What you need to know about SIDS

Cot death (or SIDS) is one of the scariest phrases you can hear as a parent. The lack of a clear explanation behind the devastating loss makes it all the more difficult to bear. Here’s what you need to know to protect your baby.

As the name implies, cot death or sudden infant death syndrome (SIDS), is the loss of a baby under the age of one year, without warning or clear clinical cause, usually during sleep.

Although SIDS is the leading cause of death among babies between one month and one year of age in the developed world, it remains rare, with less than one incident per thousand babies. Most deaths occur between two and four months of age, with 90% of cases happening under six months.

Nobody knows the exact reasons it happens, but SIDS is thought to be associated with immaturity in the brain centre responsible for breathing and waking. When these babies experience environmental changes such as overheating, or if their mouth or nose becomes covered, they are unable to regulate their heart rate, breathing and temperature, as other babies would.

Several studies have found a higher incidence of SIDS among babies placed on their stomachs to sleep than among those who sleep on their backs or sides.

A related theory is that soft bedding can trap exhaled air around a baby’s face, resulting in his re-breathing it, eventually leading to lowered oxygen levels and accumulating carbon dioxide levels.

Although we don’t yet know the why of SIDS; we do know there are certain factors that increase risk. These include sleeping on the stomach, premature birth and low birth weight, exposure to smoking, room temperature and gender (more males than females are affected by cot death).

Several studies have found a higher incidence of SIDS among babies placed on their stomachs to sleep than among those who sleep on their backs or sides. Some researchers have suggested that stomach sleeping hampers breathing as a result of pressure on the baby’s airway and jaw.

Back in 1992, The American Academy of Pediatrics launched a ‘Back to Sleep’ campaign, through which they encouraged parents to put their healthy infants to sleep on their backs. Since this recommendation, the rate of SIDS in the US has dropped by more than 50%. Still, SIDS remains the leading cause of death in young infants.

Sleep safe

We as parents can’t mitigate every risk factor, but some are within our control.

Paediatrician for Nubabi, Dr Martin Bailey offers these safe-sleep tips:

• Babies must sleep on their backs, not on their sides and never face-down. Some parents fear their babies will choke if they lie on their backs to sleep, but “healthy babies do not choke,” says Dr Bailey.
• Put baby in a cot in your room with you to start.
• Don’t smoke during pregnancy nor around your baby after birth. Infants of mothers who smoked during pregnancy are three times more likely to die of SIDS than those whose mothers were smoke-free. Exposure to secondhand smoke doubles a baby’s risk of SIDS.
• Don’t make baby’s room too hot. The ideal temperature is 16-20ºC. Avoid hot water bottles and electric blankets.
• Remove your baby’s hat once inside.
• Waterbeds, beanbags, pillows, baby nests, fleeced and other soft surfaces are not suitable to sleep on.
• Avoid duvets, quilts, bedding rolls and pillows.
• Do not use cot bumpers in cots. These present a potential risk of suffocation or strangulation.
• Use a firm mattress with a waterproof cover and single over-sheet.
• Take your baby for regular check-ups. In about half of all cases of a baby dying unexpectedly, a health condition, illness or accident is found to be the underlying cause.
• Keep up to date with immunisations. Studies have shown that babies who have their immunisations have a 50% lower risk of SIDS.
• Consider using a dummy at bedtime: There is some evidence that using a dummy reduces incidence of cot death.

While SIDS isn’t always preventable, following these evidence-based guidelines will enable you to have peace of mind, knowing you’re doing everything in your power to keep your precious baby safe at sleep times.