Sudden Infant Death Syndrome
The disease as its name suggests denotes the unexplained and abrupt demise of infants
aged one year and below. It is commonly denoted as SIDS, and it is the leading cause of infants’
deaths. This has left medical experts in a challenging position as they have not been able to
discern the condition. Even after years of thorough research, the disease remains a mystery to
scholars and medical specialists. Some campaigns have been implanted to combat this issue such
as the “Back to Sleep” campaign which commenced in 1994 (Centor, 2016) (De Luca & Hinde,
2016). It has been able to cut back SIDS incidences by more than 50% (Moon, 2016). Here we
are going to discuss the syndrome’s general overview and prevalence, factors that are presumed
to explain its onset such as genetics, triple-risk models and infant’s arousal response. The paper
will also shed some light on some of the prevention methods for SIDS and the risk factors
associated with it. This essay will prove beneficial to medical practitioners, scholars, parents, the
general public and anyone else who wishes has a newborn.
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Sudden Infant Death Syndrome
It is the condition characterized by the demise of a healthy infant in their sleep. It is most
prevalent in children under one year of age. The disease’s etiology is a challenge since it neither
has symptoms nor signs which can be used to detect it. Most of the times it occurs when parents
are asleep. In the past, it has been called “crib death” even though cribs themselves do not
contribute to the condition. Researchers have estimated that it causes over 2600 deaths annually.
It is usually devastating to a family.
Risk factors and diagnosis
Early infancy is usually coupled with various challenges since the child is vulnerable and
fragile. During this stage of growth, the child can be subjugated to ailments, injuries among other
hazards which might be detrimental to their health. SIDS is an unsolved and predominant issue
of the early infancy period. Its mortality rates surpass those of people dying from other ailments
such as HIV/AIDS, cancer, pneumonia, heart disease, child abuse and so on. The diagnostic term
has been well agreed upon by scholars and medical specialist as it involves a particularly healthy
child dying unexpectedly and the death remains a mystery until an autopsy is carried out (Dagur
et al., 2015).
Many children are found dead in their cribs annually. In America’s urban regions, SIDS
incidences can be high as 3 to 4 deaths per 1000 births (Dagur et al., 2015). In Canada alone. It
accounts for more than a 1000 deaths, in America 7000 deaths annually and Britain about 1500
SIDS cases. Within Canada’s Northwest areas, the prevalence is five times higher than in
Quebec. The reason for this difference is unknown. In developed nations where medical
amenities are available and reliable, and the proportion of socio-economically underprivileged individuals is relatively low hence being the leading cause of life loss in the post-neonatal phase
of life. Though concerning this, there are various factors which contribute to its increased
prevalence. Babies who weigh less are at a greater risk of the ailment. It is more potent between
midnight and nine in the morning rather than the rest of the day.
Exact causes are unknown even after thorough research spanning an extended period.
The only close explanations that link to the disease are few. Even though, there exist factors
which increase the syndrome’s proneness. Its prevalence rates occur to approximately 1 in every
1000 babies (Dagur, Warren, Imhof, Imhof, Wasnick, & Khan, 2015). It has been estimated that
around 3000 pass away from SIDS annually in the United States (Dagur et al., 2015). This is
such a towering figure if we look at global statistics. Most infants die within their first six
months after birth. It mostly occurs when they are asleep but can also happen while they are up.
Chances of the syndrome usually intensify in infants in the range of two to four weeks of
age. It is unusual in the first month of infancy. Studies show a 90% mortality rate occurring in
infants younger than six weeks of age (Dagur et al., 2015). SIDS does not have a definite cause
which proves to be quite a challenge for scientists and medical specialists. So far there exist no
concepts which give a credible response to this condition (Dagur et al., 2015).
Causes of SIDS have never been discovered, but scientists have been able to identify
some of the factors that increase proneness of an infant to the condition. Most of them are risk
factors are behavioral. The position that one’s puts the child to sleep is one of the most
significant factors especially when investigating the scene of death. Laying a baby to sleep on
their stomach can lead to suffocation which will eventually lead to the child’s demise.
Children born prematurely or with a low birth weight are most vulnerable to the condition
(Dagur et al., 2015). Being premature is the primary factor, but it is also enhanced by other
factors which have not been able to be identified by scientists and physicians.
Structural variations in specific portions of the mind may contribute to chances of SIDS
(Dagur et al., 2015). Victims of this ailment have been examined, and their brains stems have
shown an emerging delay in functioning and formation of some nerve pathways in the brain
(Dagur et al., 2015). These pathways regulate pulse rate, reactions to hypertension and
Co-sleeping can also cause SID in infants. This can occur if the parent when turning
suffocate the child. Another way in which the child can be affected is the spike in heat due to the
covers. Extreme temperatures due to overdressing and irregular room temperatures lead to
increased fat metabolism in the babies hence resulting to loss respiratory control (Jhun, Mata,
Nordio, Lee, Schwartz, & Zanobetti, 2017). Apparent life-threatening activities commonly
abbreviated as ALTEs (Dagur et al., 2015) denote actions whereby infants show unanticipated
changes regarding respiration, convulsions and gastro-esophageal ailments leading to
regurgitation while asleep (Dagur et al., 2015). Medical proof between these activities and SIDS
has not been found.
Over 60 theories have been put forward which suggest describing the SIDS etiology.
Some of the proposed approaches are accelerated by the various potent factors leading to the
syndrome. One theory suggests that since the child is continually developing there occurs a
defect in the neurological centers (Dagur et al., 2015). When a child is asleep and assumes an
inappropriate position, they might choke, or the fresh air in the sheets reduces, the body should
counteract this through a response hence waking up the child, but in this case, it malfunctions leading to SID. In the facedown position, the respiratory system is affected leading to
Another theory proposed is when a child is at the infancy stage, the fat tissue develops
rapidly hence affecting the structure of blood vessels which transport oxygenated and
deoxygenated blood to the respective part of the body (Dagur et al., 2015). If oxygen-rich blood
does not reach the child’s brain in time, it ceases to function. Hence the wake response is not
triggered, and the child suffocates. The neurological anomaly also affects the way they regulate
their heart rates, temperature, and respiration which also contribute to SIDS (Jhun et al., 2017).
Behavioral and environmental stresses such as alcohol and tobacco smoke contribute to
the condition's prevalence. Alcohol consumption during maternity has been proved to pose a
high risk to an unborn infant (Dagur et al., 2015). Both the mother and the child are put
predisposed to risk as research suggests. These risks include miscarriages, stillbirths, premature
babies and low-weight-born babies. Cigarettes and alcohol contain toxins which find their way to
the fetus via the placenta. It also interferes with the assimilation of food taken thus affecting the
mother's nutrition which impacts the child’s growth negatively. Research has shown that alcohol
resides in an infant’s blood twice as long as it would in the mother (Dagur et al., 2015). It causes
irreversible damage to the fetus during gestation especially the first trimester where vital organs
of the central nervous system development.
The disease has no signs of manifestation which a parent can recognize earlier to prevent
the condition. Doctors cannot even carry out a differential diagnosis procedure. This means that
neither signs or symptoms are available to diagnose the disease unlike other diseases such as
coughing, rashes, restlessness, crying, vomiting and so on. The only diagnosis method available
can only be employed after the child has died.
These diagnosis procedures include autopsies, reviewing the victim’s family history of
the case and investigation of the death scene (Moon, 2016). This is quite tragic for the family,
and they become devastated by the ordeal.
Research also showed that healthcare specialists' advice matters. Statistics have shown that safe
sleep messages did not reach most groups especially individuals of Indian, American and Indian
When babies are asleep, they experience apnea which is a temporary stop in respiration,
and if extended, a baby should wake up and breathe (Ray & Bower, 2016). Sometimes,
complications in the nerve and control centers controlling this phenomenon occur, and the baby
is not able to wake themselves to breathe, and accidental suffocation or death might transpire.
Sleeping positions are the major contributors to SIDS high frequency of occurrence. It is
considered mysterious because its clinical style of death is unidentified. Most babies who pass
away are either at home unattended or unobserved. Most of the times, at the time of the baby’s
death, they are rarely being monitored.
The child does not depict any sign of struggle or infection. The children do not show any
forewarning signs though some show little evidence of infection in the upper respiratory tract.
Prolonged apneic incidences are rarely intervened (Ray & Bower, 2016). If intervention occurs
before the period is too lengthy the baby can be resuscitated and can continue living a healthy
life whereas others are vulnerable to the same experience within a short period. Scientists have
intensified research on the central nervous system, sleeping patterns, heart, environmental
factors, chemical balances in the bodies and the heart. These studies are aimed at finding the
possibility of SIDS having multiple explanations as other disorders.
Further research is underway to investigate whether there exist pathogens responsible for
the disorder. Some studies have shown that many of the babies that die of SIDS did have
complications during their neonatal stage as well as in other situations (Moon & Task, 2016).
Such subjects have been seen to have hard a challenging post-neonatal phase characterized by
poor vigor and growth patterns. Slight pathologic changes are observed when an autopsy is
carried out on a child who has died of SIDS. Some include an enlarged thymus gland and
petechia present in lungs, brain, and thymus (Ray & Bower, 2016). Sub-acute inflammation
might be evident in the larynx also.
Some possible causes of SIDS have been proposed such as allergy to milk and other substances,
inadvertent aspiration of gastrointestinal contents which can cause laryngospasm, spinal injury,
Other researchers believe that the unexplained deaths might be due to an acute infection
of the respiratory tract by a virus, metabolism and circulation system complications. Moreover,
there has been backing to the claim that death results from sudden disruptions of physiological
functions particularly the central nervous system which interferes with the functioning of the
cardiac and respiration centers resulting in apnea and ventricular fibrillation (Ray & Bower,
2016). An investigation is underway so that vulnerable children can be identified and helped
through the risky infancy period via proper maintenance and monitoring techniques.
Although substantial evidence is absent, Sudden Infant Death Syndrome may be
classified as a sleep disorder. This relation is suggested since most deaths occur when the subject
is napping or asleep. Studies have shown that infants have a higher ability to react to low oxygen
levels in the blood using rapid eye movement (REM) than in older children and grownups (Ray
& Bower, 2016). Premature babies are commonly pre-disposed to sleep disorders such as apnea.
There is a constant discovery in all victims of SIDS after an autopsy is done such as fresh
lacerations on the heart and lungs (Ray & Bower, 2016). This mechanism is similar to that of
choking or blocking of the upper respiratory tract. Although these theories might seem credible,
they lack evidence-based links to support them. Most of the clinical information observed does
not concur with the hypothesis put forward by various scholars and researchers (Moon & Task,
Effects and prevalence
SIDS only have one effect, death of the infants. The disease is most prevalent in male
babies than females (Dagur et al., 2015). Regarding ethnicity or race, individual of America-
Indian descent and Alaskan natives are more prone to acquiring the ailment than non-Hispanic
blacks. Mortality rates among non-Hispanic Whites and Asians are considerably lower according
to 2014 CDC reports (Moon, 2016).
Researchers have also observed that the rate of occurrence is higher on the weekends than
on weekdays. This can be attributed to the comfort associated with the weekend especially to the
parents who have been working hard throughout the week and maybe tend to extend their sleep
hours. For instance, in the United States, some races are more vulnerable than others. Rates are
higher among Indian-Americans, African-Americans, and Mexicans of Asian descent than
Caucasians. Cases of SIDS prevail more among children coming from families that are deprived
socio-economically such as poor sanitation and housing (Ray & Bower, 2016). Studies have also
shown that children born out of wedlock are at a much larger risk of Sudden Infant Risk
It is more prevalent in households where cigarette smoke is regularly found. Families that
have had an incidence of child death due to SIDS have a higher rate of reoccurrence by four to
eight times than the general population (Moon & Task, 2016). In temperate and sub-tropical climatic regions there exists a small variance in the rate of unsolved deaths which occur in the
months of summer and winter (Moon & Task, 2016). In some parts of the globe, there are
significant seasonal changes in temperature, and the cases prevail more in winter than in
summer. This discovery has created a clue that cold weather may be linked to SIDS’s
Prevention and control
In essence, SIDS is not preventable through drugs or therapy, but some measures can be
employed to reduce its prevalence and get rid of predisposing factors. Parents should put into
consideration a child’s position while laying them to sleep. It is recommended the babies to be
placed on their backs and not on their stomach (Horne, Hauck & Moon, 2015). This is the safest
position recommended for children.
Using a firm and waterproof material such as a mattress in safe cot. This lessens the risk
to the condition. Placing a child on soft surfaces or materials such as sofa cushions, waterbeds,
sofas and so on increases the risk of the condition. Remove all fluffy beddings from the child’s
Ensure that when the baby sleeps, they assume a position where their feet touch the end
of the crib (Moon, 2016). In this position also ensure that the baby’s head remains uncovered
(Horne et al., 2015). The sheets or blackest should not be tucked beyond the shoulders.
For the first six months make sure that you share the room with the baby not necessarily
the same bed. This will enable periodic monitoring of the baby (Horne et al., 2015), and in case
they move from their position, you return them to normal.
Keeping soft items, toys and loose beddings away from the baby’s sleep area (Horne et
al., 2015). Do not support the child using pillows, quilts, blankets or bumpers (Ward, 2016).
They can cause serious injuries through strangulation which can lead to death.
A baby should be dressed in sleep clothing which is light such as one-piece sleepers
(Horne et al., 2015). These keep the baby warm without smothering which might result in
suffocation and heat stress (Jhun et al., 2017).
Vaccinations have also been proved to be a prevention strategy against SIDS. Research
has shown that vaccinations can reduce the risk of the disease by 60% (LaPorta & PGY, 2016).
Though additional studies have shown, there is no causal link between the ailment and
vaccinations. But parents should be advised to follow their vaccination schedules to the letter to
ensure that the babies are well monitored.
Do not allow the child to get too warm during sleep hours (Ward, 2016). The baby’s
room temperature should be between 16 to 20 0 C (Jhun et al., 2017). This can be avoided by
ensuring proper ventilation and avoiding smothering the baby with multiple cloth layers.
Behaviors which predispose children to the syndrome such as smoking and consumption
of alcohol should be avoided. Infants born to mothers who smoke are at greater peril. Taking
alcohol and illegal substances increases a baby’s risk to SIDS. Studies have shown that alcohol
consumption especially binge drinking when a pregnant lady is in the first trimester.
Breastfeeding lowers baby’s risk to SIDS (Moon, 2016). Research has shown that non-
breast fed babies are at a higher risk than breastfed babies. Psychologic analysis has stated that
breastfed infants have a higher arousal response from sleep than formula-fed babies (LaPorta &
Ensuring that family members and other individuals near the child knows how to position
the bay while sleeping (Horne et al., 2015). Show them the proper procedure for placing the
child on their back and maintain constant monitoring to ensure the child is safe.
In the past electronic cardio-respiratory devices were used to monitor a child or detect
SIDS (Moon, 2016). These have been phased out as medical practitioners termed it ineffective
since some couples reported losing their children even after using the device.
Also ensuring that there is adequate fresh air circulating the baby’s crib. A study
involving 500 babies has proved that adequate air supply and circulation using a fan reduced the
risk of SIDS (Ray & Bower, 2016). Using a pacifier is also recommended as a preventive
measure against the disorder (LaPorta, 2016). Sucking on a pacifier while sleeping lessens the
risk. Even though, policymakers have not advocated for its use since as it is safe, it also poses the
risk of suffocating the child.
Parents should be encouraged to take CPR courses which will equip them with essential
information which would be an important prerequisite for parenting (LaPorta, 2016) (Ray &
Bower, 2016). Medical specialists should recommend counseling sessions for an affected family
since it is difficult for some parents to let go of the guilt feeling. Hence they need constant
reassurance that they were not the ones responsible for the event.
Other families employed the use of wedges and positioners, but they are not
recommended. The consumer product and safety commission (CPSC) has resorted deaths caused
by these devices by suffocation or entrapment (Moon, 2016). Campaigns aimed at reducing SID
deaths have been founded. One successful campaign is referred to as the “Back to Sleep
campaign” (Centor, 2016) which fostered research on the ailment and dissemination of
information to people to help reduce risks (De Luca & Hinde, 2016). Since its inception, it has been able to reduce deaths by 50% (Moon, 2016). They have also tried to reach more people by
translating material (De Luca & Hinde, 2016).
SIDS and related ailments have devastated families and medical specialists. But progress
has been made regarding the condition. Major risk factors have been identified, and continued
research will help to discover more. Dissemination of information should be enhanced even
through social media campaigns to avoid unnecessary loss of life. Counseling is usually
recommended for affected families. Families should work with close support service such as
medics in the event of such cases and seek proper medical advice even when a baby has a minor
Centor, F. H. (2016). SIDS Prevention Through a Back to Sleep Campaign. Journal of Obstetric,
Gynecologic & Neonatal Nursing, 45(3), S29.
Dagur, G., Warren, K., Imhof, R., Imhof, N., Wasnick, R., & Khan, S. A. (2015). Current
Concepts of Sudden Infant Death Syndrome: A Review of Literature. Translational
De Luca, F., & Hinde, A. (2016). Effectiveness of the ‘Back-to-Sleep’campaigns among
healthcare professionals in the past 20 years: a systematic review. BMJ open, 6(9),
Horne, R. S., Hauck, F. R., & Moon, R. Y. (2015). Sudden infant death syndrome and advice for
safe sleeping. Bmj, 350, h1989.
Jhun, I., Mata, D. A., Nordio, F., Lee, M., Schwartz, J., & Zanobetti, A. (2017). Ambient
Temperature and Sudden Infant Death Syndrome in the United
States. Epidemiology, 28(5), 728-734.
LaPorta, M. D., & PGY, J. (2016). SIDS Prevention.
Moon, R. Y., & Task Force on Sudden Infant Death Syndrome. (2016). SIDS and other sleep-
related infant deaths: evidence base for 2016 updated recommendations for a safe infant
sleeping environment. Pediatrics, e20162940.
Ray, R. M., & Bower, C. M. (2016). Pediatric Sleep Disorders. In Clinician's Guide to Pediatric
Sleep Disorders (pp. 21-38). CRC Press.
Ward, T. C. S., & Balfour, G. M. (2016). Infant safe sleep interventions, 1990–2015: A
review. Journal of community health, 41(1), 180-196.