Sudden infant death syndrome (SIDS) refers to the unexpected, unexplained death of a child less than one year old. SIDS is rare during the first month of life. It peaks at 2 to 4 months of age, then gradually decreases.
Experts do not know the exact cause of SIDS. Many theories exist. Potential causes include: Abnormalities in a section of the brain that controls breathing during sleep and wakingAbnormalities in the control of heart rhythmChanges in how serotonin, a neurotransmitter, functions in the brainChanges in some components of the immune systemInadequate arousal response to breathing obstruction or asphyxia—a lack of oxygen or excess carbon dioxide in the body caused by interruption of breathing; may cause unconsciousness
Area of the brain involved in regulation of breathing.
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factors that increase the chance of SIDS include: Infant's age: less than 6 months oldLow birth weightDelayed fetal growthHistory of SIDS death in a siblingHistory of an acute life-threatening eventPrevious incident of unexplained severe apnea—when breathing is repeatedly interrupted and requires resuscitationSleeping on the stomach or side rather than back
Other risk factors are more general and include:
during pregnancy or in a house where the baby is sleeping
, excessive caffeine, opiate, or
use during pregnancy
Mother's age: younger than 20 during first pregnancyPovertyBlack, Native American, and Alaskan Native familiesSex: male
urinary tract infection
No or late prenatal carePremature birthRecent infection and/or feverCold weather in late fall or winterOverheatingLow socioeconomic status or low level of educationCo-sleeping in parents roomLoose covers and blankets
A baby that dies of SIDS typically appears healthy. The baby may have had a
or gastrointestinal infection in the two weeks prior to death. There usually are no warning signs that a baby is about to have SIDS.
All possible illnesses and causes of death must be ruled out before a diagnosis of SIDS is made. A complete investigation will take place including: AutopsyAssessment of the death sceneReview of the baby and family's medical histories
Emergency medical personnel should be called as soon as the infant is discovered not breathing.
should be started right away. Seek medical care right away even if the baby starts breathing again. The cause of the incident should be fully evaluated. Families may need grief counseling after the death. Some parents find
There is no way to predict which infants will die of SIDS. Several actions may help you lower your child's risk of SIDS:
Get prenatal care early and regularly.Do not smoke, drink alcohol, or use drugs while pregnant.
Babies less than one year old should sleep on their back. Do not allow a young baby to sleep on his stomach or side. However, many babies roll over after 6 months of age and do not require constant monitoring of sleep position. Ask your doctor for more information about positioning your baby for sleep.
Other factors that may help reduce SIDS risk include:
Provide a firm crib mattress.Breastfeed your baby.Do not place blankets, a comforter, pillow, or sheepskin under your baby.Do not let your baby sleep on a waterbed.Remove soft, stuffed toys and loose bedding from the sleep area.Do not cover your baby's head or face.Have your baby sleep in the same room as you do, but do not share your bed.Keep the bedroom at a comfortable temperature (68-72 degrees Fahrenheit [20-22.2 degrees Celsius]).Avoid overheating. Do not overdress your baby.Give your baby a pacifier during nap time and bedtime.While your baby is awake, place him on his stomach so that he can move his body.If you smoke, do not smoke in the house or around your baby. Ask your doctor about ways you can quit.Be sure that your baby gets routine medical care, including the recommended vaccines.Do not use cardiorespiratory monitors or other commercial devices that claim to reduce the risk of SIDS. There is no evidence that these devices are useful.
Make sure anyone else caring for your child is also aware of these recommendations.
American Academy of Pediatrics SIDS Task Force. The changing concept of sudden infant death syndrome: diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk.
Galland BC, et al. Prone versus supine sleep position: a review of the physiological studies in SIDS research.
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Sudden infant death syndrome (SIDS). EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated February 11, 2013. Accessed February 18, 2013.
Sudden infant death syndrome (SIDS). Nemours Kid's Health website. Available at:
http://kidshealth.org/parent/general/sleep/sids.html. Updated October 2011. Accessed February 18, 2013.
10/23/2009 DynaMed Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Blair P, Sidebotham P, et al. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England.
11/14/2011 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment.
Last reviewed March 2014 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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