma, Death”
  • Too soft a sleeping surface, with fluffy blankets or toys.
  • Smoking During Pregnancy “Smoking During pregnancy increases the likelihood of SIDS by three times” This also includes “Tobacco , Marijuana or Illicit Drugs
  • Exposure to passive smoke “Second Hand Smoke” This also doubles the chances for SIDS
  • Young mothers under 20
  • Babies born to mothers who had little, late or no prenatal care
  • Premature or low birth weight babies
  • Hereditary factors like siblings who have died of SIDS
  • Co-Sleeping or Sharing the same sleeping surface “such as a bed” with an individual other than a parent or sharing the same sleeping bed with an individual who is overly tired, under the influence of alcohol / drugs or overweight.
  • The infant has underlying birth defects “ie: brain stem” that make the baby unable to respond to low oxygen or high carbon dioxide blood levels.

Diagnosis

A physician will name SIDS as the cause of death “only” when no other cause is found. To find out why a baby died, medical experts will review the baby’s and parents medical histories, study the area where the baby died and combine an in depth medical exam “autopsy” to find the true cause. If no cause can be determined it will be declared as SIDS / SUDS.

Prevention

Medical professionals have linked many preventative techniques in reducing the risk of SIDS / SUDS. For more information or details on how you can reduce the risk for your baby please consult your local Pediatrician.

The most important thing you can do is to “Always place your baby to sleep on his or her back” rather than on the stomach or side.

  • Don’t smoke while you are pregnant, and don’t expose your baby to second hand smoke after your baby is born.
  • For the first 6 months have your baby sleep in a crop, cradle, or bassinet in the same room where you sleep. It is a safer sleeping arrangement than sharing a bed. Many families choose to “Co-Sleep or Bed-hare” or find that they end up bed-haring even if they do not plan to do so. Bed-sharing should be discussed with your pediatrician.
  • Reduce your use of alcohol or recreational medications such as drugs. If you smoke or have used alcohol, drugs, or medications that can alter your sleep pattern “Sedatives” bed-sharing is especially risky and should be avoided.
  • Never sleep with a baby on a couch or armchair, and it is “not safe” to place your baby on a couch to sleep. The safest place for a baby is in a crib, cradle, or bassinet that meets safety standards and has a firm mattress.
  • Car Seats – Some babies fall asleep while traveling in a car seat. Keep an eye on a baby sleep in in a car and take your baby out of the car seat frequently during long trips and when you reach your destination. Babies should “not” be left to sleep in a car seat, stroller, baby swing, sling or bouncer seat because their airway may become restricted.
  • Toys / Accessories” Keep soft items and loose bedding out of the crib. Items such as blankets, stuffed animals, toys or pillows could suffocate or trap your baby. Dress your baby in sleepers instead of using blankets or provide a small enough blanket that can easily be kicked off.
  • Crib” Make sure the crib mattress is “Firm not soft” with a fitted sheet. Do “not” use bumper pads or other products that attach to crib slats or sides. They could suffocate your baby.
  • Keep the room temperature comfortable so that your baby can sleep in lightweight clothing without a blanket if need be. To gauge this, the temperature is about right if an adult can wear a long sleeved T-shirt and pants without feeling cold. Your baby is likely too hot if they sweat or toss and turn a lot.
  • Breastfeed your baby if possible – Breastfed babies have a lower chance of SIDS / SUDS.
  • Consider giving your baby a pacifier at nap time and bedtime. Experts do not know why, though babies who bottle feed to sleep or use a pacifier are at lower risk for SIDS.

– NOTE –

There is no sure way to prevent SIDS, and no test can predict weather a baby is likely to die of SIDS. “Do not” rely on breathing “apnea” monitors, special mattresses, or other devices marketed as a way to reduce your baby’s risk for SIDS. “NONE” of these items have been proved to lower the risk of SIDS and the Public Health Agency of Canada and other experts “do not” advise their use.

Remember SIDS is rare. Be as safe as you can, but don’t let fear keep you from enjoying your baby.

If you have a caregiver or baby sitter, ensure they know all the steps to protecting the child from sudden events that could harm them.

– Above all else – If your Baby tragically is lost to SIDS “You are NOT to blame

  • Do not hesitate to seek emotional support or grief counseling, join a support group or even rely on family to help support you through this tragic loss. For a list of local Emotional and Mental Health links contact “211” in Alberta for a free access to the Mental Health Link.

If your have worries or wish to speak with a medical practitioner about concerns call your doctor or Health Link “811 in Alberta”. You can also call the “Health Link Alberta 24/7 if you have questions about SIDS or any of the information in this handout.

This information was taken From Health Link British Columbia SIDS Information slip, American Pediatric Society, US Department of Health & Human Services, Infant Death Investigation Foundation, Stollery Children’s Hospital, Boston Children’s Hospital.

This material is for information purposes only. It should not be used in place of medical advice, instruction, and/or treatment. If you have questions, speak to your doctor or appropriate healthcare provider.

In any emergency just remember to Protect Yourself!!! Call 911!!! Don’t Waste Time!!!

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#SIDS #BLS