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Sudden Infant Death Syndrome
Other names	Crib death, cot death
Specialty	Pediatrics
Symptoms	None
Causes	Unknown
Risk factors	Sleeping on the stomach, overheating, exposure to tobacco smoke
Diagnostic method	Diagnosis of exclusion
Prevention	Safe sleep practices
Treatment	None

Sudden Infant Death Syndrome (SIDS), also known as crib death or cot death, is the sudden and unexplained death of a seemingly healthy infant, typically during sleep. SIDS is a major concern for parents and healthcare providers, as it is the leading cause of death in infants between one month and one year of age.

Epidemiology

SIDS is most common in infants between 2 and 4 months old, and the incidence decreases as the infant grows older. It is slightly more common in boys than in girls. The exact incidence of SIDS varies by country and region, but it has been significantly reduced in many areas due to public health campaigns promoting safe sleep practices.

Risk Factors

Several risk factors have been identified that increase the likelihood of SIDS:

• Sleeping position: Infants who sleep on their stomachs or sides are at higher risk.
• Sleep environment: Soft bedding, overheating, and bed-sharing can increase risk.
• Parental factors: Maternal smoking during pregnancy, young maternal age, and inadequate prenatal care are associated with higher risk.
• Premature birth: Infants born prematurely or with low birth weight are at increased risk.

Pathophysiology

The exact cause of SIDS is unknown, but it is believed to be multifactorial. The "triple risk model" suggests that SIDS occurs when three factors coincide:

1. Vulnerable infant: An infant with an underlying vulnerability, such as a brainstem abnormality affecting arousal or cardiorespiratory control. 2. Critical developmental period: The first six months of life, when rapid growth and development occur. 3. External stressors: Environmental factors such as prone sleeping position or overheating.

Prevention

The following measures are recommended to reduce the risk of SIDS:

• Back to sleep: Always place infants on their backs to sleep.
• Firm sleep surface: Use a firm mattress with a fitted sheet, and avoid soft bedding.
• Room-sharing without bed-sharing: Keep the infant's sleep area in the same room as the parents, but on a separate sleep surface.
• Avoid overheating: Dress the infant appropriately for the environment and avoid excessive blankets.
• Smoke-free environment: Avoid exposure to tobacco smoke during pregnancy and after birth.

Diagnosis

SIDS is a diagnosis of exclusion, meaning it is determined after ruling out other possible causes of death through a thorough investigation, including autopsy, examination of the death scene, and review of the clinical history.

Research and Future Directions

Ongoing research aims to better understand the underlying mechanisms of SIDS and to identify potential biomarkers for vulnerability. Advances in genetic research and neuroimaging may provide further insights into the causes and prevention of SIDS.

Also see

• Infant sleep safety
• Pediatric sleep disorders
• Neonatal care
• Sudden unexpected infant death

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