Letter to the editor: SIDS awareness

Each year over 2,300 infants die of Sudden Infant Death Syndrome. Recent research identifies three factors that contribute to sudden infant death.  Parents and caregivers can avoid one risk factor with one simple action: placing child on their back to sleep.

As a Nursing Student here at WCC, and a father of three, doing this research was eye opening. Among our diverse student body, there are countless mothers and several pregnant women who could use this information to protect their children.

Jim Abraham
President WCC Student Nurse Association
jaabrham@wccnet.edu

Safe to sleep – saves lives

Premature birth, low birth weight and congenital anomalies are three of the principle causes of infant death in the United States. However, the leading cause of death in infants one month to one-year-old is Sudden Infant Death Syndrome better known as SIDS. Over 2,300 newborns die from SIDS each year in the U.S.

SIDS is a mysterious event which occurs when a sleeping baby does not awaken. Prior to sleep, the newborn appears seemingly healthy – however, some physical or environmental factor occurs and the newborn dies.

Research identifies three contributing factors:

Some research indicates SIDS occurs when three factors are present simultaneously – labeled, The Triple Threat. The first factor is an underlying vulnerability in the infant; the second, a critical developmental period; and the third, an exogenous stressor i.e. asphyxia.

Dr. Hannah Kinney, an MD from Boston Children’s Hospital and a leading researcher in the area of SIDS, states;

“During the first year of life, rapid changes in the maturation of cardio-respiratory control and cycling between sleeping and waking occur. According to the Triple-Risk Model, SIDS does not cause death in normal infants but, rather, only in vulnerable infants with an underlying abnormality. Therefore, the change to a supine sleep position is effective because once the exogenous stressor (face-down position) is removed, the vulnerable infant passes through the critical period unharmed.”

Identifying a possible cause

Sleep environmental factors, such as items in a baby’s crib and his or her sleeping position can combine with a baby’s physical problems to increase the risk of SIDS. Examples would include:

-Sleeping on the stomach or side. Babies who are placed on their stomachs or sides to sleep may have more difficulty breathing than those placed on their backs.

-Sleeping on a soft surface. Lying face down on a fluffy comforter or a waterbed can block an infant’s airway. Draping a blanket over a baby’s head also is risky.

– Sleeping with parents. While the risk of SIDS 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 — partly because there are more soft surfaces to impair breathing.

Whereas the physical factors associated with SIDS are:

– Brain abnormalities – Some infants are born with problems that make them more likely to die of SIDS. In many of these babies, the portion of the brain that controls breathing and arousal from sleep doesn’t work properly.

-Low birth weight – Premature birth or being part of a multiple birth increases the likelihood that a baby’s brain hasn’t matured completely, so he or she has less control over such automatic processes as breathing and heart rate.

– Respiratory infection – Many infants who died of SIDS had recently had a cold, which may contribute to breathing problems.

Education is paramount – is it enough?

St. Joseph’s Hospital attempts to role model a safe sleep environment during the mother/baby hospital stay. Due to the critical nature with potential fatalities, St. Joseph’s created a policy and procedure to ensure all parents and caregivers are provided the necessary tools to mitigate such tragedies.

Nurses are responsible to review the following information at discharge with new parents and caregivers: Always place infant on back to sleep – Infant sleeps by oneself in crib of bassinet – Infant on firm mattress with tightly fitting sheets – Baby should only be held by parents/family when they are awake. In addition, the parents/caregivers are encouraged to watch a safe-to-sleep video prior to discharge.

SIDS does not discriminate

Although certain groups have higher rates and certain geographic locations show increased incidence – making choices against these evidenced based recommendations could put you or your child at risk to fall victim, unnecessarily in many instances to SIDS – one of the leading causes of infant death. Remember: Safe to Sleep – Always Alone – Always on their Back – Always in their Crib.

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