Researchers are coming closer to understanding the terrifying phenomenon of sudden infant death syndrome, or SIDS.
SIDS typically affects seemingly healthy children before their first birthday. In some countries, like the United States, it is the leading cause of infant mortality. In 2020, 1,389 babies aged one month to one year died of SIDS in the country.
While experts still do not understand what causes SIDS, progress has been made to lower its risk. In 1990, 155 infants died suddenly from causes, including SIDS, for every 100,000 live births in the United States.
By the year 2000, that number dropped to 94. Interestingly, other parts of the world have reported similar reductions.
Unfortunately, this drop in infant mortality rates has stagnated over the past two decades. In 2020, there were 93 infant deaths per 100,000, only a slight improvement from two decades prior.
To be clear, SIDS is actually identified in patients by eliminating other conditions — a technique known as a diagnosis of exclusion. The mysterious form of death is simply the remaining conclusion when all other potential causes have been exhausted.
“For many years, we thought there was a thing called SIDS. That’s not the working model right now… SIDS is a descriptor — it’s a description of an outcome. And that outcome is that a seemingly well infant is placed to sleep and dies during their sleep for no apparent cause,” explained Richard Goldstein, SIDS researcher and pediatric palliative care specialist at Boston Children’s Hospital and Harvard Medical School.
SIDS being such an enigma, “SIDS vaccines” do not exist.
But while SIDS remains poorly understood, experts have identified ways to lower the risk of its occurrence. Among other recommendations, experts suggest room-sharing, avoiding soft bedding, and never sleeping with a child on a couch or chain or while under the influence of drugs or alcohol.
Crib bumpers are also best avoided. Although banned in the United States, they continue to be sold in other markets worldwide.
Ultimately, according to Anna Pease, a research fellow at the University of Bristol, “The most important thing for your baby is to consider that what they need while they sleep is very important. It’s different to what adults need while they sleep… Infants are preferential nose-breathers. The first few weeks, they just breathe through their nostrils while they’re asleep. Those are tiny, tiny little holes, and they have to get all of their oxygen for life through these tiny little nostrils. That’s why they need a clear face.”
While tempting, Pease said that it is best to avoid putting stuffed animals in an infant’s crib during the early months. “Okay, it’s nice, they want to hang onto the teddy, or you’ve hung a muslin next to their face — take it away. It looks cute for you, but these nostrils are keeping them alive. Make sure that they’re not getting covered in any way.”
Overheating is also an issue potentially linked to SIDS. Compared to adults, children overheat more easily. It is critical to make sure that infants are not overdressed or caught in excessively warm areas. Parents are reminded, for example, to ensure that sunshades on strollers do not end up creating a dangerous pocket of heat.
Research into this tragic and mysterious phenomenon has a long way to go. While identifying risk factors does not eliminate SIDS, experts agree that educating parents on safe sleep is one of the most effective means to reduce its prevalence.
