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Defined by the CDC as:

“sudden death of an infant less than 1 year of age that cannot be explained after a thorough investigation is conducted, including a complete autopsy, examination of the death scene, and review of the clinical history”

120 deaths/100,000 in 1992

56 deaths/100,000 in 2001

No change from 2001-2006

“Convergence of these factors ultimately results in a combination of progressive asphyxia, bradycardia, hypotension, metabolic acidosis, and ineffectual gasping, leading to death”

1992: AAP recommends infants be placed in non-prone position (side or supine) for sleep

1990s: National Institute of Child Health and Human Development conducts surveys on SIDS

1994: NICHHD, AAP, SIDS Alliance, and US Public Health Service campaign “Back to Sleep”

2000: AAP advised sleeping on back confers the lowest risk of SIDS

Age less than 6 months African American and Native American race Sleeping prone and side position Use of soft bedding (pillows, blankets,

bumpers) Sleeping in carseat or bouncer Maternal smoking during pregnancy Exposure to second-hand smoke Respiratory infections Bed sharing

worse with multiple bed sharers, use of alcohol or overtired adult, bed sharing on couch

Child care Higher incidence of prone positioning during sleep

Age less than 6 months African American and Native American race Sleeping prone and side position Use of soft bedding (pillows, blankets,

bumpers) Sleeping in carseat or bouncer Maternal smoking during pregnancy Exposure to second-hand smoke Respiratory infections Bed sharing

worse with multiple bed sharers, use of alcohol or overtired adult, bed sharing on couch

Child care Higher incidence of prone positioning during sleep

Room sharing without bed sharing Use of pacifier at bedtime and naptime Cool sleeping environment Tummy time Breastfeeding infant Immunization (possibly)

Co-sleeping is associated with unexplained SUDI/SIDS in infants aged < 6 months, suggesting that co-sleeping is related to the pathogenesis of death in younger infants.

The finding that intra-alveolar hemorrhage is more common in co-sleeping suggests that a minority of co-sleeping-associated deaths may be related to an asphyxial process.

Accounts for 50% of SUIDS/SIDS in U.K. Co-sleeping is increasing in U.S.

There is no evidence that bumper pads reduce the risk for injury to young infants, and these devices are not recommended because of the potential for entrapment or strangulation

Firm mattress Avoid excessive blankets Avoid overheating

Co-sleeping Shown to facilitate breastfeeding, popular in

USA No evidence for protective benefit against

SIDS Immunization

Case reports from 1970s suggested relationship between vaccination and SIDS

No relationship exists and suggests vaccination could be protective against SIDS

“Safe to Sleep” campaign (formerly “Back to Sleep” campaign) SIDS resource kits targeted for specific

populations (African Americans, Native Americans, Hispanics)

Safe Sleep for your Baby YouTube video

Nonprofit organization dedicated to safe pregnancies and survival of babies through

first years of life

Families who have had an infant die from SIDS should be treated with compassion and empathy.

They should be supported through the process of the death investigation and guided through problems: Such as ending lactation and funeral planning. Grief counseling and referral to a SIDS support group should be

offered. Parents should be counseled that the risk of future children dying

from SIDS is not increased First Candle has bilingual crisis counselors available 24 hours a

day, 7 days a week. Call toll free at (800) 221-7437 American SIDS Institute Phone: 239-431-5425 Fax: 239-431-

5536

Autopsy should be done quickly. As soon as the preliminary results are known

(usually within 12 h), they should be communicated to the parents.

Educate patients in family practice Ask about sleeping on back at EVERY pediatric

visit for infants Review modifiable risk factors for SIDS and

educate about myths vs facts about SIDS

CE program for SIDS risk reduction for nurses http://www.nichd.nih.gov/SIDS/sidsnursesce.cfm

Fact: Cribs do not cause SIDS

Fact: Babies cough up or swallow fluid that enters their airway. Doctors found no increase risk in choking or other problems in babies sleeping on their backs.

Myth: Babies can catch SIDS Fact: SIDS can not be caught. It is not contagious and there are not symptoms before death.

Myth: Cribs cause death or SIDS

Myth: Babies who sleep on their back choke on spit or vomit

Myth: Only white babies die of SIDS Fact: African American babies are twice as likely to die of SIDS as white babiesFact: Although there is no way to ensure a baby will not die of SIDS, the chances can be reduced by placing babies on their backs.

Myth: SIDS deaths can be prevented

Myth: Shots/medications cause SIDS Fact: Shots or medications do not cause SIDS. All babies should be seen for well-baby checkups and receive shots on-time.

Myth: SIDS can occur at any age Fact: SIDS is the unexplained death of a baby younger than 1. Most deaths occur between 2 and 4 months of age. The number of deaths drop significantly after 6 months of age.

3 month old male infant found dead after being placed in prone position.

Centers for Disease Control and Prevention (2012). Sudden infant death syndrome and vaccines. Retrieved from http://www.cdc.gov/vaccinesafety/Concerns/sids_faq.html.

First Candle (2012). First Candle. Retrieved from http://www.firstcandle.org.

National Institute of Child Health and Human Development (2012). Safe to Sleep public education campaign. Retrieved from http://www.nichd.nih.gov/sids.

Task Force on Sudden Infant Death Syndrome (2011). SIDS and other sleep-related infant deaths: Expansion of recommendations for a safe infant sleeping environment. Pediatrics, 128(5), 1030-1039.

Task Force on Sudden Infant Death Syndrome (2005). The changing concept of sudden infant death syndrome: Diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics, 116(5), 1245-1255.