Sudden Infant Death Syndrome (SIDS)
- Sudden, unexpected infant death (infant <1 yr old) (SUID) who was typically well before being placed down to sleep
- SUID includes sudden infant death syndrome (SIDS) as well as accidental suffocation and strangulation in bed (ASSB) and unknown cause of death in infants <1 yr of age
- SIDS deaths remain unexplained after being thoroughly investigated by autopsy, exam of the death scene, investigation of the circumstances, and review of the family and infant medical histories
- SIDS is distinct from ASSB which occurs when something limits a baby's breathing such as a blanket against the face or the baby is trapped between two objects (e.g., mattress and wall) which has increased since 1995.
- If nonfatal, known as BRUE (brief resolved unexplained event). Previously called ALTE (apparent life-threatening event)
- Leading cause of death in infants 1 mo–1 yr of age; the incidence has declined markedly since the initiation of the “Back to Sleep” program in 1994:
- 1992: 120 deaths/100,000 live births (US)
- 2001: 56 deaths/100,000 live births (US)
- No change from 2001–2008
- 2009: 54 deaths/100,000 live births (US)
- 2013: 40 deaths/100,000 live births (US)
- 2015: 39 deaths/100,000 live births (US)
- Peak occurrence of SIDS is 1–4 mo of age:
- 90% occur <6 mo of age
- 2% occur >10 mo of age
- Ethnic differences: Using 2010–2013 data, SIDS rates for non-Hispanic black and American Indian/Alaska Native populations were much higher than non-Hispanic whites, while SID rates for Asian/Pacific Islander and Hispanic populations were much lower than non-Hispanic whites
- Sleeping on back (supine) reduces incidence significantly (“Back to Sleep”). Practice of infants sleeping on their backs began initially in Europe and then in the U.S.
- SIDS deaths are most likely multifactorial
- SIDS infants likely have predisposing conditions that make them more vulnerable to both internal and external stressors
- Potential stressors include anemia, congenital diseases, dysrhythmias, electrolyte abnormalities, genetic defects, infection, metabolic disorders, neurologic events, suffocation, trauma, and upper airway obstruction
- Maternal and antenatal risk factors:
- Alcohol and illicit drug use
- Intrauterine growth restriction
- Lower socioeconomic status
- Poor prenatal care
- Prior sibling death secondary to SIDS
- Shorter interval between pregnancies
- Younger age
- Infant risk factors:
- Bed sharing
- Exposure to environmental smoking
- Gastroesophageal reflux (GER)
- Low birth weight, prematurity
- Male gender
- Soft bedding, soft sleeping surface
- Recent febrile illness
- Supine sleeping position, breastfeeding, room sharing without bed sharing (especially in the first 6 mo), and pacifier use are protective
- Home monitoring has not been shown to prevent SIDS
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Schaider, Jeffrey J., et al., editors. "Sudden Infant Death Syndrome (SIDS)." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307506/all/Sudden_Infant_Death_Syndrome__SIDS_.
Sudden Infant Death Syndrome (SIDS). In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307506/all/Sudden_Infant_Death_Syndrome__SIDS_. Accessed June 6, 2023.
Sudden Infant Death Syndrome (SIDS). (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307506/all/Sudden_Infant_Death_Syndrome__SIDS_
Sudden Infant Death Syndrome (SIDS) [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 June 06]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307506/all/Sudden_Infant_Death_Syndrome__SIDS_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Sudden Infant Death Syndrome (SIDS) ID - 307506 ED - Barkin,Adam Z, ED - Shayne,Philip, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307506/all/Sudden_Infant_Death_Syndrome__SIDS_ PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -