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Good News: One of the Scariest Childhood Dangers Is Becoming a Relic of the Past.

As a parent, your biggest fear is anything happening to your baby and luckily for us, one of the scariest things that could ever happen to your child is on the decline. Sudden Infant Death Syndrome (SIDS) is the unexplained death, usually during sleep, of an otherwise healthy baby under a year old, and it’s no longer as prevalent as it once was.

There has been a decline in Sudden Infant Death Syndrome diagnoses, most likely attributed to the change of sleep position advocated originally by the medical establishment in 1969, and since then there’s been a great deal of progress. But as experts see it, raising awareness and encouraging research is important in getting parents to reduce risks, while at the same time there is a decline in concern. It remains that SIDS is still the leading cause of death for infants 1 – 12 months old.

Sudden deaths among infants are now more likely to be reviewed by forensic pathologists instead of pediatric pathologists, and they are less inclined to label SIDS as the determining factor in a baby’s death. Forensic pathologists tend to cite suffocation, pneumonia, and, quite often, “undetermined” as the cause of death.

One problem with this is that a Sudden Infant Death Syndrome diagnosis helps parents cope with the trauma and relieves some of the guilt over whether they could have prevented their child’s death. Then, the “undetermined” diagnosis impedes research. The overall decline is confusing for the public about the risk of Sudden Infant Death Syndrome, and undermines interest among doctors to try to find the potential cause.

The cause is not known, but it is now widely suggested that SIDS might be associated with defects in the infant’s brain that controls breathing and waking from sleep.

PROTECTING YOUR CHILD

Researchers have identified issues you can take to help protect your child from Sudden Infant Death Syndrome. One of the most important is placing your baby on her back to sleep.

The crib environment, as well as sleeping position, can combine with a baby’s physical problems to increase the risk of SIDS. Babies placed to sleep on their stomach or side might have more difficulty breathing than those placed on their backs.

Sleeping on a soft surface. Lying face down on a fluffy comforter, a soft mattress or a waterbed can block an infant’s airway.

Sharing a bed. While the risk of Sudden Infant Death Syndrome is lowered if an infant sleeps in the same room as his or her parents, the risk increases if the baby sleeps in the same bed with parents, siblings or pets.

An infant may be more vulnerable to Sudden Infant Death Syndrome for different reasons, which vary according to the individual physical factors.

For example, some babies are born with problems in the portion of the brain that controls breathing and arousal from sleep.

Premature birth, or one of the multiple births such as twins, increases the chances that a baby’s brain is not completely mature, so there is less developmental control over automatic processes, such as breathing and heart rate.

Respiratory infection can also be a factor. Infants who died of Sudden Infant Death Syndrome frequently have had a cold, which might interfere with breathing.

Overheating. Being too warm while sleeping can increase a baby’s risk of SIDS.

RISK FACTORS

Research has identified several factors that might increase a baby’s risk. They include:

  • Sex. Boys are slightly more likely to die of Sudden Infant Death Syndrome.
  • Age. Infants are most vulnerable between the second and fourth months of life.
  • Race. Statistically, non-white infants are more likely to develop Sudden Infant Death Syndrome.
  • Family history. Babies who’ve had siblings or cousins die of SIDS are at higher risk of Sudden Infant Death Syndrome.
  • Secondhand smoke. Babies who live with smokers have a higher risk of Sudden Infant Death Syndrome.
  • Prematurity. Both being born early and having a low birth weight increase your baby’s chances of Sudden Infant Death Syndrome.

The maternal health might also play a role so that inadequate prenatal care or the mother’s use of drugs or alcohol in pregnancy can come into the picture. It may affect the risk of SIDS, especially if she is younger than 20 years old and/or smokes cigarettes.

SUPPORT

Losing a child to SIDS is a highly traumatic event, putting extreme strain on the family and relationships. Not only is grief involved, but also guilt, as parents blame themselves for the loss even though they may have had no role in it.

Often the forensic pathologist will put the family through a difficult investigation, but this is mandatory. Getting emotional support is very important. There are SIDS support groups which can help.

PREVENTION

One of the most successful efforts was the National Institute of Child Health and Human Development’s 1994 “Back to Sleep” (now “Safe to Sleep”) campaign, which recommended that all babies sleep on their backs on a firm, thin mattress with no blankets, crib bumpers, or other suffocation hazards. In the wake of the campaign, Sudden Infant Death Syndrome rates declined by more than 50 percent.

Place your baby to sleep on his or her back, rather than on the stomach or side, every time you put the baby to sleep for the first year of life. This isn’t necessary when your baby’s awake or able to roll over both ways without help but until then don’t assume that child care providers will follow this rule.

Keep the crib as bare as possible. Use a firm mattress and avoid placing your baby on thick, fluffy padding, such as lambskin or a thick quilt. Don’t leave pillows, fluffy toys or stuffed animals in the crib. These can interfere with breathing if your baby’s face presses against them.

Don’t overheat the infant.  Don’t cover your baby’s head.

Have your baby sleep in your room, at least for the first six months to a year in a safe crib or bassinet within reach of you and where you can hear them if they wake.

Sleeping with the child in your bed with you does have hazards. Adult beds aren’t safe for infants. A baby can become trapped between the headboard slats or suffocate in the pillows, the space between the mattress and the bed or the wall. Also, a sleeping parent might accidentally roll over and smother the child.

Breastfeed your baby. Breastfeeding for at least six months lowers the risk of SIDS.

Baby monitors and other commercial devices that claim to reduce the risk of Sudden Infant Death Syndrome are most likely worthless. The American Academy of Pediatrics discourages the use of monitors and other devices because of ineffectiveness and safety issues.

Offer a pacifier. It’s possible that giving your baby a pacifier without a strap or string at naptime and bedtime might reduce the risk of Sudden Infant Death Syndrome. But if you’re breastfeeding, wait until your baby is 3 to 4 weeks old and you’ve settled into a regular nursing routine. If there’s no interest in the pacifier, don’t force it on the child.

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