SIDS (sudden infant death syndrome)

1. SAFE SLEEP SIDS (sudden infant death syndrome) “Back to Sleep” only!!

2. What is Sudden Infant Death Syndrome (SIDS)? SIDS is the sudden and unexpected death of an infant under one year of age that remains unexplained after a complete investigation including: - An autopsy - A death scene investigation - Review of medical history

3. Child Fatality Data

4. What causes SIDS? There are still no adequate medical explanations for SIDS deaths, current theories include: stress in a normal baby, caused by infection or other factors a birth defect failure to develop a critical period when all babies are especially vulnerable, such as a time of rapid growth.

5. Triple Risk Model • Certain infants possess underlying vulnerabilities that place them at risk for sudden death. • It is believed that the convergence of these three factors can set the stage for a SIDS death. • Risk reduction efforts are geared toward keeping these factors from converging.

6. What are some risk factors for SIDS? • Prone sleep position • Soft bedding • Maternal smoking during pregnancy • Exposure to nicotine after birth • Overheating • Late or no prenatal care • Prematurity and/or low birth weight • Young maternal age • Male gender

7. At what age does SIDS most likely 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. 

8. Boys are at a higher risk, 60:40 ratio

9. Why does sleep position make a difference? • Less potential for rebreathing CO2 • More arousable • Less “burrowing” • Less moving around the sleep area • Jaw is less likely to occlude airway • May have better airway and cardiovascular protective mechanisms • May be less compression of vertebral arteries

11. Will a baby choke on spit-up or vomit during sleep if placed on its back? No, babies have a natural reflex to turn their head and spit will drip out the side of the mouth instead of pooling around the mouth (which may put them at a higher risk).

12. What is a healthy temperature environment for a sleeping infant? • Avoid over heating/ over bundling, can disrupt arousal. • Dress as is comfortable for adults. • Thermostat no higher than 70̊ • Dress in layers

13. How does Nicotine relate to SIDS? • Smoking during pregnancy and exposure to second hand smoke are highly correlated with SIDS risk • Research suggests that nicotine may further disrupt an infant’s arousal mechanism • Dose-response: the more the cigarettes smoked, the higher the risk • Maintain a smoke-free zone around the baby • Nicotine on clothing can also be harmful

14. Can pacifiers help reduce the risk of SIDS? Studies have consistently shown that there is a significant reduced risk of SIDS with pacifier use. • Consider offering baby a pacifier at naptime and bedtime. • Do not force baby to take pacifier if he/she refuses it. • Do not resist once baby falls asleep. • Introduce pacifier after one month of age to breastfed infants to ensure breastfeeding is firmly established.

15. What is a safe sleep environment? • Firm, flat sleep surface is essential • Use of crib or portable crib is recommended • No pillows, sheepskins, fluffy comforters, blanket rolls, bumper pads or burp rags. • No stuffed toys in bed with the baby • No waterbeds EVER • Avoid use of blankets that can cover the baby’s face; instead dress the baby in layers under blanket sleeper in cold weather • Position infants “feet-to-foot” if blankets are used

16. If a blanket is being used, put the baby’s feet at the foot of the bed. Tuck the blanket around the crib mattress only as far as the baby’s chest.

17. What is SIDS not? SIDS is NOT: • caused by external suffocation • Caused by vomiting and choking • Contagious • Painful and does not cause suffering • Predictable • NEW (Referred in Old Testament-1Kings 3:19)

18. Could a baby who died of SIDS be resuscitated? • No, a baby who dies of SIDS will die. However, this should never be a reason not to attempt resuscitation. • SIDS is only a diagnosis after death and a complete investigation.

19. What do you do if baby will not sleep on his/her back and cries? • Sing, hum, or play soft music. Even making a soft rhythmic sound (Shhhhhhh) over and over will help calm the baby. • If needed, walk baby in your arms, then place him/her on back in the crib when baby is sleepy. • If baby still cries, ask for advice from your doctor or from a trusted friend or family member who has experience getting infants to sleep on their backs. • Place baby’s crib near your bed for at least 6 months. Your breathing may help your baby’s breathing patterns. This can help to lower the risk of SIDS.

20. Are babies uncomfortable on their backs? • Babies do sleep longer and more soundly on their tummies, but that is the problem. They sleep so deeply that they can not wake up easily when they might be in danger. • Some babies seem happier on their tummies. However, babies will adjust to sleeping on their backs if you start placing them on their backs for EVERY sleep.

21. What if baby wakes up fussy during the night? • Wait a moment to make sure the baby is actually awake. Some babies fuss a bit during an “active phase” of sleep, and then fall back asleep. • If baby wakes up and cries, go to him/her as quickly as possible (that helps calm baby so he/she can fall asleep again. • Hold and feed baby is he/she is hungry, and comfort him/her before placing back to sleep in their own crib. • Try not to play with baby during the night when he/she wakes up.

22. Why is tummy time important? • To help develop upper body strength and prevent flat spots on the baby’s head. • Tummy time should be encouraged during play time. • Limit time baby spends in swings, bouncy chairs, car seats, and other devices to reduce the incidence of flat spots.

23. Create a safe sleep zone EVERY TIME! On their Back In a crib or bassinet Without blankets or toys ALONE On a properly fitting firm mattress