Introduction
The loss of an infant to its family is tragic, and more so when the infant dies suddenly without any signs of warning, Sudden death infant syndrome (SIDS) is such a tragedy.
Overview of Sudden Death Infant Syndrome (SIDS)
Kum-Nji, Mangrem, Wells and Henry, 2001, define Sudden death infant syndrome (SIDS) as “the sudden and unexpected death of an apparently healthy infant”. The cause of death in SIDS remains inexplicable in spite of a thorough examination of history and a detailed postmortem. (1). In SIDS the age considerations are below one year. (2).
SIDS as an affliction was known to mankind since the biblical times. (1). In the middle ages in Europe SIDS was given different names steeped in mystery and superstition prevalent in those times. Till the nineteenth century there was not much concern evinced on SIDS, as smallpox, diphtheria, scarlet fever, cholera, whooping cough and the like were taking a heavy toll of life, particularly those of infants. It took till 1969 for SIDS to be identified as a distinct disease and given the name Sudden death infant syndrome (SIDS). (3).
In the United States of SIDS is the leading cause of post-neonatal infant mortality. During the last decade of the twentieth century there was a remarkable decline in the mortality rate from SIDS, as the sleeping position if the infant was recognized as a causative factor and public health policy initiatives to promote a supine sleeping position were put in place. As a result the mortality rate of SIDS dropped from 1.3 1000 live births in 1990 to 0.7 per 1000 live births in 1998. (4). By 2002, as per National Center for Health Statistics, the mortality rate due to SIDS in the United States of America had dropped further to 0.51 per 1000 live births. (5).
Cause of Sudden Death Infant Syndrome (SIDS)
The cause of SIDS is still unknown. There are a number of hypotheses regarding the causal mechanism of SIDS. The hypotheses center on three abnormalities of the brain stem. These consist of abnormal sleep/wake regulation, abnormal temperature regulation, and abnormal cardiorespiratory regulation. (1). Multiple factors are probably responsible for SIDS. The first factor is the presence of a biological vulnerability like heart or brain defect.
The second is the presence of an environmental stressor, like the infant sleeping on the stomach. A combination of these two factors is probably essential for SIDS to occur. The third factor is that these things must occur during the critical period of the development in the life of an infant, which is typically the first six months of the life of an infant. Thus the three factors of vulnerability, critical development period and the environmental stressor combine to form the triple risk model for the occurrence of SIDS. Researchers have identified several risk factors for SIDS. Males are more likely to die of SIDS. For unknown reasons there is a race factor involved, with Black or American Indians more prone to SIDS.
The most vulnerable period is between the first and sixth months of age of the infant. Other risk factors include premature delivery or low weight at birth, sleeping on the stomach, born to mothers that smoke or use drugs, exposure to tobacco smoke in the environment, born in the cooler months of fall and winter, inadequate prenatal care, placental abnormalities, low weight gain during pregnancy, and infants born to teenage mothers. (6).
Prevention of Sudden Infant Death Syndrome
Prevention of SIDS strategies essentially targets the environmental stressors of the triple risk model. The first prevention strategy was the targeting of the “Back to Sleep” campaign in 1994, which encouraged positioning of the infants on their back for sleeping.
This prevention strategy is believed to be the cause of the initial drop in incidence of SIDS in the United States of America. (1). The other prevention strategies include encouraging of cessation of smoking and use of drugs in pregnant mothers and the maintenance of a smoke-free environment around the baby; careful selection of bedding in the form of a firm mattress; use of a crib or a bassinet for the infant to sleep in; keeping the crib or bassinet in the same room as the mother; maintaining a moderate room temperature; giving the infant a pacifier to suck at naptime and sleep time, and encouraging breastfeeding frequently. (6).
Conclusion
SIDS is a tragic affliction, the causes of which still remain elusive. The most probable reasoning as to the cause of SIDS is the triple risk model is the presence of an abnormality and an environment stressor at the vulnerable age of the infant. Prevention is the current means of reducing the incidence of SIDS. There are indications that the prevention strategies have assisted in the drop of incidence rates of SIDS.
Works Cited
- Kum-Nji, Philip. Mangrem, Carole, L., Wells, Peggy, J. & Henry, Aaron, E. “Reducing the Incidence of Sudden Infant Death Syndrome in the Delta Region of Mississippi: A Three-Pronged Approach”. Southern Medical Journal, 94.7 (2001): 704-710.
- Burnett, Barkley, Lynn & Adler, J. “Pediatrics, Sudden Infant Death Syndrome”. emedicine. 2006. Web.
- “The History of Sudden Infant Death Syndrome (SIDS)”. pregnancyplace. 2007. Web.
- Pickett, Kate, E. “Widening Social Inequalities in Risk for Sudden Infant Death Syndrome”. American Journal of Public Health, 95.11 (2005): 1976-1981.
- Carolan, Patrick, L. “Sudden Infant Death Syndrome”. emedicine. 2007. Web.
- “Sudden infant death syndrome (SIDS)”. MayoClinic.com. 2007. Web.