Sudden Infant Death Syndrome

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Sudden Infant Death Syndrome

• S.I.D.S.

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Definition of SIDS

• The sudden and unexplained death of an infant
  under one year of age.
• Leading cause of death in infants under 12 months

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Outline

• Historical Perspective
• Proposed Causes and Symptoms
• Treatment
• Prevention

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Historical Perspective

• And this woman child died in the night because
  she has over laid it 1 Kings 319-20
• 1291 a German poster forbid mothers from taking
  their infants under 3 years of age to bed with
  them.
• Late 1800s SIDS was first defined Sudden and
  Unexplained Death in Children

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Proposed Causes (External/Internal)

• Tiny hemorrhages
• Asphyxiation
• Immune System Disorders
• Apnea Hypothesis

• Sleep position
• Temperature
• Smoke/Narcotics
• Bedding

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Sleep Position

• The baby is in the prone position
• (Lying on its stomach)

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Temperature

• The temperature of the environment would
  determine how warmly the infant is dressed or how
  tightly a blanket is wrapped around the infant.

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Smoke/Narcotics

• The presence of smoke during pregnancy increases
  the infants chance 3 times for having SIDS.
• The use of narcotics during pregnancy increases
  the infants chance 10 times for having SIDS.

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Bedding

• Improper bedding such as a too soft mattress or a
  big fluffy blanket could cause the infant to
  inhale stale air during the night.

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Tiny Hemorrhages

• Autopsys revealed that tiny hemorrhages inside
  of the babies chest could be responsible for
  congestion in the lungs during the night.

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Asphyxiation

• Asphyxiation by carbon dioxide is associated with
  soft bedding because the infant only breathes in
  stale air (containing mostly carbon dioxide)
  throughout the night, and does not receive the
  proper amount of oxygen.

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Immune System Disorders

• Infants who have an immune system disorder are at
  higher risk than those who do not, because it is
  likely to cause a change in heart rate during the
  night.

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Apnea Hypothesis

• The cessation of airflow to the nose and mouth
  (central apnea)
• The pause is called central and usually last for
  about 15 seconds
• Most widely accepted hypothesis

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Sleep Apnea Hypothesis

• There is an abnormality in the regulation of the
  breathing activity that leads to prolonged
  central apnea, hypoxia which leads to coma, death

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Treatment

• Because SIDS has no known cause and happens
  randomly there is no treatment available.

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Prevention

• Lying the infant on its back during sleep
• Proper bedding
• Controlled environment temperature
• Good prenatal care
• Avoidance of smoke and narcotics
• Monitors
• Co-sleeping with parents

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Co-Sleeping

• Co-sleeping is widely believed to be a
  prevention of SIDS

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Case Study

• In Zimbabwe SIDS practically does not exist.
• English pediatrician Duncan Keely found that
  infants almost always sleep with their mothers,
  at least until 6 months of age.

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What does Co-sleeping do?

• Allows for the mother and infant to interact
  their breathing patterns.
• Exchange sensory stimuli such as sound, movement,
  touch, vision, gas, and temperature.
• Infants spend less time in the deep stages of
  sleep.
• Allows the baby to be near the mother for breast
  feeding during the night.

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Teddy Bear Experiment

• A special teddy bear was developed to reflect the
  babies breathing pattern
• Babies showed quieter sleeping patterns
• The teddy bear apparently facilitates
  neurobehavioral development.

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Breast feeding

• Human milk provides less calories than formula,
  which indicates the need for more frequent
  feedings.
• More frequent contact with mother

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Natural Selection and SIDS

• When an infant is separated from its caregiver,
  its natural instinct is to protest (cry).
• Natural selection probably favored the infants
  who protested.

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Case Study (parent-infant separation)

• When monkey infants were separated from their
  caregivers for as short as 3 hours, they
  experienced significant effects such as
• Decrease in body temp.
• Release of stress hormones
• Sleep disturbances
• Compromises to the immune system
• Cardiac arrhythmias

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Case Study (cont)

• Compared to monkeys, human infants are less
  neurologically developed.
• The symptoms of the monkeys are less likely to
  occur in human infants.

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Cultural Risks

• Culture plays a big part in the occurrence of SIDS

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Cultural Risks
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Case Study (England)

• A study in Birmingham found that on average 22
  of Asian babies are put to sleep on their backs,
  and only 3 of white babies.

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Study (cont)

• 98 of Asian babies slept in the same room as
  their parents for the 1st year.
• 34 in the same bed.

• 65 of White babies slept in the same room.

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Summary

• There is no known cause or treatment for SIDS.
  Although there is action that can be taken for
  the prevention of SIDS. Co-sleeping and breast
  feeding, under proper conditions, are the two
  most significant prevention techniques.
• Cultural practices have relevance to the
  occurrence of SIDS.

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Conclusion

• Education of the parents makes all the difference.