SIDS

For other uses, see SIDS (disambiguation).

Sudden infant death syndrome
Other names
  • Cot death
  • crib death
Safe to Sleep logo
The Safe to Sleep campaign encourages having infants sleep on their back to reduce the risk of SIDS.
Specialty
Usual onsetOne to four months in age[1]
CausesUnknown
Risk factors
Diagnostic method
Differential diagnosis
Prevention
Frequency1 in 1,000–10,000

Sudden infant death syndrome (SIDS), sometimes known as cot death, is the sudden unexplained death of a child of less than one year of age. Diagnosis requires that the death remain unexplained even after a thorough autopsy and detailed death scene investigation.[2] SIDS usually occurs during sleep.[3] Typically death occurs between the hours of midnight and 9:00a.m.[4] There is usually no noise or evidence of struggle.[5] SIDS remains the leading cause of infant mortality in Western countries, constituting half of all post-neonatal deaths.[6]

The exact cause of SIDS is unknown.[7] The requirement of a combination of factors including a specific underlying susceptibility, a specific time in development, and an environmental stressor has been proposed.[3][7] These environmental stressors may include sleeping on the stomach or side, overheating, and exposure to tobacco smoke.[7] Accidental suffocation from bed sharing (also known as co-sleeping) or soft objects may also play a role.[3][8] Another risk factor is being born before 37 weeks of gestation.[1] Between 1% and 5% of SIDS cases are estimated to be misidentified infanticides caused by intentional suffocation.[9][10] SIDS makes up about 80% of sudden and unexpected infant deaths (SUIDs).[3] The other 20% of cases are often caused by infections, genetic disorders, and heart problems.[3]

The most effective method of reducing the risk of SIDS is putting a child less than one year old on their back to sleep.[1] Other measures include a firm mattress separate from but close to caregivers, no loose bedding, a relatively cool sleeping environment, using a pacifier, and avoiding exposure to tobacco smoke.[11] Breastfeeding and immunization may also be preventative.[11][12] Measures not shown to be useful include positioning devices and baby monitors.[11][12] Evidence is not sufficient for the use of fans.[11] Grief support for families affected by SIDS is important, as the death of the infant is unexpected, unexplained, and can cause suspicion that the infant may have been intentionally harmed.[3]

Rates of SIDS vary nearly tenfold in developed countries from one in a thousand to one in ten thousand.[3][13] Globally, it resulted in about 19,200 deaths in 2015, down from 22,000 deaths in 1990.[14] SIDS was the third leading cause of death in children less than one year old in the United States in 2011.[15] It is the most common cause of death between one month and one year of age.[1] About 90% of cases happen before six months of age, with it being most frequent between two months and four months of age.[3][1] It is more common in boys than girls.[1] Rates of SIDS have decreased by up to 80% in areas with "Safe to Sleep" campaigns.[13]

  1. ^ a b c d e f "How many infants die from SIDS or are at risk for SIDS?". National Institute of Child Health and Human Development. 19 November 2013. Archived from the original on 2 April 2015. Retrieved 9 March 2015.
  2. ^ "Sudden Infant Death". Centers for Disease Control and Prevention. Archived from the original on 18 March 2013. Retrieved 13 March 2013.
  3. ^ a b c d e f g h Kinney HC, Thach BT (August 2009). "The sudden infant death syndrome". The New England Journal of Medicine. 361 (8): 795–805. doi:10.1056/NEJMra0803836. PMC 3268262. PMID 19692691.
  4. ^ Gilbert-Barness E, Spicer DE, Steffensen TS (2013). "Sudden Death Syndrome". Handbook of pediatric autopsy pathology (Second ed.). New York, NY: Springer New York. p. 654. ISBN 9781461467113. Archived from the original on 14 January 2023. Retrieved 15 September 2017.
  5. ^ Sethuraman C, Coombs R, Cohen MC (2014). "Sudden Unexpected Death in Infancy". In Cohen MC, Scheimberg I (eds.). Pediatric & Perinatal Autopsy Manual. Cambridge. p. 319. ISBN 9781107646070.
  6. ^ Raven L (2018). "Sudden Infant Death Syndrome: History". In Duncan JR, Byard RW (eds.). SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future. Adelaide (AU): University of Adelaide Press. ISBN 978-1-925261-67-7. PMID 30035955. Archived from the original on 27 July 2022. Retrieved 28 September 2020.
  7. ^ a b c "What causes SIDS?". National Institute of Child Health and Human Development. 12 April 2013. Archived from the original on 2 April 2015. Retrieved 9 March 2015.
  8. ^ "Ways To Reduce the Risk of SIDS and Other Sleep-Related Causes of Infant Death". NICHD. 20 January 2016. Archived from the original on 7 March 2016. Retrieved 2 March 2016.
  9. ^ Hymel KP (July 2006). "Distinguishing sudden infant death syndrome from child abuse fatalities". Pediatrics. 118 (1): 421–427. doi:10.1542/peds.2006-1245. ISSN 1098-4275. PMID 16818592.
  10. ^ Milroy CM, Kepron C (June 2017). "Ten Percent of SIDS Cases are Murder - or are They?". Academic Forensic Pathology. 7 (2): 163–170. doi:10.23907/2017.018. PMC 6474533. PMID 31239971.
  11. ^ a b c d Moon RY, Fu L (July 2012). "Sudden infant death syndrome: an update". Pediatrics in Review. 33 (7): 314–320. doi:10.1542/pir.33-7-314. PMID 22753789.
  12. ^ a b "How can I reduce the risk of SIDS?". National Institute of Child Health and Human Development. 22 August 2014. Archived from the original on 27 February 2015. Retrieved 9 March 2015.
  13. ^ a b Duncan JR, Byard RW (2018). "Sudden Infant Death Syndrome: An Overview". In Duncan JR, Byard RW (eds.). SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future. University of Adelaide Press. ISBN 9781925261677. PMID 30035964. Archived from the original on 2 July 2020. Retrieved 1 August 2019.
  14. ^ Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  15. ^ Hoyert DL, Xu J (October 2012). "Deaths: preliminary data for 2011" (PDF). National Vital Statistics Reports. 61 (6): 1–51. PMID 24984457. Archived (PDF) from the original on 2 February 2014.