Sudden Infant Death Syndrome causes. How to prevent the occurrence of a dangerous disease? How is such a diagnosis made?

13.06.2019

Usually these children are well cared for, they do not show noticeable signs of the disease. An autopsy reveals no apparent cause of death, so the diagnosis is Sudden Infant Death Syndrome (SIDS), or Crib Death.

This usually occurs between the ages of 3 weeks and 7 months (most often at 3 months). Already from the name itself it is clear that the causes of this phenomenon, such as infection or metabolic disorders, cannot be found, even despite the post-mortem autopsy.

Most often, SIDS occurs in winter in boys with low birth weight. Also at increased risk are premature newborns, babies of smoking mothers, babies with a family history of SIDS, and babies who sleep in the prone position. There are many theories regarding the causes of SIDS, but none of them have been proven. Infection, milk allergy, pneumonia, and child abuse have been refuted as possible causes. At present, the most plausible assumption is that the development of activation centers in the brain in some children is delayed, as a result of which they are distinguished by a predisposition to stop breathing under certain conditions.

If your baby sometimes stops breathing or turns blue, the pediatrician will likely want to take him to the hospital to assess the severity of the baby's condition and eliminate the causes. If these cases are quite severe, he may suggest that you learn cardio-respiratory techniques and use a home monitor when the baby is sleeping. This device measures the infant's respiratory rate and warns of a critical decrease in it with an audible signal. If the baby was born premature, the pediatrician may suggest monitoring the baby with breath-stimulating medications such as caffeine or theophylline. Feeling the full bitterness of loss, many parents who have lost children due to SIDS become depressed because of guilt and begin to protect their other children or babies born after the tragedy doubly. Ask your pediatrician who you can contact for help in your area. Currently, the best preventive measure for parents is to put the baby to sleep on his back. The American Academy of Pediatrics has recommended since 1992 that babies should always be put to sleep in this position. Before, more than 5,000 children died of SIDS every year in the United States. But today, with fewer tummy-sleeping babies, the death rate from SIDS has dropped to less than 3,000 babies a year. Just switching from sleeping on your stomach to sleeping on your back has reduced the death rate from SIDS by 50%. Every death is a tragedy. Campaigns continue to encourage parents and all caregivers to put babies to sleep on their backs. However, no matter what preventive measures are taken, it is not possible to prevent all deaths of children from SIDS.

ALTE (apparent life threatening event = apparent life-threatening condition): episodes during which the infant suddenly turns blue or very pale with a change in muscle tone (decrease or increase), respiratory arrest, which are life-threatening and require the caregiver to provide stimulation or resuscitation .

SIDS (CBCM) is the sudden unexpected death of a child, the cause of which is not revealed at the time of death and at autopsy.

To this day, this terrible event, shrouded in mystery, has been happening more and more often in recent years.

The sudden death of a child in the first year of life is an instantaneous and inexplicable cessation of the infant's life. The maximum risk of sudden death exists for babies aged 3-6 months, and by 12 months it decreases markedly. Known groups of babies for whom the risk of sudden death is higher than for others: neurologically immature infants who have a slow heart rate (vagal malaise), swallowing problems when food is inappropriate, severe gastroesophageal reflux (which is extremely rare) .

Parents need to know if their child is in a “risk group”. The pediatrician will tell them about this, who, after a thorough examination of the newborn, must confirm that the baby is healthy and everything is in order.

It is equally important to properly treat a child with diseases of the upper respiratory tract or breathing problems in order to avoid possible consequences.

If the baby sleeps on a hard surface, in a room that is not too hot (if possible, at an air temperature of 18 ° C, but in any case not higher than 20 ° C), and without a blanket, this will prevent sudden death associated with stuffiness and risk of asphyxia.

Finally, even if the baby is in the “risk group”, you need to believe in your child and think as little as possible about his sudden death, no matter how difficult it will be for you to do this. The more you are sure that he is healthy, the more closely you are connected with him, the less you will think about a possible tragedy, although you will not be able to completely forget.

In the event of a sudden death of an infant, it is very important to find out why the child died, even if it is painful for you. Therefore, you should contact the specialists who deal with cases of sudden infant death in your city (region) so that doctors can determine the cause of death.

Life goes on, and you need to understand whether your future children will also fall into the “risk group”. In addition, sooner or later you will still begin to think about the causes of the death of the baby. and your psyche may suffer greatly from the fact that you did not take any action in a timely manner in order to establish a diagnosis. So the consequences of refusing a pathological examination can be very unfavorable both for yourself and for the children that you may have in the future.

In the event of a sudden death of a child, I repeat, it is necessary to carry out a post-mortem examination (even if the autopsy contradicts your beliefs). Only it can reveal the true cause of death. The absence of reasons will confirm the accidental sudden death and convince you that this will not happen with the next child. If the autopsy reveals any malformations of the baby or other causes of death of the baby, then you will be able to take certain precautions in the next pregnancy.

SIDS is the most common cause of death in infants aged 2 weeks to 1 year and accounts for 35-55% of all deaths in this age group. The incidence of SIDS 0.5/1000 born in the United States; there are racial and ethnic differences (the average risk of SIDS for children of African Americans and Indians is twice as high). The peak incidence is between the 2nd and 4th month of life.

What to Avoid...

Stand over the baby all day and night, fearing that he might suddenly die.

And no matter how anxious some parents may be, it is not recommended to keep an infant in the parents' bedroom during the entire first year of life, nor to wake him from time to time to make sure that everything is in order, especially towards the end of the first year of life. when he wakes up easily as soon as someone enters the room.

Putting a newborn monitor (apparatus for constant monitoring) to avoid his sudden death.

An apparatus hanging on a child around the clock often provokes false alarms, prevents the baby from moving normally and does not allow, say, washing in comfortable conditions. And besides, its presence does not reassure anxious parents too much.

Laying an infant on its back or on its side, uncovered with a blanket, on a hard bed, in a room that is not too hot, will significantly reduce the risk of sudden death.

In the old days, sudden infant death was rather rare. A child can die both in the mother's womb and during childbirth (see the articles "Miscarriage", "Stillbirth"). This fate can overtake a newborn on the first day of life, and the fetus on the penultimate day of pregnancy.

Through the efforts of classical medicine, a mosaic of causes was laid out, each of which was assigned a certain role, but none of them could satisfactorily explain the phenomenon of sudden infant death. Statistics show that although this happens more often to the children of socially disadvantaged mothers, mothers with a more prosperous social and financial situation are also not immune from such a blow of fate. The infant mortality rate is especially high among the children of smokers. It must be understood that poisoning of the body with toxic substances, especially mercury, plays a significant role in this. The more amalgam fillings in a mother's mouth, the more her internal organs are contaminated with mercury. At the same time, this phenomenon, albeit less often, still happens in the lives of those mothers who have not smoked a single cigarette in their lives, led a completely healthy lifestyle and consciously approached nutrition. In the old days, one of the causes of death of a child was considered to be his position on his stomach during sleep. The point of view of classical medicine, which asserted that in this case the still immature respiratory organs of the child are blocked, does not make sense, otherwise how could the child have been able to breathe normally during the entire previous period?

Despite everything, the cause of sudden infant mortality has not been identified. Of course, every death has its own meaning and can be interpreted on its basis; both sides of the coin should be taken into account. If a child leaves this world in this way, the reason, in the first place, may be related to himself. It may be that in a short period of time he has already experienced enough, and at this level of being he simply has nothing more to do. It is possible that he does not dare to live or does not want to get involved with the earthly world. Of course, the point may be that the upcoming life suddenly loses all meaning for him, which was probably influenced by maternal projections of guilt. It can be assumed that the conditions in which he found himself seem to the future person incompatible with life. In general, it is likely that the sensory system of the newborn is capable of perceiving much more than we are able to imagine.

To prevent this extraordinary fate, causing fear and horror, classical medicine has developed devices that can monitor the child's breathing. This sensitive babyphone, which today consists of only a sensitive transmitter placed near the child's head, can nevertheless drive even the most stable mother into a frenzy. False alarms deprive the mother of sleep and nerve cells. The house turns almost into an intensive care unit, where everything is under total control.

Particularly sophisticated devices of this kind inflict a blow on the child if he is suddenly late with the next breath. As a result, electrical equipment deprives children of restful sleep, and the parents who installed it, realizing their good intentions, from incessant care themselves become like a ball of nerves. At the opposite pole we meet a native woman who carries a child on her body and knows when it's time for him to poop. She does not need any instrumentation, they are replaced by intuition and inner wakefulness. The threat of sudden death does not hang over her child. In this regard, we can certainly proceed from the fact that sudden infant mortality, one way or another, is due to the progress of our civilization. Children stop breathing for no apparent reason, which symbolically means that they are not tuned in to communication with this world. I recall the inexplicable phenomenon of whales that are thrown onto land to die there, which shakes many people to the core, and not only the fierce defenders of the animal world.

Although technical monitoring tools focused on the prevention of sudden infant death do not help, they nevertheless clearly indicate how great our communication problems are today. Their solution, as the practice of archaic peoples shows, is to establish and maintain close contact with the child. The one who carries the child everywhere on himself, puts him to sleep in his own bed and is always ready to help him, has less reason to fear. In most cases, nothing happens against the background of such contact. At the same time, if it happens that the child stops breathing, the mother herself can provide him with the necessary assistance. Every woman with a driver's license has learned how to do this as part of a first aid course.

As already mentioned, the interpretation of the circumstances of sudden infant death will most likely lead us to certain communication problems that explain, among other things, the causes of addiction to cigarettes. Even the notion of classical medicine about an immature respiratory center is connected with the idea of an insufficiently mature form of communication with the air world. Mothers with a well-developed instinct for a child experience fewer fears and are confident that they will always be there for their child precisely in those moments when he needs them.

From the child's point of view, the situation involves the process of establishing contact with this seemingly uninhabitable world. The child simply disconnects from it, never daring to try to truly begin to live in it. The unwillingness to communicate with this world is especially clearly manifested in the refusal to breathe. If we start from the fact that children reflect the problems of their environment and therefore their parents, then a truly frightening mirror image opens up to our eyes, which also allows us to conclude how far the communication problems in the relationship between parents have gone.

Sudden infant death occurs with equal frequency in the clinic and at home, and it immediately activates the projection of guilt. Yes, such a death is perceived as a fatal blow of fate, but incriminating her mother is very rarely fair. Nevertheless, a large-scale projection of guilt often develops in the soul of a mother against her background: having lost a child, she feels defeated and punished.

But we have completely lost sight of the fact that dying is a human property, and living is life-threatening. At least we do not want to remember this in connection with the beginning of a new human life. That is why the mourning coming after the death of a child is so hard, that is why the danger of being stuck in despair and guilt for life is so great. Sudden infant death is the hardest form of therapy for those who think they have everything under control. They are made to understand, impressively and intimidatingly, that this is not the case after all. But, no matter how hard it is, one should accept and understand that death is connected with life and is its unchanging, natural opposite, ultimately attracting and taking away all living things, and also feel: the only thing that separates us from death and liberation , - this time.

For mothers specifically, the tragic event of sudden infant death marks the realization that motherhood is intimately linked to birth and death. Giving the child life, the mother simultaneously gives him the opportunity to die. To give birth is also to let go and say goodbye. The grieving Mother, represented in the composition of the Pieta, the Virgin Mary holding the dead Jesus on her knees, is a manifestation of this deeply feminine experience.

“A mother who has lost a child is no longer afraid of anything,” says a Jewish proverb, meaning that she has already experienced the worst, passed the test, matured and, if she is able to accept fate, has found peace. Bitterness and hatred towards fate, on the contrary, indicate that she continues to carry this death in herself and is not ready to come to terms with the cyclical nature of life. For being a mother means always being ready to say goodbye, one way or another.

How to respond to SIDS

If there are other children in the family, parents are afraid to let them out of their sight or, on the contrary, are afraid to take responsibility for caring for them. Some parents want to talk it out, while others hide their feelings.

The rest of the children in the family are also, of course, upset, whether they show their feelings or not. Young children either do not move a single step away from their parents, or begin to misbehave in order to attract their attention. Older children may seem unnaturally carefree, but experience tells us that in this way they simply try to protect themselves from strong feelings of bitterness and guilt. It is hard for parents to understand why a child feels guilty, but all children sometimes have not the best feelings towards their brothers and sisters, and their immature thinking tells them that their hostile thoughts caused death.

If parents avoid talking about a dead child, then this silence only exacerbates the guilt of other children. Therefore, it would be better if the parents talk about the baby, explain that the cause of his death was a special kind of disease and that no one is to blame for this. Statements like "our baby is gone" or "he will never wake up" will only bring confusion to the child's soul. It is especially useful in such cases if parents will try to answer every question of the child and every comment. At the same time, children feel that they are not forbidden to tell their parents about their deepest experiences.

Parents should discuss their problems with specialists, psychologists, psychiatrists, a priest, so that they themselves can realize and express their overwhelming feelings.

Frequency and time of onset

It is currently the most common cause of death in infants. The frequency depends on the region and is 0.09-0.8 per 1000 live births.

SIDS (SIDS) and ALTE are observed in infants in the first year of life (maximum at 2-4 months).

Causes and risk factors for sudden infant death syndrome

The causes, despite numerous studies, have not been fully elucidated. All attempts to identify risk factors for SIDS (CBCM) in an individual child, such as in a sleep laboratory study, have been unsuccessful.

Statistically increased risk:

In those who were premature or in children with low birth weight.
In children with previous episodes of ALTE.
SIDS (CBCM) in siblings.
Sleep lying on your stomach or in an unstable position on your side.
Use of pillows, soft toys, blankets in a dream.
Smoking and medication during pregnancy, passive smoking after childbirth.
Psychosocial overload (too young mother).
Overheating.
Co-sleeping with parents in the same bed.
Long QT syndrome.
The child is artificially fed.

Attention: statistically increased risk (as always) does not mean causation.

Tips for parents to prevent sudden death syndrome:

Lay your baby out to sleep on your back.
The temperature in the room is cool, 16-18 °C; a thin blanket or envelope is enough. If the skin between the shoulder blades of the child is warm, but not sweaty, then the child is comfortable.
The use of a firm elastic mattress that allows air to pass through is recommended.
Make sure that the child cannot get tangled in the blanket with his head. Pillows and soft sides - not for a baby bed.
The child can sleep in the same room as the parents, but in their own bed.
Make sure there is no cigarette smoke in the room.
Breastfeed your baby for as long as you can.
If the baby sucks on a pacifier, give him a pacifier to sleep.
No pillows or soft toys in bed.

Home monitoring

Attention: still no statistical evidence that home monitoring reduces SIDS mortality, rather there are isolated cases where monitoring has been effective.

Monitors. Only monitors that display heart rate and respiration rate are suitable. Reason: agonal twitching of the diaphragm can be regarded as breathing. The monitor should store episodes of anxiety. Monitors that record only breathing are not suitable.

Indications:

Former preterm infants with episodes of apnea appearing after 4 weeks postpartum at estimated gestational age.
Former premature infants with bronchopulmonary dysplasia and the need for oxygen therapy.
Siblings with SIDS.
Children with severe sleep apnea (ALTE).
We recommend a home monitor only if parents insist on it (document the conversation!).

Practical approaches:

Be sure to teach parents the techniques of resuscitation on a mannequin.
Provide parents with the information leaflet “Actions in case of alarms”.
Discuss the date of the meeting to analyze the cases of alarm triggering.
The purchase of the monitor is carried out by the health insurance fund, negotiating with the supplier. A certificate confirming the need for a home monitor must be presented.
Training for parents on how to use the monitor is carried out by the rental company or by the representative of the Health Insurance Fund.

Advice. Inform parents that the monitor very often gives false alarms and disturbs sleep. Probably the GT-Med monitor is the most comfortable.

Diagnosis for suspected ALTE

Anamnesis:

Accurate description of the condition at the time of the episode and during the preceding hours.
Is the child sweating (whole body)?
Abnormal movements of the limbs, tongue, or eyes (convulsive equivalents)?
Fever?
Diarrhea, vomiting?
Stridor, cyanosis when crying or eating (upper airway stenosis, unrecognized heart failure)?
Family history: Has there been a sudden death in the family?

Physical examination:

Respiratory disorders (stridor, rhinitis, wheezing in the lungs, retractions, micrognathia)?
Noise in the heart, pulse and blood pressure in all four limbs.
Indications of violence (unexplained bruising, wounds)?

Additional research.

Basic studies (minimum program):

Blood: complete blood count with leukocyte formula, blood gases, electrolytes, calcium, magnesium, urea, ALT, ACT, glucose, CRP, urea, lactate.
Urine: pH, ketone bodies.
Ultrasound of the brain, EEG (seizure equivalents?).
ECG to rule out long QT syndrome.

Further investigations (depending on the situation):

X-ray of the chest.
Ultrasound a. vertebralis with doppler.
Virological study (RSV?).
Immunoglobulins (with IgE).
Lumbar puncture, blood culture.
Organic acids, amino acids, metabolism research.
Phenylpropionate test.
Lactate / creatinine in the urine, lactate in the cerebrospinal fluid (lactate acidosis).
Carnitine biotinidase deficiency?
Polysomnography to rule out obstructive sleep apnea.
pH-metry to rule out gastroesophageal reflux.
Exclusion of abuse of the child (Battered child) by examining the fundus and X-ray of the bones of the skeleton (some cases of sudden death are associated with violence).

Actions in the event of the death of an infant

Organizational:

SIDS(CBCM) - mandatory forensic autopsy.
The death certificate states "cause of death unknown."

Research:

Desirable: skin, liver, muscle biopsy (large biopsies are deep frozen and fixed in formalin and glutaraldehyde).
Collection and freezing of plasma, urine and cerebrospinal fluid samples.
Blood culture and lumbar puncture.

Help for parents:

Suggest a conversation. Many parents want to talk.
Prepare your parents for the arrival of the criminal police to investigate the death. This will calm them down.
Take a picture of the child and attach; photo to the medical history; if necessary, give a photo and parents. Sometimes parents want to talk a little later.
important communities. Inform parents as early as possible: GEPS: Sudden Death Research Society. Society of Orphaned Parents.

Prevention

It is recommended to put children to sleep on their backs, unless other medical indications contradict this. The position during sleep on the side or with the support of the child is too unstable. The frequency of SIDS increases with overheating (eg, clothing, blanket, hot room) and in cold weather. Thus, every effort should be made to avoid excessively hot or too cold environments, unwrapping the infant, and removing soft bedding such as sheepskin, pillows, soft toys, and quilts from the crib. Nipples can be helpful because they help open the airways. Mothers should refrain from smoking during pregnancy, children should not be exposed to smoke. Parents/guardians should not allow the child to sleep in their own bed. Breastfeeding is recommended to prevent infections. There is no evidence that home apnea monitors reduce the incidence of SIDS and therefore they are not recommended for prevention.

Crib death most often occurs while the baby is sleeping. Scientists cannot say why this happens, because studies show that children who die in their sleep are completely healthy.

SIDS - sudden infant death syndrome

It is believed that premature infants, that is, babies with low body weight, most often die for no apparent reason. In order to give birth to a healthy baby on time, mothers need to visit antenatal clinics more often, during pregnancy not change the climate zone, not have sex, not be physically and mentally stressed.

SIDS - Sudden Infant Death Syndrome often occurs when the baby sleeps on his stomach. The position on the back allows you to wake up and scream in time. The crib should not have soft pillows and blankets that can cover the mouth or nose of the child. The optimal sleeping position for a child is lying on its back and with its head turned to one side.

When the child begins to roll over and hold his head, he will choose the most comfortable sleeping position.

The child must not be overheated. There must be enough air in the crib. The baby should be covered with a thin blanket or diaper that only reaches the middle of the body. Nest beds, which have high soft sides that do not allow oxygen to pass through, carry a great danger.

What can be done to prevent sudden infant death? First, you need to properly organize the sleeping place of the crumbs. The mattress should be dense and smooth, it is necessary to provide a large amount of air in the crib and remove excess from it. Secondly, in the room where the child is located, there must be fresh air. It is necessary to ventilate the room often and in no case do not smoke.

If the room is cold, it is better to put a winter set of clothes on the child, and not to cover him with blankets that he can throw over his face.

Sudden Infant Death Syndrome age

If the child died a week after birth, then this means that there were some problems during gestation. Most often this happens in smoking mothers who do not deny themselves and in the intake of alcoholic beverages. At risk are children who weigh less than two kilograms. Women should know that between births you need to endure at least fourteen months. Sudden infant death syndrome from birth to six months of age. The peak is three months. Boys die more often than girls.

The child dies as a result of cardiac or respiratory arrest. This happens due to the immaturity of the autonomic and central nervous systems. The cerebellum is responsible for blood pressure and respiration, the poor performance of this part of the brain leads to the death of the child.

Sudden Infant Death Syndrome: Causes

There are no scientifically substantiated causes of SCM. No family is immune from this. Even if the parents do not smoke, strictly follow the instructions of pediatricians, properly organized a sleeping place for the child, they still cannot ensure absolute safety for their child. However, you need to be especially vigilant in the first six months, then the risk of SIDS decreases.

The causes of sudden infant death syndrome have not yet been established. Even after the autopsy, it is not possible to understand for what reason the respiratory arrest occurred. There are a number of factors that can affect respiratory arrest, if you take precautions, you can avoid a terrible tragedy, but no one will give an absolute guarantee.

Sudden Infant Death Syndrome: risk factors

Sometimes babies die in their sleep for no apparent reason. Experts are trying in vain to understand the cause of this phenomenon, but they have little success. In their impotence, doctors give recommendations to mothers who are more likely to calm themselves than really help children.

Sudden Infant Death Syndrome risk factors: stuffy room, abundance of soft materials in the crib, smoking parents, age up to six months.

If the child stops breathing, you need to pull yourself together and do not panic. The life of a child depends on the speed of actions of an adult. First of all, you need to do artificial respiration, then call an ambulance. If there is someone nearby, it means that one person is doing cardiopulmonary resuscitation, and the second is calling a doctor. Even if it seems that the child is already dead, you can not stop, it is necessary to continue resuscitation, because the baby can breathe at any moment.

It is impossible to completely prevent the occurrence of SIDS, but certain preventive measures can be taken.

Sudden Infant Death Syndrome Prevention. Before conception, you need to quit smoking and drinking. You can not allow others to smoke nearby, because passive smoking can adversely affect the development of the crumbs.

A woman should be registered in the antenatal clinic in the early stages. In order to avoid the development of pathologies, you must strictly follow the instructions of the doctor.

The best thing a mother can give her child is breast milk. It is advisable to feed the child up to one and a half years, if this is not possible (not enough milk or you have to go to work), then at least up to six months. Breastfeeding not only strengthens the immune system, but also provides a strong emotional bond between mother and child.

Children are happiness. Without them, life seems dull and meaningless, even if it is eventful. However, the birth of a child is a responsible matter. Children not only give joy, but also care. Parents have to constantly think about their nutrition, clothing, hygiene, make sure that the child does not get sick and develops correctly. Cases when women without any problems bear and give birth to children in a natural way are so rare that they can be counted on the fingers. Basically, bearing and giving birth to children is impossible without the help of doctors. Some people can't conceive on their own. Today, the level of development of medicine is so high that one should not be afraid to give birth and raise children. The main thing is that specialists are nearby. Those who in the past were doomed to death or childlessness, today give birth to two or three children and live a happy full life.

Sudden death syndrome (SDS) is one of the mysteries of medicine. They talk about it in the case when the death of a child occurs unexpectedly against the background of complete well-being at the age of up to 2 years, and at autopsy the cause of death remains unknown. Death of newborns older than 1 year is extremely rare.

Today, SHS is the 3rd leading cause of infant mortality after perinatal conditions.(the period from to the 7th day of extrauterine life) and congenital anomalies. The frequency is 1:500 children.

Despite the efforts of doctors around the world, today there are more questions than answers in this problem. Therefore, we can only talk about hypotheses. But do not sound the alarm to parents, therefore, this does not mean that this can happen to your child, but as they say, "informed means armed." And now we will look at the risk factors that most often lead to SHS.

Risk Factors for Sudden Death Syndrome

Risk factors leading to SHS:

1. Hereditary factor. In families that have lost a child from SHS, the recurrence of this tragedy is 7 times more likely.

2. Approximately half of the infants who died in this way had manifestations of a viral infection of the upper respiratory tract within 48 hours before the onset of death, many of them died due to the so-called action of the respiratory syncytial virus.

3. Studies on the topic of SHS show that in the body of babies who died with SHS, the level of the hormone serotonin (the hormone of happiness) was significantly reduced, which is directly involved in many vital physiological processes, both cardiac and respiratory. Therefore, the lack of serotonin is possible and is a physiological cause that disrupts the processes of respiration and heartbeat, which leads to respiratory arrest and cardiac activity, followed by SHS.

4. Also significant risk factors for SHS are stillbirths in previous pregnancies.

5. Children of Indian and African American families are at risk of SHS two to three times more often than children from European families.

6. The male sex of the baby. Girls die a little less often than boys. According to statistics, for every 1 girl who died with a diagnosis of SHS, there are 1.5 boys. In part, this ratio can be explained by the fact that immunity in infancy is slightly higher in girls than in boys.

7. Thymomegaly, i.e. an increase in the thymus gland is a characteristic pathoanatomical sign in children who died from SHS. This is due to the fact that the thymus compresses the mediastinal organs and releases a hormone-like substance that lowers blood pressure and affects metabolic processes in the muscle, all of which subsequently leads to SHS.

8. Environmentally unfriendly environment.

9. Mothers who did not seek prenatal care from doctors.

10. Bad habits of parents: alcoholism, drug addiction (a healthy lifestyle should be followed 2-3 years before the birth of a child). If the baby is somehow exposed to tobacco products (smoke, nicotine in mother's milk), this significantly weakens his immune system and reduces respiratory function, which can lead to SHS.

11. Young age of the mother (less than 17 years).

12. Short interval between births (less than 12-14 months).

15. Low level of education of parents.

16. Poor parental care for the baby (the mother ignores the crying of the child, feels displeasure from the need to care for the baby, devotes little time to him).

17. Mother's illnesses during,).

18. Prematurity (a child born at a period of less than 37 weeks), low birth weight (less than 2 kg).

19. Late terms (the baby must be attached to the breast in the first 30 minutes in the delivery room).

20., which is an "environmental disaster" for the child. SHS is much less common if the baby is breastfed before 6 months of age. Therefore, you need to continue as much as possible. It also naturally normalizes the production of hormones in infants, including the hormone serotonin.

21. Putting the baby to sleep on his stomach. In the first year of life, until he begins to actively roll over, he should not sleep on his stomach. Even if the baby already knows how to roll over on his tummy, let him toss and turn, but when he falls asleep, you need to turn him on his back. There are several good reasons for lying on the back during sleep: a) Sleeping on the stomach increases the risk of so-called "rebreathing", when oxygen circulation is difficult and the infant begins to inhale the same air that he exhaled before. And catastrophically lacking oxygen, his heart gradually slows down and stops; b) When the baby sleeps on his stomach face down, he involuntarily squeezes his lower jaw, and since the joints and ligaments are not yet developed enough to hold it without the slightest displacement. Thus, the upper airways narrow and breathing becomes more difficult, which also leads to SHS.

22. Vitamin E deficiency, which leads to increased vascular permeability and respiratory dysfunction.

23. 2-4-6 months of life are the periods of maximum risk of developing SHS. This is due to the fact that at this age the child is already able to independently turn face down in a dream, but their survival instincts have not yet developed. That is, if the baby does not have enough oxygen, he will not take any maneuver (will not turn around, will not cry, will not throw up his head) to save himself. Babies under 2 months old are not able to roll over by themselves, and in children over 4 months old, the instinct of self-preservation gradually develops. After 10 months, cases of SHS were practically not observed.

24. In the morning hours (4-6 hours). The respiratory center, which controls the processes of breathing and awakening, is not yet sufficiently developed in babies, and therefore babies cannot adequately respond to suffocation and does not manifest itself in any way during it.

25. Cold seasons (autumn, winter). At this time, the tension of the adaptive reserves of the body increases.

26. Weekends and holidays. Almost half of the cases of SHS were registered these days, this is due to the fact that parents tend to take a break from worries and want to have fun and the child does not receive proper attention.

Prevention of SHS

As a result of many years of research into the causes of infant mortality, the World Health Organization (WHO) has developed child care recommendations to reduce the risk of SHS:

It should also be noted that the implementation of these WHO recommendations by parents can reduce the infant mortality rate by about 20%.

In well-developed Western countries, cardiorespiratory monitors are actively used, which monitor the heart rate and respiratory rate, and if a child has any failure in his sleep, the device starts to “squeal”. The only thing we can do is to organize a large-scale educational campaign for parents. The results of the study of the problem require both the improvement of the system for monitoring cases of SHS by the health authorities, and the development of a broad educational program for parents around the world.

I hope that this article will not go unnoticed by parents and expectant mothers and will help you and your baby.

Sudden Infant Death Syndrome (SIDS) is a medical diagnosis of a healthy child who has died for no apparent reason. This is an inexplicable tragic case that does not have unambiguous scientific confirmation. According to statistics, today, 0.2% of infants are subject to uncaused death.

The reasons

If the doctor could not determine why the child died, he is diagnosed with Sudden Infant Death Syndrome. The reasons why children die are still unknown.

One version of SIDS is considered to be a defect in the centers of respiration and awakening. Such infants cannot adequately respond to non-standard situations. If oxygen supply is cut off during sleep, the baby may not wake up from anxiety and SIDS will occur.

As the child grows older, the risk of sudden death tends to zero. The highest frequency of SIDS cases is observed among children of the second - fourth month of life.

Preschoolers no longer have the concept of Sudden Infant Death Syndrome. Most often, after nine months there is no reason to fear for the condition of the child.

Possible causes of SIDS are:

Prolongation of the QT interval on the ECG. This indicator reflects the time from the moment of contraction of the ventricles of the heart to their complete relaxation. Normally, this indicator is 0.43-0.45 ms. Increasing this value may result in ventricular arrhythmias resulting in neonatal death;
Apnea. The brain temporarily stops stimulating the respiratory muscles. An adult can control this condition, hold the air up to 2-3 minutes. For infants, failure to take in oxygen within 30 seconds will result in death. The intervals between breaths are lengthened mainly in premature babies;
serotonin receptors. At autopsy after SIDS, an insufficient number of these cells was found in the medulla oblongata. A deficiency of nerve endings that respond to serotonin disrupts the cohesive work of the respiratory and cardiovascular centers. There is a theory that this is what causes SIDS;
Errors in thermoregulatory function. The air temperature in the room where the child is located should be in the range of 18-20 ° C. When overheated, immature cells of the medulla oblongata may refuse to perform their functions. Even a short-term cardiac arrest or cessation of breathing will cause the sudden death of an infant;
Infection. The immune system protects the child not only from the negative effects of bacteria and viruses, but also takes part in the work of the heart and lungs. Weakening of the body in utero or during the neonatal period can cause SIDS;
genetic predisposition. If the family has already encountered cases of sudden cardiac arrest or SIDS, then the risk of death of the baby is about 90%. The birth of a healthy child with strong immunity is not a guarantee of his viability.

Predisposing factors

cold season;
second month of life;
mother of a child under 20;
smoking during pregnancy;
premature baby;
low birth weight;
intrauterine fetal hypoxia;
resuscitation to the child during delivery.

You can reduce the risk of death by observing the following conditions to preserve the health of the child:

Do not put the baby to sleep on the stomach.

Until the baby learns to roll over on his own, sleep should occur while lying on his side. If the child is laid on the stomach, the risk of asphyxia or suffocation increases, as a result - death.

When oxygen is cut off, the baby will be inactive - suffocation will cause sudden infant death syndrome. The age of a child who rolls over from his stomach to his back on his own is more than six months;

Maintain optimum temperature.

Overheating, as well as excessive cooling of the child's body, adversely affects the functioning of the body, leading to the death of the baby. To prevent SIDS, the temperature is adjusted using air conditioners and heaters;

Eliminate smoking.

Nicotine, both during pregnancy and after the birth of a child, is very harmful. The task of a parent is to protect their baby from SIDS, so it is worth limiting not only the active exposure to tobacco smoke, but also the passive one.

The apartment where the child is located should not smell of cigarettes. If one of your relatives has such an addiction, ask them to go outside and keep them away from the baby until all the smell has completely disappeared;

The sleeping surface should be of medium hardness.

Choose mattresses specially adapted for newborns. Do not put a pillow under the child's head (the exception is orthopedic rollers recommended by a pediatrician or orthopedist).

With a disproportionate load on the musculoskeletal system of the infant, deformation of the ribs and spine occurs. Compression of the chest negatively affects respiratory and cardiac activity, death will occur if the work of vital organs stops;

Baby blankets. To minimize the risk of SIDS during sleep, do not cover the child with voluminous and heavy capes;

Note! In the cold season, it is better to dress the child warmer rather than using a blanket. The baby can move it to his face with his hands and cut off access to oxygen.

Leg support. The child is placed mainly in the bottom of the bed. If the legs rest against the side, this will reduce the likelihood of slipping down and covering the head with a blanket, and will prevent death from suffocation.

Features of the child's behavior

SIDS is neither predictable nor preventable. All that parents can do is to show a little more control over the health and behavior of the baby. Give your child more attention if you notice the following:

increased body temperature;
loss of appetite;
motor passivity;
the presence of respiratory diseases (read how to protect a child from a cold?>>>);
long laying the child to sleep;
frequent crying;
sleep in unusual conditions for the child.

Sleep with parents

If you feel more comfortable sleeping with your baby, good luck. You don't have to get out of bed to breastfeed your baby.

Feeling the native smell, the baby sleeps more soundly and calmly, he wakes up less often. Mom will immediately calm down if the little one starts to act up. Waking up will be more awake for parents who didn't run half the night to the crib.

Constant contact strengthens the emotional connection. A mother's dream is very sensitive. Even in sleep, you control every movement of your baby and can eliminate the occurrence of SIDS.

Important! When sleeping together, mother and baby should not hide in the same blanket.

The choice is yours. Sleep the way you feel most comfortable. You don't have to change your routine on purpose. Co-sleeping is the best solution for a mother with a baby, and it does not increase the risk of SIDS.

Parents should not sleep in the same bed as their child if:

very tired;
drank alcohol;
are taking sedatives.

Should I give my baby a pacifier?

How does a pacifier affect the occurrence of SIDS? Sucking during sleep actually reduces the risk of infant death. One explanation is that air is constantly drawn in through the pacifier circle, even if the baby is covered up. But don't force it into your child's mouth.

Note! If the child is used to sleeping with a pacifier, then it is worth weaning him gradually. Abruptly stopping the use of a pacifier, on the contrary, can increase the risk of death.

Breath monitor

Continuous monitoring of the newborn's breathing can be ensured by using an electronic device. The sensor is attached to the child's body, and the ultrasonic sensor is attached to the child's bed. In case of interruptions in breathing, the device will signal a rhythm failure.

Does everyone need to use it? Such a device will help prevent SIDS. But it is used if the child has breathing problems or is at increased risk of infant death. No one forbids purchasing a monitor for parental peace of mind.

First aid for respiratory arrest

You notice that the child has stopped breathing. Do not panic, get together, it depends on the accuracy of your actions whether SIDS will come or not. Sharp movements are made with the fingers along the spinal column from the bottom up. The baby is taken in your arms: start to shake him up, massage the arms, legs and earlobes.

These actions are enough to normalize breathing and prevent SIDS. If the condition does not improve, call an ambulance. Start doing chest massage and artificial respiration. The onset of death can only be ascertained by a doctor, until his arrival, continue resuscitation.

Important! The chest of a child is very fragile. The heart area is massaged with the index and middle fingers on the lower third of the sternum.

Predisposition to death in infancy is laid in utero. Bad habits of both parents can seriously affect the health of the baby and provoke SIDS. During pregnancy, you should completely avoid the use of alcohol, drugs and cigarettes. Do not neglect the advice of doctors.

Lack of proper control over the child, lack of attention to him from the parents can lead to death in the cradle. More than half of SIDS cases occur on weekends and holidays, according to a study by British pediatricians.

Scientists have confirmed the fact that preventive vaccinations, air travel or the type of mattress in a baby's crib are not the causes of sudden infant death syndrome.

Roshchina Alena Alexandrovna, pediatrician. Especially for the site Lessons for moms.

Infants, whose age varies from 2 to 4 months, are most susceptible to sudden death syndrome. By six months, this phenomenon is extremely rarely recorded, and among 9-month-old infants and older children, only isolated cases of SIDS have been noted.

The conducted studies helped scientists to find out the most dangerous period of infant mortality, but so far the exact cause of the sudden death of infants has not been found out. There are several major predisposing factors for SIDS. Pathological anatomical studies have proven some connection between the underdevelopment of certain parts of the brain and the frequency of infant mortality.

Understanding Sudden Infant Death Syndrome

It was not until the late 1960s that the medical community faced the acute question of mortality in infancy. It was during this period that the term SIDS was introduced. Of course, children have died before, but only at the end of the last century, pediatricians around the world began to "sound the alarm", conducting all kinds of campaigns to try to prevent the development of this syndrome.

Although infants are able to quickly adapt to new conditions, their mortality due to external or internal causes is still high. Usually, apparently healthy children die due to various developmental pathologies, due to infections, and often as a result of previous injuries. Unsuspecting parents put their baby to bed and then find him dead there.

A sleeping baby may experience respiratory problems. As a rule, its short-term delay for children is considered the norm. As soon as the level of oxygen in the blood drops, signals from the brain cause the child to wake up and restore breathing.

Only in rare cases, sleep apnea is fatal. If parents began to notice that their baby holds its breath for 10-15 seconds in a dream, and several stops occur within an hour, then this is a serious reason to show the child to the doctor.

As a rule, the cause of death is determined at autopsy by the pathologist, and only when this fails, the diagnosis of SIDS is made. According to statistics:

African American children are much less likely to die from SIDS;
about three children out of a thousand who died at the autopsy fail to identify the cause of death;
more than half of the dead are boys;
in 90% of cases, 2-4-month-old children die;
SIDS risks are highest when a child reaches 13 weeks of age;
the death of a child in more than half of the cases is associated with the wrong behavior of the parents;
40% of infants on the eve of death had symptoms of a cold;
most often, the development of the syndrome of sudden death of a child contributes to the period of cold weather.

Parents whose children are at risk need to make every effort to create the most favorable living conditions for their child. They need to be more attentive to the whims of the baby and devote most of their free time to him.

Factors that can provoke this phenomenon

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So far, such a phenomenon as SIDS has not been studied in full. Medical workers remain at a loss when a healthy child suddenly dies of caring parents. No one can answer with 100% certainty what caused Sudden Infant Death Syndrome. The most likely provoking factors are:

stop breathing during sleep;
disturbed heart rate;
pathology of the coronary vessels supplying oxygen to the brain;
deterioration in the general state of health of the child against the background of psycho-emotional stress;
infection;
compression of the vertebral arteries.

It is also worth highlighting some factors that can adversely affect the health of the child and lead to sudden sudden death at night:

nicotine and drug addiction of the mother during the period of gestation;
delayed intrauterine development of the baby;
the birth of a child prematurely;
incorrect position of the baby in the crib during sleep (on the stomach);
improperly selected bedding (large pillow, soft blanket, etc.);
foreign objects in the crib (bottle, nipple, toys, etc.);
excessive air temperature in the children's room;
parents smoking.

Many dead babies could have been saved - most often children die through the fault of their parents. If at the autopsy the doctor finds traces of violent death, then SIDS qualifies as murder. It is not uncommon for her own mother to cover the baby with a pillow so that she no longer hears his crying.

Parental care and attention are the main guarantee of a long and happy life of a child.

Sometimes parents can inadvertently harm their helpless child. Due to the fact that the neck muscles of the baby are weak, any careless movement or shaking of the baby leads to concussions or bruises of the brain (we recommend reading:).

Often the baby calms down after a shake, he can lose consciousness and fall into a coma. Very often, children die in their sleep when their own mother, under the influence of sleeping pills or alcohol, leans with her body on a nearby sleeping helpless baby.

How high is the risk of developing SIDS?

For newborns and infants up to 2 months, sudden death syndrome is not typical. The peak of deaths occurs at the age of 13 weeks. If the child has moved to the next age category, he is already more than 6 months old, in this case, the risks of SIDS are reduced to 10%.

One-year-old children die in their sleep extremely rarely, only isolated cases are recorded. Adolescents and adults who were completely healthy can also die suddenly with increased physical activity, and at rest.

SIDS most commonly occurs in children from birth to 1 year of age. As soon as the baby learns to roll over, sit down and stand up, then the risks of sudden death syndrome approach zero. From this moment on, the child can change the position of the body in a dream, taking the most comfortable position for himself.

Is the syndrome possible in an adult?

Unfortunately, sudden nocturnal death syndrome is also found among the adult population, so no one can say exactly until what age this phenomenon should be feared. Year by year, cases of death are recorded in the world when healthy people from 18 to 30 years old die for no clear reason.

Although many studies have brought scientists closer to unraveling the causes of SIDS, the phenomenon of sudden adult death requires serious study. The scientific community insists on the need to introduce a new term SIDS (Sudden Adult Death Syndrome). In young people, cardiac activity stops or breathing stops during sleep. At autopsy, there are no pathological changes that can cause death. On the contrary, in most cases the deceased was distinguished by good health.

Based on the available and very conflicting statistics, it can be assumed that on average 4 people die every week for no apparent reason in the world. More than 200 cases of SHS are recorded per year.

If you look at other data obtained by scientists in the UK, the mortality rate from SHS is simply amazing. In this country, 3,500 people die every year for no reason.

First aid for a child with sudden respiratory arrest

Health workers in the maternity hospital and district pediatricians should conduct conversations with newly-made parents so that they, in turn, can immediately provide emergency care to their child. Knowing the terrible symptoms of sudden infant death syndrome, you can avoid the tragedy.

After stopping breathing, the child can be saved if measures are taken in time. Symptoms of SIDS can last from 1 to 30 minutes. Usually in infants, breathing becomes weak. The child does not show activity, the skin turns blue, muscle tone decreases.

As soon as parents suspect that the baby's heart rhythm is disturbed or there are breathing problems, you should immediately call an ambulance team. You can not waste a minute, you need to try to restore cardiac and respiratory activity, without panicking and keeping your composure. To do this, do the following:

with fingers several times intensively hold along the spine;
shake the baby lightly, trying to wake him up;
massage feet, hands and earlobes.

Thanks to such actions, the child can be brought to life. He wakes up, his breathing and heart rate is restored. However, if all the manipulations carried out did not give a positive result, you do not need to stop, you need to massage again and again until the ambulance arrives.

It is also necessary to give the baby a heart and chest massage. All actions must be performed with extreme caution, since the bones of the baby are still too fragile, you can injure him.

Is it possible to prevent the development of the syndrome?

Thanks to many years of research, doctors have been able to prove the effectiveness of preventive measures in the fight against SIDS. You can reduce your risk of sudden nocturnal infant death by:

Stop smoking, as tobacco smoke is highly toxic. Its constant impact on the fragile body of the child is unacceptable.
There should be no foreign objects in the crib. Children under 1 year old do not need a pillow, their mattress should be hard.
You can not cover the baby with a warm blanket during sleep. The baby is not able to control his movements, he can easily pull the blanket over himself, thereby limiting access to fresh air.
Many experts are of the opinion that it is better for a child to sleep with his mother. So she can control the baby's sleep. It must be understood that the use of alcohol or sleeping pills in this case is unacceptable.
When placing the baby in the crib for sleep, it is necessary to lay him on his back, and take his head to the side, or on the side, fixing the body on both sides with a positioner.

If during pregnancy a woman takes care of her health, regularly visits a antenatal clinic and follows the recommendations of doctors, then she has every chance to give birth and raise a healthy child. It has also been observed that breastfed babies have good health and better adapt to the environment than formula-fed babies.

Based on the foregoing, a simple conclusion can be drawn: parents need to lead a healthy lifestyle, pay more attention to their child and follow the basic rules of children's sleep hygiene.

If the baby is at risk for SIDS, parents should take care in advance to purchase equipment specially designed for such cases. So during the sleep of the child, you can track his heart rate, in case of violation of which the alarm will go off. A respiratory monitor is placed next to the crib, and electrodes are attached to the child's body.

SIDS statistics in Russia

Sudden Infant Death Syndrome (SIDS) is not a disease. This is a diagnosis that is made only in cases where it is impossible to establish the true cause of death of an infant. At autopsy, there are no pathologies, no traces of violence, a lethal outcome is diagnosed as a result of SIDS.

Recently, statistics of sudden deaths among the child population have been kept in the Russian Federation. According to the statistics obtained, in Russia, the rate of sudden death per 1,000 children born is 0.43.

Educational activities of the Foundation for the Study of Infant Mortality began in 1991. Since then, the number of infant deaths in sleep has dropped significantly. Parents began to listen to the recommendations of specialists, tragic cases decreased by 75%, but SIDS continues to take the lives of babies.