Sudden Infant Death Syndrome (SIDS)
This is also known as sudden unexplained infant death (SUID). It is defined as...
“The sudden and unexpected death of a child under 1 for which no adequate case is found after a thorough post mortem and case report”
SUIDs cause 40% of deaths in infants over a week old. This makes them the leading cause of mortality in children that age.
There are many risk factors, but these are summarised well into the triple risk model
- Age 1-6 months (peaking at 12 weeks)
- Preterm or very low birth weight
- Boys are affected more than girls
- Multiple Births
- + Family History
- Maternal age (increased risk if mother under 20)
- Household in Lower socioeconomic group
- Single parents
- Smoking in the household
- Baby sleeps lying on its front ( 8x risk)
- Baby sleeps lying on its side (2 risk)
- Coexistent illness (cold)
- Baby overheats at night*
*The face is an important area of heat loss in infants. If this is covered, either by blankets/lying prone/hats then often infants can overheat.
In recent years there has been a large reduction in the rates of SUIDs ( decrease of >50%!!) as a result of the BACK TO SLEEP campaign which started in 1991.
Information on the back to sleep campaign :
Main points of the back to sleep campaign are
- Infants should sleep on their backs with their feet at the foot of the bed
- Infant overheating should be avoided, don’t use pillows and avoid blankets/hats (yes...even if it looks cute)
- Infant should sleep in parents room for 6 months
- Don’t smoke near the infant
- Don’t bring the infant into bed with you
- Don’t sleep with the infant in a chair
- Seek help promptly if the infant is unwell
After a SUID
- Document everything
- Notify the relevant people (consultant, child protection agency, police, GP, coroner)
- Do bloods (cultures, fbc, u+e’s, clotting, blood sugar), Lumbar puncture, urine and stool cultures.
- Samples of infant’s clothing and bedding may be needed
- An autopsy and coroner’s inquest is a legal requirement, however distressing for the family it may be
- The family need to be reassured that this is no ones fault.
- Non-accidental injury must be on your radar, although extreme care must be taken if you peruse this route near a grieving family
- Advice about the grieving process should be given
- Suppression of lactation (although not always needed/wanted) can be given
- CABERGOLINE- PO 250μg every 12hours for 48 hours.
- In an attempt at preventing recurrence within the same family, there is a ‘care of the next infant’ project (commonly known as CONI)