Sudden infant death syndrome
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Sudden Infant Death Syndrome, is the term for the sudden and unexplained death of an apparently healthy infant aged one month to one year. SIDS is a definition of exclusion and only applies to an infant whose death remains unexplained after the performance of an adequate postmortem investigation including (1) an autopsy, (2) investigation of the scene and circumstances of the death and (3) exploration of the medical history of the infant and family. Generally, but not always, the infant is found dead after having been put to sleep and exhibits no signs of having suffered. The inexplicable nature of the syndrome often leaves parents with a deep sense of guilt in addition to their grief. In the United Kingdom the term Cot death is synonymous with SIDS.
Very little is known about the possible causes of SIDS. It is important to note that ruling a child's death to be a case of SIDS is not describing the cause of death, but in fact a statement that the cause of death remains unknown. Although there is no known way to prevent it, research has provided several risk factors which are related to an increased incidence of the syndrome.
The use of baby monitors, particularly those with motion sensors, can allow the parents to remotely keep track of their child.
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Risk factors
Prenatal risks
- inadequate prenatal care
- inadequate prenatal nutrition
- tobacco smoking
- use of cocaine or heroin
- teenage pregnancy
- less than a one year interval between subsequent births
Post-natal risks
- low birth weight (especially less than 1.5 kg)
- exposure to tobacco smoke
- laying an infant to sleep on his or her stomach (see positional plagiocephaly)
- failure to breastfeed
- excess clothing and overheating
- excess bedding, soft sleep surface and stuffed animals
- sex (60% of deaths occur in males)
- age (incidence is higher between 2-4 months)
In addition, research indicates a reduced risk of SIDS in conjunction with a safe co-sleeping arrangement. Though findings are still preliminary, the proximity of a parent's respiration is thought to stimulate proper respiratory development in the infant.
SIDS and child abuse
Controversial British paediatrician Sir Roy Meadow believes that many cases diagnosed as SIDS are really the result of child abuse on the part of a parent suffering from Munchausen Syndrome by Proxy (a condition which he himself identified). During the 1990's and early 2000's, a great many mothers of multiple apparent SIDS victims were convicted of murder on the basis of Meadow's opinion. However, in 2003 a number of high-profile acquittals brought Sir Roy's theories into disrepute, and many now doubt their credibility. Several hundred murder convictions are now under review.
On the other hand, in a 6 March 2004 incident, a father is being accused of the murders of four of his children, one of which had been ruled a case of SIDS[1] (http://www.cnn.com/2004/US/Northeast/03/06/tracking.child.abuse.ap/index.html), and the National Clearinghouse on Child Abuse and Neglect Information indicates more than half of child abuse cases may be unreported or described as SIDS.
Mattress gas theory
One theory is that SIDS can be caused by toxic gasses developing in crib mattresses that contain substances such as phosphorus, antimony, and arsenic. [2] (http://www.healthychild.com/cribdeathcause.htm) A study in New Zealand found that a group of infants sleeping on mattresses wrapped with an impermeable cover to prevent the escape of these gasses experienced zero incidents of SIDS.
Conditions that may mimic SIDS
Medium Chain Acyl Dehydrogenase (MCAD) deficiency.
External links
- SIDS Families (http://www.sidsfamilies.com/)
- SIDS International (http://www.sidsinternational.minerva.com.au/)de:Plötzlicher Säuglingstod
it:Sindrome di morte infantile improvvisa nl:wiegendood ja:乳幼児突然死症候群