Sudden Infant Death Syndrome. Causes of sudden infant death syndrome Sudden death of an infant in a dream

Sudden death syndrome in children (SIDS) is the death of a child in the first year of life, which has practically no abnormalities in health. Moreover, the reason for this cannot be determined even by the pathologist during the autopsy. Quite often, the syndrome is referred to as "death in the crib" or "death without a cause." However, the reasons, risk factors for the occurrence of this practically unexplored phenomenon still exist. By eliminating them, parents can minimize the risk of SIDS.

Description

Sudden death syndrome is not a disease. Such a diagnosis is made posthumously if the analysis of the child's history and the results of the autopsy do not allow determining the cause of death. If it is possible to discover that a pathology that was not previously identified led to a fatal outcome, the diagnosis of SIDS is not made.

Since ancient times, information has been received about cases of sudden death of babies, but an explanation for this phenomenon has not yet been found, despite the fact that scientists around the world are trying to solve this problem. It is noteworthy that SIDS is not typical for children of the Asian race, and in the white race it occurs twice as often as in Indians and African Americans.

Most often, sudden death syndrome occurs when the child is sleeping, and no symptoms appear the day before. Currently, up to 6 cases of such a phenomenon are recorded for every thousand of their peers.

Until what age can sudden infant death occur?

The study of the phenomenon made it possible to identify some patterns of this mysterious phenomenon:

Factors that increase the risk of SIDS

Scientists by studying cases of sudden death in infants were able to identify a number of factors that contribute to its development:

The development of postpartum depression in the mother.
The birth of a baby by a single mother.
Poor social and economic family conditions (parents do not have knowledge of how to properly care for a child, parents do not have a job, family members smoke, there is no regular ventilation of the apartment, there is crowding in the apartment).
During pregnancy, the mother took drugs or smoked.
The mother gave birth when she was less than 17 years old.
Recently, the child has suffered any disease.
There was hypoxia and anemia of the fetus during its gestation.
Medical supervision of pregnancy was started at a late date or was absent altogether.
Reported cases of stillbirth or SIDS in these parents in the past.
The mother had many pregnancies, and the intervals between them were short.
Multiple pregnancy.
The baby was underweight at birth.
Infant prematurity. Moreover, the risk of developing SIDS is higher, the lower the gestational age of the child.
Overheating of the child's body. This factor can be attributed to both excessive heating in the room, and the use of too warm blankets when sheltering a child.
Too soft bedding is used for the child - blankets, mattress, pillows.
Sleep of the child in the position on the stomach.

The causes of sudden infant death are not fully understood. Separately, it should be noted an increase in the risk of SIDS in the case when parents smoke. Studies show that SIDS cases would be reduced by 40% if mothers did not smoke during pregnancy. Moreover, the danger lies in both active and passive smoking. Even smoking in a neighboring room, in which a window is open and ventilation is turned on, is harmful.

Probable causes of sudden death

SIDS is not fully understood by scientists. However, some of its mechanisms are described. Currently, there are several theories that can explain the mechanism of development of this phenomenon.

Normal sleep is often accompanied by respiratory disorders, in which it can stop for a short time. The result of such a stop is the development of hypoxemia. Normally, hypoxemia provokes awakening and subsequent restoration of respiratory function. If breathing is not restored, sudden death occurs. The reasons for this are given below.

Regulatory mechanisms in a child are in an immature state, and therefore apnea in infancy is a common occurrence. If such breath holdings occur more than once an hour, and their duration reaches 15 seconds, it is important to contact your pediatrician immediately.

A separate group of scientists believe that the leading factor in SIDS is heart rhythm disturbances, and not apnea. Among them are a frequently changing heart rate, bradycardia (accompanied by a decrease in the number of heart contractions to 70 or less beats per minute), disturbances such as blockades and extrasystoles.

This theory is confirmed by the mutation of the gene found in some cases of SIDS development, which is responsible for the structure of the sodium channels located in the heart. Changes in these structures provoke cardiac arrhythmias.

Even in healthy children, a violation of the heart rhythm can be noted, up to its short-term stop. If such phenomena are noted in infancy, it is important to immediately contact a pediatrician and examine the baby.

What else can cause sudden death syndrome? Changes in the structures of the brain stem. The medulla oblongata contains the vasomotor center and the respiratory center responsible for cardiac activity. Studies of some cases of SIDS have revealed a violation of enzymatic synthesis, the formation of acetylcholine receptors in the brain stem under the influence of tobacco smoke components. It is assumed that such changes may contribute to the development of SIDS.

In some infants, after sudden infant death, structural changes and damage to the cells that form the stem brain were revealed, which arose at the stage of intrauterine development as a result of hypoxia.

Ultrasound echography, which was performed on children rescued after respiratory arrest, found that in 50% of cases there is a pathology of the arteries that supply the brainstem with blood. This may suggest that impaired cerebral circulation can provoke SIDS in some children.

Blood circulation is disturbed if the artery is clamped due to the incorrect position of the baby's head. Due to the underdevelopment of the muscles, the child is not able to turn his head on his own. The child can reflexively turn his head to a safe position only after 4 months.

In addition, there is a violation of blood circulation if the baby sleeps on its side. The blood flow is most severely disturbed when sleeping in the prone position. Studies confirm that in this position there is a sharp slowdown in breathing and a weakening of the pulse.

The combination of a large number of pathoanatomical changes found in all deceased children allows us to judge that SIDS often develops against the background of severe stress to which the child's body has undergone. Similar pathoanatomical changes are expressed in the form of small hemorrhages found in the thymus gland, the outer shell of the heart, lungs, traces of ulceration on the mucous membranes of the gastrointestinal tract, wrinkled lymphoid formations, reduced blood viscosity. Such phenomena are symptoms of nonspecific stress syndrome.

Clinically, this syndrome manifests itself in the form of a runny nose, discharge from the eyes, enlargement of the tonsils, spleen, liver, rash, weight loss. Most often, such symptoms are observed in a child about 3 weeks before the development of SIDS in 90% of cases. However, many scientists believe that these symptoms are not sufficient for subsequent death. It is quite possible that the combination of any violations in the development of the child and stress can lead to terrible consequences.

It was noted that the majority of children who died suddenly during the week before the onset of SIDS had symptoms of a viral infection. At the same time, the children were examined by a pediatrician, and some babies were prescribed antibiotics.

Among the supporters of this theory, there is an opinion that pathogens secrete cytokinins and toxins that can disrupt the body's defense mechanisms, for example, the ability to wake up from sleep during sleep apnea. Thus, the risk factors present are exacerbated by infection. Toxins of pathogenic microorganisms (Staphylococcus aureus is often found postmortem) can provoke and increase inflammation.

The data obtained suggest that toxins affecting children, together with risk factors, can cause death.

Recent studies report the discovery of the SIDS gene in a comparative DNA analysis of children who died from SIDS and healthy children. It is generally accepted that the likelihood of sudden infant death syndrome is three times higher in those children who have a mutation in the gene responsible for the formation and subsequent development of the child's immune system. However, scientists prefer to believe that the presence of a mutated gene does not provoke SIDS in itself, but only in conjunction with other factors.

Some studies indicate the likelihood of sudden death as a result of the presence of the bacterium Helicobacter pylori in the body. This conclusion is based on the fact that this particular bacterium is most often found in dead children. These microbes provoke the synthesis of ammonium, which causes respiratory disorders, and as a result, the sudden death of the infant occurs. It is assumed that the child, spitting up, can inhale some of the microbes in the vomit. Thus, ammonium enters the bloodstream and causes respiratory failure until it stops.

Consider another likely cause of sudden infant death syndrome.

Swaddling a baby as a risk factor

Experts are divided on the safety of swaddling. Swaddling is believed by some to reduce the risk of SIDS by preventing the baby from rolling over and covering their head with the blanket.

Others are of the opinion that swaddling disrupts the physiological development of the baby. Tight swaddling limits the movement of the child, does not allow him to take a comfortable position. As a result, thermoregulation is disturbed - in a straightened position of the body, its heat transfer increases.

In addition, breathing is limited, that is, the risk of developing pneumonia and SIDS increases significantly.

Pacifier as a way to prevent SIDS

Some researchers believe that the use of a pacifier during the periods of daytime and nighttime sleep of the baby can reduce the risk of SIDS. This effect is explained by the fact that the design of the nipple ensures the penetration of air into the respiratory organs of the child in cases where he is accidentally covered with a blanket over his head.

You should start using a pacifier from 1 month, when breastfeeding is already established. However, if the child refuses to take a pacifier, persistence should not be shown. Weaning a baby from a pacifier should begin at the age of 1 year.

Safety of co-sleeping baby with mother

Various scientists ambiguously interpret joint sleep with an infant. Undoubtedly, joint sleep helps to prolong the period of breastfeeding. Relevant studies have revealed that when a mother and child sleep together, the risk of developing SIDS in the latter is reduced by about 20%. This can be explained by the fact that the baby's body has sensitivity and is able to synchronize breathing and heartbeat with the mother's breathing and heartbeat.

In addition, the mother, being nearby, is able to subconsciously control the child's sleep. It is noted that the risk of sudden death increases if the baby first cries loudly, and then falls asleep soundly. During such periods, the child should not be isolated, it will be safer if he is next to the mother, who is able to notice the cessation of breathing and provide timely assistance.

However, on the other hand, co-sleeping significantly increases the risk of sudden infant death syndrome if the baby's parents smoke. Even if smoking is not carried out in the presence of the baby, in a dream the smoker exhales air saturated with harmful components contained in tobacco. A similar situation occurs if parents use alcohol or drugs. In addition, the likelihood that a soundly sleeping parent will inadvertently crush the baby increases. When sleeping together with a child, it is also not recommended to abuse perfumes.

Rules for choosing a bed for a baby

The best option for placing a crib is the mother's room. It should be placed away from the radiator, heater, fireplace. This will prevent the baby from overheating. The mattress must be firm and flat. On it you can lay an oilcloth, and on top - a carefully straightened sheet. It is better to do without a pillow. Children's bed should be of such a degree of rigidity that it does not leave dents from the child's head.

During the cold period, the child's blanket should be made of wool, and not wadded or downy. The use of a thermal blanket is prohibited. Do not cover the child higher than shoulder length. This minimizes the chance of the child accidentally covering their head. In this case, the child in the crib must be positioned so that he rests his legs against the lower side of the bed.

If a sleeping bag is used, then it must be selected in strict accordance with the size (to avoid the child shifting to its bottom). The average temperature in the children's room should be no more than 20 degrees Celsius. Overheating of the baby causes a deterioration in brain control over the activity of the respiratory center.

You can determine if the child is cold by touching his tummy. The definition of hands and feet is considered incorrect, as they can be cold even if the child is hot. Upon returning from a walk, it is necessary to undress him, even if this may wake him up.

When laying down to sleep, the baby should be placed in the supine position. To prevent regurgitation and further aspiration of vomit during sleep on the back, the child should be held in an upright position for about 15 minutes before laying down. This will allow the air swallowed with the food to escape from the stomach.

Sleeping on your stomach increases your risk of sudden death for several reasons:

Weaker physiological control of the activity of the lungs, heart, vegetative functions.
The balance between the sympathetic and parasympathetic divisions of the NS may be disturbed.
There is a violation of ventilation of the lungs. This is doubly important for infants under 3 months of age, who have weakened reflexes that promote ventilation.
Sleep on the stomach is deeper due to an increase in the awakening threshold.

This position is most dangerous in a dream for those children who usually sleep on their backs, and turn over on their stomachs by accident. Toddlers who prefer to sleep on their stomachs should be turned over on their backs after they fall asleep. Less safe than on the back is also considered the position on the side. Do not put soft toys in the crib.

After six months, the baby can already roll over on his own in bed, so you can let him take the most comfortable position for him. However, he should be put to sleep on his back.

Using the baby monitor

Currently, there are specialized devices that allow you to control the heartbeat and breathing in babies up to a year old. Such monitors have a special alert system that is triggered when the heart rhythm is disturbed or breathing stops suddenly.

Such devices are not capable of protecting the baby from SIDS, but they can notify parents in a timely manner of existing problems. This will provide timely assistance to the child. The most appropriate use of such monitors is in children who are at risk of developing sudden infant death syndrome, who have respiratory problems.

Risk groups by age

Atypical SIDS is for babies up to a month old. Most often, the syndrome occurs from 2 to 4 months. According to statistics, the most critical is the 13th week of life. About 90% of all cases of SIDS occur before the age of six months. It is extremely rare for children to develop sudden death syndrome after one year of age, although such cases have been reported even in adolescence.

Help a child

If a child has a sudden cessation of breathing, you should immediately take him in your hands, vigorously run your fingers several times along the spine, in the direction from bottom to top. Then you need to massage the earlobes, feet, hands, shake it up. Most often, such actions lead to the restoration of breathing.

If breathing is still not restored, you should immediately contact the ambulance service. In anticipation of her arrival, the child should be given a heart massage and artificial respiration.

Thus, it is impossible to completely eliminate the risk of sudden death due to the fact that its causes are not fully understood. However, each parent can minimize the risks by reducing developmental factors.

Sudden Infant Death Syndrome is a diagnosis that is made when an almost healthy child under the age of 1 year dies in a dream for no apparent reason. Death occurs due to respiratory arrest. Doctors still cannot establish the exact cause of this phenomenon, although active research on this problem has been conducted since the 1950s.

There are many theories of sudden infant death syndrome, risk factors have been established, and prevention has been developed. The mortality rate among children has fallen significantly due to this phenomenon. Despite many successes in studying this problem, medicine has not yet been able to establish the main cause of sudden infant death syndrome and eliminate it completely. The mystery of this phenomenon has given rise to many myths and increased parental fears.

What is Sudden Infant Death Syndrome?

Sudden Infant Death Syndrome is often referred to as "death in the cradle" because the child dies in his sleep in his bed. Death always comes unexpectedly, without any previous signs. An autopsy and examination are not able to answer why a healthy child without any developmental defects falls asleep and never wakes up again.

Serious research on this problem began in 1950. After 9 years, the term "sudden infant death syndrome" was first introduced. Several important discoveries have been made that could explain individual deaths, but the underlying cause of SIDS has not yet been identified.

SIDS is not always the cause of a child's death. Unfortunately, babies often die from internal and external causes. These can include developmental anomalies, tumors, infections, and abuse. The cause is quite easily established by studying the medical history or at the autopsy. And only in the event that not a single study could give a clear answer about the cause that provoked infant death, they make a diagnosis of "sudden infant death syndrome." Thus, we can say that this is a diagnosis of exclusion.

Causes of sudden death syndrome in children

Children are most at risk of sudden death aged 4 to 6 months. By 9 months, the risk is significantly reduced, and at the age of 1 year it is already practically reduced to 0. Researchers were able to establish the exact age when the risk of SIDS is highest, but it was not possible to establish the exact cause. Several main hypotheses have been identified that attempt to explain the cause of sudden infant death:

Factors that increase the likelihood of developing sudden infant death syndrome

Since 1989, much more attention has been paid to the study of SIDS than before. Despite some success, it has not been possible to establish the exact cause of this phenomenon. However, scientists were lucky identify several factors, which significantly increase the likelihood of sudden death syndrome:

Can sudden death syndrome be prevented?

It is impossible to completely exclude the possibility of developing sudden infant death syndrome. Fortunately, this is a fairly rare occurrence., which affects only 0.2% of children. In most cases, even children lying on a soft feather bed on their stomach will instantly wake up and change their position, with insufficient oxygen supply. And only in rare cases, with a combination of factors such as age, genetics and adverse external conditions, sudden death syndrome can develop in children.

Although it is impossible to completely eliminate the possibility of a child dying from SIDS, parents can significantly reduce the risk of developing it. Prevention must be taken care of not only after birth, but throughout the entire period of pregnancy. It has been proven that women who irregularly attended antenatal clinics and did not follow all the doctor's recommendations significantly reduced their child's chances for a healthy and long life.

Sleep as prevention

Since sudden infant death syndrome develops in babies during sleep, parents should make every effort to secure baby's bed. First of all, you need to make sure that the air temperature in the room is constant and does not exceed 22 degrees. It will also be useful to purchase a humidifier.

When choosing a crib for a child, it is necessary to give preference to a firmer mattress, since one of the causes of SIDS is too soft a feather bed.

The pillow must be discarded. Instead of a blanket, it is better to use a special heat-resistant bag. Lay the baby to sleep only on the back, and after he learns to roll over on his own, you can lay it on its side.

Some pediatricians categorically do not recommend co-sleeping of parents and child. It is believed that this is one of the causes of sudden death syndrome. This is true only if the mother is completely exhausted and so tired that in a dream she can accidentally crush the child and not feel it. Also, co-sleeping should not be practiced if the parents have consumed alcohol, drugs or smoke in bed.

In all other cases, co-sleeping is desirable and even beneficial for the baby. During the 9 months of pregnancy, the mother's heartbeat calmed the baby in the womb. After birth, during co-sleeping, his sensitive organism again tunes in to the rhythm of the mother's heart and breathing. This is an excellent prevention of SIDS. In addition, the mother sleeps so sensitively that if the baby stops breathing, she will wake up and help him.

In the event that parents prefer separate sleep with the child, the baby's crib must be moved as close as possible to the parent. You need to lay the crumbs at the very bottom of the crib so that the legs rest against the side. This will not allow the baby to slide down and cover himself with a blanket, which can provoke suffocation.

Before you put the baby to sleep, you need to let him burp, holding it upright for several minutes. Especially attentive parents need to be if the child goes to bed after a strong tantrum or in an unfamiliar place.

What else can help reduce the risk of sudden infant death syndrome

Parental love and care is not a panacea for SIDS, however, it helps to reduce the likelihood of developing the syndrome. It has been proven that in families where the child was not desired or is raised by a single mother, SIDS is the main cause of death for babies under the age of 1 year.

Loving parents who want to eliminate all possible risk factors as much as possible should adhere to the following guidelines:

Modern gadgets for parents to help

At the moment, there are many devices that monitor the child's breathing and heartbeat. There are both simple models and multifunctional ones on the market. The most common monitors can beep if the child's breathing rhythm goes astray. You can also find devices that will track the baby's heart rate, blood oxygen levels and send data to the parents' phone or computer.

Of course, such gadgets cannot completely exclude the possibility of developing sudden death in infants. But they can warn parents about the danger. This will allow you to call an ambulance in time and save the baby's life. The use of such sensors is especially important for premature babies.

In addition to these modern devices, you can use the well-known pacifier. It has been proven that the risk of developing sudden infant death syndrome is reduced if the baby sucks on a pacifier during sleep, since additional air enters through its circle.

How to help a child if he stops breathing

In cases where parents immediately noticed a child's respiratory arrest, almost always they managed to save the baby. First of all, it is necessary to discard panic and pull yourself together, since the life of their crumbs will depend on the confident and correct actions of adults. The child must be picked up and with a sharp movement, hold the edge of the palm or fingers along the spine. After that, it is necessary to rub the baby's feet, palms and earlobes; loosen it up a bit.

Usually, these actions are quite enough for the child to resume breathing. If these steps do not help, you need to call an ambulance. All the time, before the arrival of doctors, the child needs to do a heart massage and artificial respiration. Massage the heart with great care, as it is very easy to break children's ribs.

Possible precursors of sudden infant death syndrome

It is impossible to predict the development of sudden death syndrome and this phenomenon has no clear causes. Still, there are some moments, which can become dangerous harbingers of the possible development of this syndrome. Parents should pay special attention to them and especially carefully monitor the child.

What can be hidden behind SIDS

Sometimes child abuse or accidental killing trying to pass it off as sudden death syndrome. If serious fractures and injuries are easily detected by doctors immediately, then intentional strangulation is not so easy to determine. If a second child dies in a family due to SIDS, this should raise serious thoughts about possible abuse. In the case of the death of 3 children, doctors rarely doubt that the cause was abuse.

Shaken baby syndrome is also being passed off as SIDS. In the event that the child cries and cannot be calmed for a long time, some parents begin to shake the baby violently. A fragile neck and a sufficiently large head of a baby, as a result of shaking, provoke damage to the vessels of the brain, which can lead to coma or death.

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.

Causes

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.

Sudden Infant Death Syndrome (SIDS)- this is a concept applied to the unexpected death of a child of the first year, which occurred in a dream without established causes. SIDS is said to be in the event that the study of the medical record and the place of death, as well as the post-mortem examination, do not give a clear answer about the causes of the death of the infant. To assess the risk of sudden infant death, test algorithms (Magdeburg scoring table) are proposed, ECG and polysomnography are performed. Prevention of SIDS includes optimizing the child's sleep conditions, identifying children at risk, and providing home cardiorespiratory monitoring.

General information

Sudden Infant Death Syndrome (SIDS, "Death in the Cradle", Sudden Infant Death Syndrome) is the unexplained death of an infant during sleep in the absence of adequate causes leading to death. As follows from the definition, the syndrome excludes the presence at the time of death of an infection, an accident, previously unidentified congenital (including genetic) or acquired diseases or their consequences. Neither the study of the medical records of the deceased child, nor the examination of the place of death, nor the results of the autopsy allow us to name the cause explaining the death.

The prevalence of SIDS in the world is 0.2-1.5 cases (in Russia - 0.43 cases) per 1000 children. Infants under 8 months of age are most at risk for SIDS; The largest number of sudden infant deaths occurs at the age of 2-4 months. 60% of children who die as a result of SIDS are boys. Usually, the sudden death of a child occurs during the time interval from midnight to 6 am, mainly in the winter season. SIDS accounts for up to 30% of deaths in children in the first year of life, which explains the unrelenting concern of young parents and pediatricians about this problem.

Causes of SIDS

The study of the problem of sudden infant death has been conducted for several decades, but an unambiguous explanation of the causes of this phenomenon has not yet been received. Theories of historical interest include the explanation of the mechanism of SAF:

accidental (accidental) suffocation (when the baby is in the parent's bed, unintentional suffocation with bedding);
compression of the trachea by an enlarged thymus (asthma thymicum);
lymphatic-hypoplastic diathesis (status thymico-lymphaticus).

At the present stage in pediatric neurology, sudden infant death syndrome refers to sleep disorders (parasomnias). The following are considered as basic hypotheses explaining the pathogenesis of SIDS:

Sleep apnea. The category of children at increased risk of developing sleep apnea includes preterm infants with an immature respiratory system.
Disturbances in the rhythm of cardiac activity (arrhythmias). A large-scale study that lasted for 20 years showed that the presence of a prolonged QT interval on ECG data increases the risk of sudden infant death by 41 times. A practical consequence of this discovery has been neonatal ECG screening in some countries, as a result of which beta-blockers are prescribed to children with congenital long QT syndrome and an increased risk of SIDS.
Compression of the vertebral artery. One of the hypotheses explaining SIDS is the assumption that the position of a sleeping child on the stomach with the head turned to the side causes compression of the vertebral artery, a decrease in perfusion of the brainstem and death from central sleep apnea. The authors of this hypothesis propose to use ultrasonography of extracranial vessels as a screening method for identifying children at risk of sudden death.
Other theories. The theory of violation of the awakening reaction and inefficiency of "grasping" breathing in response to hypoxia and hypercapnia developing in a child has not yet found an unambiguous explanation. Perhaps the key to SIDS lies in the dysregulation of sleep, respiration, and temperature homeostasis by the neurotransmitter serotonin. Proponents of other hypotheses try to explain the pathogenesis of sudden death of infants by an excess of endorphins, defects in beta-oxidation of fatty acids, insufficient maturity of cardiorespiratory function control by the central nervous system, etc.

Some authors propose to classify SIDS as an extreme manifestation of borderline conditions in newborns and children of the first year of life, which can occur when exposed to minimal non-specific factors.

Risk factors

Despite the many hypotheses, none of them can serve as a universal explanation for the SIDS phenomenon. However, long-term observations reveal a number of factors that significantly increase the risk of sudden death in infants. These include:

young age of the mother (under 20 years old),
prematurity of the child and body weight less than 2500 g,
baby male,
artificial feeding,
sleep on the stomach and on a soft surface,
overheating during sleep
smoking in the house, etc.

As to whether the risk of sudden infant death increases when a child sleeps together in the same bed with parents, there is no clear answer. Most researchers tend to see co-sleeping as a preventive factor by synchronizing the child's breathing and heartbeat with the mother's breathing and heartbeat, as well as the mother's ability to quickly respond to the child's respiratory arrest. On the other hand, the likelihood of SIDS is increased due to the danger of over-covering and overheating the child, sleeping on a soft pillow, etc. Contrary to misconceptions, preventive vaccination of children is not the cause of sudden infant death.

Abortive ADHD

In relation to infants who experienced an obvious life-threatening episode in infancy and survived, the concept of abortive sudden infant death syndrome, or near-miss SIDS, is used. Characteristic signs of an obvious life-threatening episode are sudden cessation of breathing, pale or cyanotic coloration of the skin, hypotension or hypertonicity of the muscles that occur in a child for no apparent reason, with complete well-being. Obvious life-threatening episodes during the first months of life occur in 0.6% of infants.

In 50-70% of cases, in such children, it is possible to identify a correlation between an obvious life-threatening episode with any pathological condition: convulsive syndrome, myopathy, respiratory tract infections, gastroesophageal reflux disease, congenital malformations, metabolic diseases, etc. Therefore, children who have had an abortion SIDS, it is necessary to conduct a comprehensive examination with the participation of various pediatric specialists: a pediatrician, a pediatric neurologist, a cardiologist, a gastroenterologist, a pulmonologist, a pediatric otolaryngologist, etc.

Of the instrumental studies, EEG, polysomnography, transcranial ultrasound, ECG, ultrasound of the child's heart, ECG Holter monitoring, chest x-ray can be of the greatest diagnostic value. Laboratory methods may include infectious diagnostics (ELISA, PCR, microbiological examination), determination of blood acid-base balance, biochemical blood test, etc.

Assessing the risk of developing SIDS

The lack of reliable knowledge about the causes of sudden infant death makes it possible to assess the degree of risk exclusively by statistical methods. So, to identify children at risk, the Magdeburg SIDS score table was proposed, highlighting as criteria:

mother's age,
baby's birth weight,
sleeping position of the child
bedding features,
mother smoking,
duration of breastfeeding.

Among the objective methods for identifying children at risk for the development of SIDS, ECG and polysomnography are not the first plan. The algorithm proposed by I.A. Kelmanson, contains 6 clinical and 12 morphological features that allow post-mortem differential diagnosis of sudden infant death syndrome and life-threatening diseases and is of interest mainly to pathologists.

Prevention

If an obvious life-threatening episode occurs, it is necessary to take the child in your arms, shake it up, vigorously massage the hands, feet, earlobes, back along the spine. Usually these actions are enough for the child to breathe again. If breathing is not restored, it is urgent to call an ambulance and start artificial respiration and closed heart massage.

Prevention of SIDS includes primary and secondary measures. The principles of primary prevention are based on antenatal measures (refusal of bad habits before pregnancy, rational nutrition of the mother, sufficient physical activity, prevention of preterm birth, early registration and management of pregnancy under the supervision of an obstetrician-gynecologist, etc.).

Primary prevention measures also include optimizing the sleeping conditions of an infant: sleeping on the back, using a sleeping bag that excludes the baby from rolling over on its own tummy, sleeping on a dense mattress, avoiding overheating, sufficient access to fresh air, maintaining a temperature and humidity regime, the absence of pungent odors and tobacco smoke.

Secondary prevention of SIDS involves the identification of high-risk groups and the implementation of targeted measures (fortifying treatment,

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", holding all sorts 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

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 due to 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.