The syndrome of sudden infant death (SIDS) is the leading cause of death in infants under 1 year of life. It is characterized by a sudden death frame, unexpectedly and without apparent cause, which occurs usually during nighttime sleep of an apparently healthy baby.
The syndrome of sudden infant death, also called sudden infant death syndrome or "cot death" is rare but traumatic, because it is totally unexpected. Its real incidence in Brazil is unknown, but is thought to be similar to other countries, averaging 1-5 cases per 10,000 babies. In the US, occur each year, about 2,500 cases of sudden death in infants.
In this article we will explain what is the syndrome of sudden infant death, what are its causes and what parents can do to prevent this so catastrophic event.
The syndrome of sudden infant death is defined as the sudden death of a child under one year of age that remains unexplained after an extensive investigation, including autopsy. The diagnosis of sudden infant death syndrome can only be established after discarded other possible causes of death, such as abuse, accidents, poisoning, infections or previously unknown genetic diseases. In only 15% of cases of sudden death it is possible to identify a cause of death.
Sudden infant death usually occurs in children between 1 month and 1 year of life, but 90% of cases involve infants less than 6 months. The most dangerous time, with the highest number of cases is between 2 and 4 months. Most babies die in their sleep, usually between midnight and 6 am, and there are no signs that they have had any kind of suffering. 60% of cases occur in children.
It is important to emphasize that SIDS is not a parental neglect signal. This form of sudden death is not caused by vaccinations is not contagious. Babies and children who had recent close contact with a dead baby does not run any risk. There is also no evidence that SIDS has a hereditary factor. The risk of a family who has had a case of sudden infant death have a new episode with a second child is only 1%.
As just mentioned, to be considered sudden infant death syndrome, the late baby may have no identifiable cause of death. This does not mean, however, that SIDS do not have a cause. Certainly has us is that we can not identify it.
Among the theories most currently accepted, one has gained a lot of attention. It is thought that SIDS occurs a delay in maturity brainstem baby, central nervous system area that controls breathing, heart rate and blood pressure. Babies prone to sudden death have greater difficulty waking up when subjected to stress, such as low oxygen or excess heat.
The central nervous system immaturity theory is corroborated by the fact that sudden death is more common in premature babies or low birth weight.
Risk factors for the syndrome of sudden infant death
Only the immaturity of the brain nervous system does not seem sufficient to explain the occurrence of sudden death in infants. The most likely is that the SIDS framework is multifactorial, occurring when a baby with greater predisposition is subjected to one or more risk situations, as will be explained below.
Studies show that in 95% of babies who suffered an unexplained sudden death is possible to identify at least one risk factor. In 88% of cases, two or more risk factors can be pointed out.
Sleeping face down can cause sudden death in babies
Among the main risk factors, one stands out: sleeping face down, i.e. with the stomach.
From the 1990s, various international pediatric societies have launched campaigns to encourage parents to put babies to sleep on their backs. In the US, in 1992 about 75% of babies sleeping face down. After 1 year campaign, the rate dropped to just 11%. This simple change in sleeping position was responsible for a 58% reduction in cases of sudden death in infants.
The position of greater risk is the stomach. Let the baby sleep side is also dangerous, though not as much as the stomach. The safest way to put your baby to sleep is on his back.
By immaturity of the central nervous system, very young babies seem to be less able to recognize that they are suffocating, so they do not usually wake up or change position when they are having trouble breathing during sleep. belly sleeping down hinders baby's breath and facilitates him to stay with the face toward the mattress, which favors the airway obstruction. For this reason, very soft mattress or the presence of pillows, towels or sheets around the baby's head should also be avoided.
Sleeping in the same room with parents decreases the risk of sudden death, but sleep in the same bed as them increases, as it makes the surface more uneven mattress. Some pediatricians also do not recommend that twin babies sleep in the same crib.
It is also important to prevent the baby to sleep for many hours in places other than the birthplace of the bed. Prams car, baby-comfort or stroller are made to carry the baby and should not replace the bed at night.
Hot environments can be dangerous for the baby
Another factor that is usually linked to sudden infant death is heat. Rooms with very high temperature or babies who sleep with excess clothing with lots covered are at higher risk.
As babies lose much heat through the face, sleeping facedown in hot rooms becomes dangerous because in addition to not being able to breathe well, the face leaning against the bed has less ability to dissipate heat.
Cigarette linked to sudden infant death
Another important risk factor for sudden death of infants is maternal smoking. Mothers who smoke during pregnancy or who return to form soon after delivery, exposing the baby to secondhand smoke increase the risk of SIDS.
Early contact with smoke or toxins from cigarette still in the intrauterine period changes the cardiovascular and respiratory normal operation, making the baby more susceptible to episodes of suffocation in bed.
Mothers who use illegal drugs or abuse alcohol also have a higher risk of having a baby to present sudden death.
As explained in this text, the attitude that reduces the risk of sudden infant death is to put the baby to sleep on his back, belly up. very small babies do not change position during sleep. If you put belly up, so it will be, if the bed is firm and has no irregularities.
Babies should sleep on the bed, avoid letting it all night in the cart or baby-comfort.
Avoid objects in the bed that can be pulled accidentally to face the baby, such as cloths or sheets.
Babies do not need pillows or blanket.
Avoid very soft mattresses.
Do not let the baby sleep in your bed at night.
Do not smoke during pregnancy or after delivery.
Do not let the baby's room gets too hot. If you live in cold places, careful not to dress the baby with excess clothing.
What can help:
Sleeping in the same room of parents (not in the same bed) up to 6 months.
Use of pacifiers exclusively at night to sleep from the first month of life. Attention: pacifiers before the first month can disrupt breastfeeding and after 2 years can disrupt the dentition.
Breastfeeding reduces the risk of SIDS.
Keep the room temperature around 23°C, so that the baby can be comfortable without having to bundle up excessively.
There are market some breathing and heartbeat monitors for babies. The studies, however, have shown that these devices do not reduce the risk of sudden infant death syndrome, therefore, are not recommended.
