Sudden death of a child after a year. Consequences of abuse. Help for parents who have experienced the sudden death of a child

Sudden Infant Death Syndrome (SIDS) refers to the sudden death of healthy child under the age of 1 year as a result of cessation of breathing and cardiac arrest, the cause of which cannot be established during pathoanatomical examination. Sometimes the syndrome is called "death in the crib" or death for no reason. However, there are reasons, or risk factors for the development of this little-studied phenomenon, and parents, by excluding them from their lives, can save their child's life and health.

SIDS is not a disease, it is a post-mortem diagnosis, which is made when neither autopsy results nor analysis medical card The child is unable to determine the cause of death. Such a diagnosis is not made in case of detection of a previously undiagnosed malformation or death as a result of an accident.

cases sudden death among babies have been known since ancient times, but no explanation has been found for them to this day, despite the fact that scientists from all over the world are working on this problem. For unknown reasons, death in the cradle is not typical for children from Asian families. Sudden death of a child occurs twice as often in white families than in African Americans and Indians.

Most often, SIDS occurs in a child's sleep without any symptoms on the eve of any symptoms. Cases of SIDS are registered in 5-6 children out of a thousand of their peers.

As a result of case studies infant death without reason, some regularities of this ominous and mysterious phenomenon were revealed:

SIDS in 90% of cases happens before the age of 6 months of the baby (more often from 2 to 4 months);
previously, deaths in the cold season predominated (the highest mortality in January); at present, the probability of death does not depend on the time of year;
boys die in 60% of cases;
SIDS is impossible to predict and prevent;
SIDS is not associated with preventive vaccinations.

Risk Factors for SIDS

Sudden death syndrome is believed to be facilitated by infants sleeping in the prone position.

When studying cases of SIDS, a number of factors contributing to its occurrence (risk factors) were identified:

position during sleep of the child on the stomach;
use of soft bedding for the child: mattress, pillows, blankets;
overheating of the child (use of wadded blankets or excessive heating in the room);
prematurity (the lower the gestational age of the baby, the greater the risk of SIDS);
low birth weight of the child;
multiple pregnancy;
a large number of pregnancies in the mother and short intervals between them;
cases of SIDS or stillbirth of previously born children of these parents;
late start or lack of medical supervision during pregnancy;
and fetal hypoxia;
a disease recently transferred by a child;
mother's age is under 17;
smoking, drug or alcohol use by the mother;
bad economic or social conditions in the family (crowding in the apartment, lack of regular airing, family members smoking, unemployed parents, lack of knowledge of infant care);
the birth of a child by a single mother;
maternal depression in the postpartum period.

I would like to specifically point out the danger of death in the cradle due to smoking parents. Studies have shown that if pregnant women did not smoke, the number of SIDS would decrease by 40%. Both active and passive smoking during gestation and after the birth of a baby is dangerous. Even smoking in the next room is harmful. open window or a fan.

Likely Causes of SIDS

Until the end, SIDS has not been studied. But still, some of the mechanisms that occur when it occurs are described. There are several theories that explain the mechanism by which SIDS occurs.

Respiratory dysfunction

During normal sleep, there is a periodic violation of the function of breathing, and breathing on a short time stops. As a result of such a stoppage of respiratory activity, an insufficient amount of oxygen is formed in the blood (hypoxemia), which normally causes awakening and restoration of breathing. If the restoration of breathing does not occur, the child dies.

Due to the immaturity of regulatory mechanisms, short-term respiratory arrests (apnea) in infants are not uncommon. But if such breath holdings are noted more than one per hour, and they last longer than 10-15 seconds, you should immediately contact a pediatrician.

Violation of cardiac activity

Some scientists believe that the leading factor in SIDS is not apnea, namely, cardiac arrest (asystole). Risk factors, these scientists call heart rhythm disturbances by the type of extrasystoles and blockades on the electrocardiogram, a decrease in the number of heartbeats less than 70 in 1 minute (bradycardia), and a frequently changing heart rate.

In support of this theory, scientists cite the discovery in some cases of SIDS of mutations in the gene responsible for the structure of sodium channels in the heart muscle. It is the change in these structures that leads to a violation of the heart rhythm.

Violation of the heart rhythm, up to a short-term cessation of the heartbeat, can also be observed in healthy children. But if such stops are noticed in an infant, you should immediately consult a doctor and conduct an examination of the child.

Changes in the brain stem

Both the respiratory center and the vasomotor center responsible for the work of the heart are located in the medulla oblongata. The studies revealed in some cases violations of the synthesis of enzymes, the formation of acetylcholine receptors in the cells of the medulla oblongata when exposed to tobacco smoke or its components. These changes contribute to the onset of SIDS.

Some children who are victims of SIDS have structural lesions and cell changes in the dining area of the brain, which appeared during intrauterine development due to hypoxia.

Ultrasound echography performed on children who were saved after respiratory arrest revealed pathology of the arteries that supply blood to the brain stem in 50% of cases. This may indicate a violation cerebral circulation which has been the cause of SIDS in some children.

Violation of blood circulation occurs in connection with the clamping of the artery at a certain position of the baby's head. Since the neck muscles are not yet sufficiently developed, the child cannot turn his head on his own. Only after the child reaches four months does the baby reflexively turn it into a safe position.

The blood supply to the brain worsens when the baby is laid to sleep on its side, but blood flow to the brain is even more reduced when the baby is on the stomach. In studies in such situations, a weak pulse was noted and breathing was sharply slowed down.

Stress

Confirmation that SIDS develops as a result of severe stress for the child's body is a whole set of pathoanatomical changes that are found in all absolutely victims of the syndrome.

These are changes such as: small hemorrhages in the thymus gland, lungs, sometimes in the outer shell of the heart, traces of ulceration of the mucosa digestive tract, wrinkled lymphoid formations, decreased blood viscosity. All these phenomena are symptoms of a nonspecific stress syndrome.

Clinical manifestations of this syndrome are such signs as a runny nose, discharge from the eyes; enlargement of the tonsils, liver and; ; weight loss. These symptoms occur 2-3 weeks before SIDS in 90% of children. But many researchers do not consider them significant for subsequent death. It is likely that stress, combined with any disturbances in the development of the child, leads to sad consequences.

Immune theory and infectious mechanism of SIDS

Most of the children who died suddenly had some kind of infection within a week or on the last day of life. The children were examined by a doctor, some of them received antibiotics.

Proponents of this theory believe that microorganisms secrete toxins or cytokinins that cause a violation of the defense mechanisms in the body (for example, awakening from sleep). As a result, the presence of risk factors in the event of infection is exacerbated. Toxins of microorganisms (most often posthumously isolated Staphylococcus aureus) provoke and enhance the inflammatory response. And the baby's body is not yet able to regulate its own defense reactions.

Other researchers compared the types of antibodies to microbes in children who died from another cause, and from SIDS. It was revealed that a significant number of children who died in the cradle had IgA antibodies to enterobacteria and clostridia toxins. Healthy children also have antibodies to these microorganisms, but of other classes (IgM and IgG), which indicates the body's immune defense against this toxin.

The data obtained allowed the researchers to conclude that such toxins affect all children, but risk factors (overheating, exposure to tobacco smoke components, and others) lead to a violation of protection mechanisms. As a result, a combination of infection and risk factors leads to death.

Recently, there have been reports of the discovery of the SIDS gene in the study of the DNA of healthy children and toddlers who died from SIDS. It turned out that the risk of sudden infant death increases three times in children with a mutated (defective) gene responsible for the development immune system. However, scientists believe that the presence of such a gene leads to death in the presence of other factors, that is, only in combination with them.

A number of studies indicate that the pathogen can be the cause of SIDS peptic ulcer(Helicobacter pylori). This conclusion is justified by the fact that this microorganism is much more often excreted in the tissues of the stomach and respiratory tract in children who died from SIDS, compared with those who died from other causes. These microbes can cause ammonium synthesis, which causes respiratory failure and SIDS. It is assumed that if, during regurgitation, a child aspirates (inhales) a certain amount of microbes contained in vomit, then ammonium is absorbed into the bloodstream and causes respiratory arrest.

Is swaddling a baby a risk factor?

Expert opinions differ. Some of them believe that it is necessary to swaddle a baby, because he will not be able to roll over and cover himself with a blanket, which means that the risk of SIDS is less.

Proponents of the opposite opinion argue that swaddling hinders the development of the physiological maturity of the baby. Due to tight swaddling, there are restrictions in movements (the child cannot take comfortable posture), which violates the processes of thermoregulation: the heat transfer of the body increases in its straightened position.

Breathing is also limited, which means that swaddling increases the risk of pneumonia and SIDS, and subsequently the child’s speech develops worse. With tight swaddling, the baby will have less close contact with the mother, which is also important for its development.

Can a pacifier help prevent SIDS?

According to some researchers, a pacifier can reduce the risk of SIDS when putting the baby to bed at night and daytime. Experts explain this effect by the fact that a circle of a dummy will help air to enter the child's respiratory organs, even if he accidentally covered himself with a blanket.

It is better to start using a dummy from the age of one month, when it is already debugged breast-feeding. But one should not be persistent if the child refuses, does not want to take a pacifier. Weaning the baby from the pacifier should be gradual, at the age of 12 months.

Is it safe for baby and mother to sleep together?

It is believed that the joint sleep of an infant with his mother reduces the risk of developing sudden death syndrome in him by 20%, provided that the mother does not smoke.

The joint sleep of an infant with its mother (or with both parents) is also ambiguously interpreted by different scientists. Of course, such a dream contributes to a longer breastfeeding. Studies have shown a 20% reduction in SIDS when co-sleeping with parents. This can be explained by the fact that the baby's sensitive body synchronizes its heartbeat and breathing with the mother's heartbeat and breathing.

In addition, in a dream, the mother subconsciously controls the sleep of the child who is nearby. The risk of sudden death is especially increased when, after loud crying, the baby falls asleep soundly. During this period, it is safer for the child not to be isolated in his crib, but to be near the mother, who will notice the cessation of breathing and provide assistance in a timely manner.

But on the other hand, the risk of SIDS increases significantly with co-sleeping if the parents smoke. Even if they do not smoke in the presence of a child, then during sleep, components that are part of tobacco smoke are released in the air exhaled by the smoker, which are so dangerous for the baby. The same applies to the use alcoholic beverages and narcotic drugs, when the danger for the child to be crushed by one of the soundly sleeping parents increases. You should not abuse perfume if you sleep with a child.

The risk associated with co-sleeping, also increases in the case of the birth of a child in the gestational age of up to 37 weeks or with a weight of up to 2.5 kg. You should not sleep with the baby if the mother is taking medication that causes drowsiness or is feeling very tired. Therefore, it is safest to place the baby after feeding in a crib, which is in the mother's bedroom, next to her bed.

What should be the child's bed? What is the best way to put it to sleep?

The crib is best placed in the mother's room, but not near a radiator, fireplace or heater to prevent overheating of the baby. The mattress should be firm and flat. On the mattress, you can lay an oilcloth, on top - a well-straightened sheet. It is better not to use a pillow at all. The bed should be so firm that the child's head does not leave an indentation.

A blanket in the cold season should be woolen, not downy or wadded. Do not use a thermal blanket. Cover the child with a blanket no higher than the shoulders, so that the baby does not accidentally cover himself with his head. The child should rest with the legs on the bottom side of the crib.

Using sleeping bag it is necessary to select it strictly in size so that the child cannot go down in it. The temperature in the child's room should not exceed 20˚C. When the baby overheats, the control of the brain over the work of the respiratory center worsens.

To make sure that the child is not cold, touch his tummy, not his arms or legs (they are cold even if the child is warm). After returning from a walk, undress the baby, even if he wakes up.

Putting the baby to sleep should only be on his back. To prevent regurgitation and subsequent aspiration (inhalation) of vomit in the supine position, it is necessary to hold the child for 10-15 minutes before laying in vertical position. This will help him to remove the air swallowed with food from the stomach.

The prone position increases the risk of SIDS for a number of reasons:

sleep is deeper (as the awakening threshold rises);
ventilation of the lungs is disturbed; this is especially important for infants at 3 months of age, when the reflexes that promote ventilation weaken;
possible imbalance between the sympathetic and parasympathetic nervous systems;
the physiological control over the work of the heart, lungs, autonomic functions (including awakening during sleep) is weakened.

The position on the stomach is especially dangerous for children, who, as a rule, sleep on their backs and accidentally roll over on their stomachs in their sleep. Babies who like to fall asleep on their stomachs should be placed on their backs after they fall asleep. The side position is also less secure than the back position. Soft toys should not be placed in the crib.

In the second half of the baby's life, when he himself can roll over in bed, you can allow him to take a position that is comfortable for him during sleep. But you still need to put him to sleep on his back. If the child is on his stomach, it is better to turn him on his back.

Although sudden deaths occur more often at night and in the early morning, children should not be left unattended during daytime sleep. The portable cradle is convenient because the mother can do homework and be in the same room with a sleeping baby.

Will a baby monitor help?

Modern tragedy prevention methods offer special devices (monitors) to monitor the breathing or, together, the breathing and heartbeat of an infant from birth to a year. Monitors are equipped with warning systems that turn on when breathing stops or heart rhythm is disturbed.

These devices cannot prevent or protect a child from SIDS, but they will sound an alarm, and parents will be able to provide timely assistance to the child. Especially such monitors are important for children in the group increased risk SIDS, or if the child has had trouble breathing.

Breast milk or formula milk?

Breastfeeding significantly reduces the risk of an infant developing SIDS.

Studies by many authors have confirmed the importance of breastfeeding for the prevention of SIDS: breastfeeding only up to 1 month increased the risk of SIDS by 5 times; breastfeeding only up to 5-7 weeks - 3.7 times. At mixed feeding children were not at increased risk of sudden death.

positive action mother's milk due to the presence in it of not only immunoglobulins, but also omega-fatty acids, which stimulate the maturation of the baby's brain.

Breastfeeding helps to strengthen the child's immunity and prevent respiratory infections, which can become a starting point for SIDS.

If the mother does not breastfeed her baby and also smokes, then the risk of death in the crib is even more increased.

Most threatened age for SIDS

Sudden death for an infant under one month old is not typical. Most often it happens from the second to the fourth month of life (most often at the 13th week). 90% of crib deaths occur before six months of age. After the child reaches the age of 1 year, cases of SIDS are extremely rare, although cases of sudden death have been described in apparently healthy adolescents (when running, in physical education classes, and even at rest).

How to help a child?

In case of a sudden stoppage of breathing in a child, you should quickly pick him up, make an energetic movement with your fingers along his spine from the bottom up, massage his earlobes, arms, feet, and shake the child. Usually after this, breathing is restored.

If there is still no breathing, immediately call ambulance, and, without wasting time, before the arrival of the doctor, perform artificial respiration and heart massage on the child. Every parent should have the skills to do so.

Summary for parents

Unfortunately, it is impossible to completely exclude the possibility of sudden death of a baby, because the causes of its occurrence have not been fully studied. But to minimize the risk of "death in the crib" is possible and necessary.

A significant degree of risk of sudden death of the unborn child lays the mother during pregnancy. Bad habits(smoking, drug and alcohol use), neglect of medical supervision during pregnancy lead to changes in the fetus, which can then cause SIDS.

New parents do everything they can to keep their children healthy. But sometimes a child who seems perfectly healthy dies for no apparent reason.

When a baby dies before the age of 1, it is Sudden Infant Death Syndrome (SIDS). Since this condition often occurs during sleep, the term "cradle death" may also be heard.

SIDS is defined as the sudden death of an infant under 1 year of age that remains unexplained after a thorough investigation of cases, including performing a full autopsy, examining the site of death, and reviewing clinical history. Cases that do not meet this definition, including those without post-mortem investigation, should not be classified as sudden infant death; episodes that involve an autopsy and a thorough investigation but remain unresolved may be labeled as indeterminate or unexplained.

Pathogenesis

Although numerous hypotheses have been proposed as the pathophysiological mechanisms responsible for SIDS, none have been proven. The triple risk model proposed by American experts suggests that sudden death syndrome is an intersection factors, including the following:

a defect in the nervous control of respiratory or cardiac function;
a critical period in the development of homeostatic control mechanisms (the form of the body's response to the conditions of existence);
exogenous external stimuli.

SIDS is rare in infants who do not have risk factors or those with only one risk factor. In one study, 96.3% of infants who died had 1 to 7 risk factors, with 78.3% having 2 to 7. In another report, 57% of infants had one internal factor risk and 2 external.

Death occurs when a baby is exposed to stress factors, which has insufficiently formed structural and functional defense mechanisms.

Epidemiological evidence suggests that genetic factors play a role, and many studies have attempted to identify genes associated with SIDS.

Several anatomical and physiological data support the role of apnea (respiratory arrest) in SIDS.

One study analyzed data from 6 home-monitored infants. Of the 6 deaths, 3 were attributed to SIDS. All patients with SIDS experienced bradycardia (decreased contractile activity of the heart) that preceded or occurred simultaneously with central apnea; 1 had tachycardia (increased heart rate) to bradycardia. In 1 patient, a slow decrease in heart rate was found for approximately 2 hours before death.

In general, sleep apnea can be classified the following three main types:

central or diaphragmatic (i.e., there is no effort in breathing);
obstructive (usually due to upper airway obstruction);
mixed.

While short central apnea (<15 секунд) может быть нормальным во всех возрастах, то длительная остановка дыхания, которая нарушает физиологическую функцию, никогда не бывает физиологической. Некоторые патологические доказательства и обширные теоретические данные подтверждают центральное апноэ как причину СВДС, а обструктивная остановка дыхания играет ассоциированную, если не ключевую, роль у некоторых младенцев.

As the etiology of SIDS, expiratory apnea (stopping breathing on exhalation) has been proposed; however, evidence of its presence is found only in a small number of cases.

Other findings also point to a role for hypoxia (low oxygen in the body), both acute and chronic, in SIDS. Hypoxanthin, a marker of tissue hypoxia, is elevated in the vitreous (a gel-like structure behind the lens of the eyeball) of patients who die of SIDS compared to controls who die suddenly.

Asphyxia (suffocation) in newborns occurs following well-defined steps.

Stage 1 - tachypnea (rapid shallow breathing) for 60 to 90 seconds, followed by apparent loss of consciousness, urination, and no effort to breathe.
Stage II - deep, gasping respiratory efforts, separated by 10-second periods of respiratory silence.
Stage III - petechiae (red dotted spots) form on the pleura (covering the lungs), the child stops choking.
Stage IV - death if resuscitation has not begun.

Although the autopsy of infants who die from SIDS often does not reveal pathological changes, most infants have an extremely large number of petechiae. Their presence suggests that repeated episodes of asphyxia were observed for hours to days before death, causing intermittent bouts of shortness of breath with associated petechial formations.

Thus, repeated bouts of asphyxia, which were previously self-limited by arousal and recovery of consciousness without medical intervention, may eventually prove fatal.

Etiology

There are several conditions that can lead to SIDS. They usually vary from one child to another.

brain anomalies

Some newborns are born with brain disorders. They are more likely to experience SIDS than others. Certain parts of the brain control breathing and the ability to wake up from deep sleep. When the brain does not send a signal to perform the appropriate functions, the child dies.

Respiratory infection

When a child suffers from a prolonged cold, a doctor should be consulted immediately.

Many babies die when they suffer from persistent colds, further contributing to breathing problems.

Low birth weight

Premature birth or low birth weight of the baby lead to a higher chance of SIDS. When a child is not mature enough, their body has less control over breathing or heart rate.

Hyperthermia (overheating)

Excessive wrapping of the child raises the temperature of his body. This leads to an increase in the metabolic rate, and the infant may lose control of breathing.

Smoking

If a mother smokes, the chances of her baby dying from SIDS increase.

Having extra items in a crib or an infant sleeping in a bad position increases the risk of SIDS.

Some sleep patterns that increase the likelihood of SIDS are as follows.

Sleeping on the stomach - in this position, the baby has difficulty breathing.
Sleep on a soft surface. Sleeping on soft mattresses or with a fluffy comforter pressed against your face can cause your baby's airways to become blocked.
Covering an infant with heavy blankets and covering the face completely is also dangerous.
Sleep with parents. It is better when the baby sleeps in a room with them, but on a separate bed. When a child shares a bed with his parents, the space becomes crowded and he has difficulty breathing.

At-risk groups

Although sudden death syndrome can affect a normal healthy child, researchers have identified several factors that increase its risk:

boys are more likely to suffer from SIDS than girls;
infants who have reached the age of 2 - 4 months;
infants whose siblings or cousins have died of SIDS;
babies born to smoking mothers.

Babies are at a higher chance of SIDS if their mother experiences some of the the following factors:

inadequate prenatal care was provided;
weak weight gain during pregnancy;
placental abnormalities;
have a medical history of urinary tract infections or STDs;
smoking or drug addiction during or after pregnancy;
anemia;
pregnancy before the age of 20.

Diagnostics

Typically, an infant who died of SIDS was put to bed after breastfeeding or bottle feeding. The baby's checks at variable intervals are unremarkable, but the baby is found dead, usually in the position he was laid in at bedtime.

Although most babies appear healthy, many parents claim that their children "were not themselves" in the hours before they died. Diarrhea, vomiting and lethargy were noted two weeks before death.

Also observed following:

cyanosis (50 - 60%);
breathing problems (50%);
abnormal limb movements (35%).

It is important to determine the exact time sequence of events. Need to answer to the following questions.

Did the baby have a foreign body, trauma in the airways?
Does the infant have a history of apnea?
How active was the infant before the apnea? Interruption of breathing after a paroxysmal (paroxysmal) cough in a child with an upper respiratory tract infection suggests whooping cough.
Time and amount of the last meal. Parents may misinterpret post-feed regurgitation as a life-threatening event.

What was the position of the child?

What was noted first? Movement of the chest wall and increased breathing in the absence of airflow indicate obstructive sleep apnea. Lack of chest wall movement, respiratory effort, and airflow is indicative of central apnea.

What is the apnea period (in seconds)? Most healthy children stop breathing momentarily when they sleep.

Has the child's skin color changed? The location of the cyanosis should be checked; some healthy children develop blueness around the mouth when they cry, and acrocyanosis (blue skin on the hands, feet, and ear shells) or discoloration during bowel movements can be misinterpreted as life-threatening.

What was the child's muscle tone (for example, sluggish, stiff, or trembling)? Stiff or jerky movements accompanied by apnea suggest affective-respiratory attacks (an attack of breath holding).

What was done (for example, cardiopulmonary resuscitation) and how was it done? The doctor should carefully question parents or other witnesses about their efforts to resuscitate the child; the lack of need for resuscitation suggests a benign cause, while the need for cardiopulmonary resuscitation suggests a more serious cause.

Circumstances related to death

Findings consistent with SIDS are in the following:

we see a healthy baby being fed, put to bed and found dead;
silent death of children;
resuscitation measures were unsuccessful;
the age of the deceased child is younger than 7 months (90% of cases with a peak prevalence of 2-4 months).

The course of pregnancy, childbirth and infancy.

received data, related to SIDS:

prenatal care from minimal to maximal;
reported smoking during pregnancy, as well as preterm birth or low birth weight;
subtle defects in nutrition and neurological status (eg, hypotension, lethargy, and irritability) may be present.

Other factors include:

decrease in height and body weight after birth;
multiple pregnancy;
the infant has thrush, pneumonia, regurgitation, GER, tachypnea, tachycardia, and cyanosis;
unwanted pregnancy;
insufficient prenatal care or its absence;
late arrival at a medical facility for childbirth or childbirth outside the hospital;
the child is not observed by a pediatrician, there is no immunization;
use of alcohol or other drugs during and after pregnancy;
deviant feeding methods;
previous unexplained medical disorders (eg, seizures);
previous episodes of apnea.

Autopsy results

At autopsy, the infant will usually show signs of normal hydration and nutrition, indicating proper care. There should be no symptoms of obvious or hidden injury. An extensive examination of organs usually does not reveal signs of a congenital anomaly or an acquired pathological process.

Intrathoracic petechiae are commonly found on the surface of the thymus (thymus gland), pleura, and epicardium (outer lining of the heart). Their frequency and severity does not depend on whether babies were found in bed face down, up or to the side.

Microscopic examination may reveal minor inflammatory changes in the tracheobronchial tree.

Laboratory research

Laboratory tests are done to rule out other causes of death (eg, electrolytes are checked to rule out dehydration and electrolyte imbalance, cultures are done to rule out infection). With SIDS, these data, as a rule, are not detected.

Although there is no guaranteed way to prevent SIDS, parents should take several protective measures to reduce the risk of an unexpected incident.

1. Put your baby to sleep on their back:

a baby is more at risk for SIDS when they sleep on their side or on their stomach. During this position, the baby's face strongly rests on the mattress, and he cannot breathe freely;
make sure the baby's head is open, and it's best to put the sleeping baby on its back. This helps him breathe more comfortably.

2. Keep your baby's crib clean and tidy:

do not leave stuffed toys or pillows in the baby's crib, as this interferes with his breathing when the baby's face is pressed against these objects.

3. Avoid overheating the child:

it is advisable to use a sleeping bag or light blankets to keep the child warm;
do not use any additional coverings and do not cover the child's face when he sleeps;
when covering the baby with fluffy blankets, as the child makes a lot of unconscious movements, and the blanket can suffocate him;
choose small blankets and place them at the foot of the mattress so that it covers the shoulders of the child;
swaddling or wrapping the baby in fluffy and thick coverings makes him feel uncomfortable and makes it difficult to breathe;
an overheated child is anxious and cannot tolerate high body temperature for a long period of time.

4. Breastfeeding is very beneficial:

breastfeeding increases the immunity of the child and protects him from respiratory tract infections;
it is advisable to breastfeed the baby for at least six months, which effectively reduces the risk of SIDS.

5. Pacifier suggestion:

pacifier sucking during sleep effectively eliminates the risk of SIDS;
but if the baby is not interested in the nipple, do not force him;
put the pacifier in the baby's mouth before sleep. But do not put it in your mouth after he has fallen asleep;
keep the nipple clean to prevent harmful germs from entering the baby's body.

6. Do not smoke around the baby:

parents who smoke should give up their addiction before and after the birth of their child;
passive smoking often leads to suffocation of the baby;
babies born to mothers who smoke are at greater risk of SIDS.

7. Make sure your baby sleeps on a hard surface:

always put the baby to sleep on a hard surface;
do not put the child on the sofa, between the pillows;
When the baby falls asleep in the carrier, try to put him on a firm mattress as soon as possible.

8. Prenatal care:

early and regular prenatal care is effective in reducing the risk of SIDS;
follow a balanced diet;
mothers need to undergo frequent medical examinations throughout the entire period of pregnancy. This will provide an early diagnosis of any abnormalities of the growing fetus. Brain pathologies often lead to SIDS;
regular physical examination also reduces the risk of preterm birth or low birth weight.

9. Regular pediatrician check-ups and immunizations:

when the child looks ill or suffers from respiratory problems, see a doctor immediately;
the child must be vaccinated according to the schedule. Immunization protects him from life-threatening diseases;
studies show that vaccinating a child at the indicated time reduces the risk of SIDS;
If your child develops sleep apnea, take him to the doctor immediately. The doctor examines health disorders and takes the necessary treatment procedures.

Conclusion

decline risk of SIDS involves attention to detail. Although sudden death syndrome is rare in children, parents should do everything in their power to prevent this from happening.

The first year of a child's life is often filled with worries about his health and life. Many mothers literally do not leave the baby's bed, listening to the breath. These fears are not accidental, because every parent has ever heard of such a tragic and still little-studied phenomenon as sudden infant death syndrome. Healthy, it would seem, the baby calmly falls asleep and does not wake up. It is important to understand the risk factors leading to death in the cradle in order to prevent a tragic outcome.

Content:

What is SIDS and what causes it

Sudden Infant Death Syndrome (SIDS) is a tragic phenomenon that is still not fully understood. The term was introduced in the 60s of the 20th century, but cases of death of infants under unclear circumstances were previously described. In the 80s, attempts were made to study the factors influencing the occurrence of this syndrome and its prevention. SIDS is referred to as a diagnosis of exclusion.

The cause of death is determined by the history of the development and illness of the child, according to the results of the autopsy. However, in a number of cases, children who develop normally and in accordance with their age, who do not have chronic and other diseases, internal pathologies, suddenly die. When opening the causes that led to death, it is also not possible to establish. It is these cases that are united under the name of sudden death syndrome. Another name is "death in the cradle", which is more common among parents, since the death of a child occurs during sleep.

In most cases, signs of chronic oxygen starvation are found. Which factors lead to sudden death remains open, but concomitant causes have been identified that pose a risk to newborns.

Incorrectly organized sleep of the child, laying on the stomach

The sleep of a child in the first months of life on his stomach is the main risk factor, pediatricians say. The data are based on observations made since the last decade of the 20th century. In the USA and European countries, after the official recognition of the rule that the baby must be placed on the back, and not on the stomach, the mortality rate has decreased by 2 times. In the GDR, on the contrary, in the 90s of the last century, babies began to be laid on their stomachs, following the old example of Western European countries, and the sudden death of newborns for unknown reasons increased.

Attention: There are conditions in which laying a baby on its back is contraindicated. For example, with frequent spitting up, the contents of the stomach can enter the respiratory tract, and the child will suffocate.

The use of soft mattresses, pillows in cribs leads to an uncomfortable position of the head and neck of the baby, who is not yet able to choose a comfortable sleeping position for himself. These factors can cause oxygen starvation (hypoxia).

The baby should be covered up to the chest, sticking out the arms and thereby, as it were, fixing the blanket. If the child is covered so that his nose is at least partially hidden under the covers, it is highly likely that he will inhale the exhaust air, which also leads to an increase in carbon dioxide in the blood.

Undeveloped thermoregulation

Normal body temperature in children of the first months of life is below the norm of an adult. You can see that it fluctuates depending on the ambient temperature. Excessive wrapping, out-of-season clothing causes overheating, which negatively affects the activity of the respiratory system and heart, leads to interruptions in their work and causes sudden death.

Brief respiratory arrest (apnea)

In most healthy children, periodic breathing is observed, that is, the alternation of the normal rate of inhalations and exhalations with deep breaths and subsequent breath holding from 5 to 15-20 seconds. Sometimes, most often in a dream, there is a significant increase in the time of holding the breath. This phenomenon is observed in premature babies and passes on its own by the time they were supposed to be born. In some cases, the feature is also found in full-term babies. Such babies should be watched especially carefully.

It is recommended to use respiratory motion recorders that give sound signals when the baby is not breathing for a long time. Such devices are necessary for parents whose children have experienced cases of apnea, heart rhythm disturbance, loss of consciousness.

In most cases, with an unknown cause of death of a child under the age of one year, an increase in the level of carbon dioxide in the blood is recorded, leading to oxygen starvation. The very same reasons why the baby’s breathing stops have not yet been established. Many doctors, scientists and researchers suggest that the reason lies in the immaturity of the respiratory center of infants in conjunction with the listed risk factors.

Cardiac disorder, cardiac arrest

They are the result of heart rhythm disturbances, a decrease in heart rate to 70 and below, arrhythmias. These data support the results of an autopsy, which reveals anomalies in the development of sodium channels in the heart muscle.

There is also a hypothesis about the prolongation of the Q-T interval, which on the electrocardiogram indicates the period that passes from the beginning of the contraction of the heart muscle to its relaxation. In adults, the connection between the lengthening of this time and sudden cardiac death has been established for a long time. When studying the history of the development of children who died from sudden death syndrome, such violations were revealed in 35% of cases. This is a completely physiological phenomenon, passing by the age of 6 months, reaching its peak at the 2nd month of a child's life. Just this age is regarded as the most dangerous in terms of the occurrence of SIDS.

Pathological changes in the brain

Some children who are victims of sudden death have been found to have changes or lesions in certain parts of the brain. This could happen even during the period of intrauterine development, at the time of childbirth, or already during the life of the baby. In any case, these changes are caused by hypoxia.

Often the cause of SIDS is a violation of cerebral circulation, which is confirmed by the results of ultrasound of the brain performed on children who were rescued after respiratory arrest.

Immune theory of VDS syndrome

Some children who died suddenly or of unknown cause were diagnosed with an infectious disease shortly before death. This gave reason to assume that the toxins that entered the body as a result of the vital activity of microorganisms caused a disruption in the work of some protective functions.

Other studies have found IgA class antibodies to toxins, such as enterobacteria and clostridia, in a proportion of infants who die in the cradle. In other children who died for established reasons, these antibodies were either completely absent or were of a different class - IgM and IgG, which indicates the presence of immunity from these toxins.

Of course, any toxins are detrimental to the baby's body, but in combination with other factors (overheating, improper care, and others) increase the risk of infant death at times.

Consequences of child abuse

Child death can occur as a result of intentional actions of parents. If the beatings are fixed immediately, then some consequences of violent actions become known only after the autopsy. These include, for example, shaking syndrome, in which damage to small vessels of the brain occurs, intentional or unintentional strangulation.

Other possible causes

In addition to these, there are other factors that can lead to death in the cradle:

heredity - cessation of breathing in a dream in the parents, brothers or sisters of the baby;
illness of a woman during the period of bearing a child, the use of alcoholic beverages or drugs, smoking;
delayed intrauterine development of the child, complicated or prolonged childbirth, birth trauma, low birth weight.

Important: It should be noted that more than 60% of sudden infant deaths occur in boys (according to Wikipedia). The most dangerous is the age of 2-4 months.

In fact, there are many hypotheses regarding the causes of the VDS syndrome, but more often it is a combination of factors (physiological, external, developmental characteristics, and others). None of these hypotheses gives an exact explanation and does not combine at least half of all cases of death in the cradle described in medicine.

How to reduce the risk of child mortality

Since this condition has not been studied and carries a lot of ambiguities and uncertainties, we can say that all recommendations are of a precautionary nature and are based on long-term observations. To reduce the risk of SIDS, doctors advise the following rules for caring for a child:

Make sure your baby sleeps on their back. We are talking about children who do not know how to roll over. If the baby himself rolls over on his stomach during sleep (age after 5-6 months), do not endlessly return him to his back, but only more carefully observe him during his sleep. At the same time, pediatricians warn that constant sleep on the back can lead to the development of curvature of the soft bones of the skull (plagiocephaly).
Dummy sucking. This fact has not been studied for certain and is in the nature of a hypothesis. It is believed that the dummy calms the baby, prevents apnea, the heart rate during sucking is more stable.
Co-sleeping with mother. Also one of the most controversial issues, the study of which is still ongoing. It has been established that there are countries and cultures with a low rate of sudden infant mortality, where it is customary for children and parents to sleep together. But there are also high rates of infant death among cultures with similar co-sleeping practices. Here, the emphasis is on the fact that when sleeping together, a number of factors can affect the well-being of the baby: the smell of tobacco or alcohol from the parents, the risk of accidentally covering the child (“sleep”).
Compliance with the temperature regime, the absence of overheating as a result of wrapping.
Smooth pregnancy, no stressful situations.
No exposure to tobacco smoke in an infant.
Natural feeding.

Proper medical care of the infant plays an important role in prevention. Up to a year, a child should undergo preventive examinations every month, where development indicators are recorded and conclusions are drawn about possible risks. For any ailments of the baby, it is necessary to show the doctor.

Video: How to equip a baby's crib, temperature in the nursery

Prevention of SIDS

The well-known Russian pediatrician, Doctor of Medical Sciences, I. M. Vorontsov, who deals with the causes of sudden infant death syndrome, gives the following recommendations in his works:

Try to put the baby to sleep up to six months not on the stomach, but on the back, using a thick mattress, but not using a pillow.
Instead of a blanket, it is advisable to take a special sleeping bag for children of the first year of life, which prevents the baby from accidentally covering his head.
When using a blanket, the baby should be placed so that the legs rest against the back of the crib and it is not possible to slide under the blanket.
The child should be put in his own crib, but he must sleep for up to a year in the same room and next to his parents, so that even at night it is possible to control his condition and breathing.
Do not overheat, but do not supercool the baby, observe the temperature regime in the nursery (not higher than + 22 ° C), do not wrap or swaddle tightly so that you can move your arms and legs. Tight swaddling not only restricts movement, but also compresses the internal organs, including the lungs, as a result of which hypoxia may develop.
Avoid smoking in the apartment where the child lives.
Eliminate any pungent odors, loud sounds, close too bright light, especially during the baby's sleep.
It is important to continue breastfeeding until at least 4-6 months of age.
Carry out a general strengthening massage, age-appropriate gymnastics and hardening.

Some conditions of the child require increased attention from the parents. These include high fever, various inflammatory diseases (pharyngitis, laryngitis, tonsillitis and others), runny nose, sinusitis, the presence of adenoids that make breathing difficult. It is important to observe the child and his sleep after prolonged crying or in unusual conditions for him (for example, at a party). In the presence of an allergy in a baby, it is important for a nursing mother to monitor her diet, avoid dust and pollen during hay fever, be especially careful when introducing complementary foods and avoid allergen products.

Since the problem of sudden infant mortality is unexplored, it cannot be prevented with 100% probability. But it is possible to eliminate all the risk factors that in one case or another led to the death of children for unknown reasons.

Video: Pediatrician about the causes of SIDS

Question to the doctor:

In the magazine "Lisa my child" for February I read an article from which, to be honest, my hair stood on end. The fact is that, after reading several books by various pediatricians, I decided to put my child to sleep on her tummy. Indeed, gaziki departed well, did not suffer from colic, slept peacefully all night.
And now I find out that this is one of the main causes of sudden infant mortality syndrome. The results of the "sleeping on the back" campaigns carried out in Holland prove this to some extent. Thank God we're fine. But somehow it doesn't feel right. I think this is nonsense (chest compression, etc.). I'm planning on having my second child soon. How to be?
Sincerely, Lena.

Answer:
SIDS is Sudden Infant Death Syndrome.

The first thing that is reflected in the name is "sudden", that is, incomprehensible, fast, inexplicable. So, let's immediately take one truth as a basis - no one knows why, all the reasons expressed in relation to this are not conclusive and are speculative.

Secondly, this is very, very rare. The public outcry of the problem is much greater than the true medical side of the issue.

And now, having calmed down a little, reliable information.

The results of the study of the causes of sudden infant death syndrome open up opportunities for improving the methods of preventing this acute problem, which is typical for most economically developed countries. This, according to the Air Force, was recently announced by British scientists who studied in detail 325 cases of sudden death of children under the age of one year.

According to researchers, six out of every ten cases of sudden death of children are due to negligence of parents or non-compliance with basic rules for caring for an infant. In addition, scientists came to the conclusion that significant factors of increased risk of sudden death of a child are cases of stillbirth during previous pregnancies in the mother, the social disadvantage of the family, and the male sex of the baby. Most often, the so-called "death in the cradle" occurs at the 13th week of a child's life.

Contrary to popular belief, the study did not find an association between SIDS and preventive vaccinations, the age of the mother, the child's air travel, or the type of mattress in his crib.

The results of studying the problem require both the improvement of the system for monitoring cases of sudden infant death by the health authorities, and the development of a broad educational program for parents, scientists say. The researchers' recommendations for the prevention of "cradle death" are in the form of a booklet that will be distributed to families with a new baby.

From the news. The development of sudden infant death syndrome is due to a genetic defect British scientists have discovered a genetic defect, the presence of which can explain the development of the so-called. sudden death syndrome (SIDS). And although the researchers themselves assure that this is probably not the only reason, the discovery will help doctors identify children at significantly greater risk. Remedicus dated February 19, 2001.

It is difficult to find a more terrible situation than the death of a small child, which occurred quite suddenly, in a dream - without previous illnesses, severe injuries, and for no apparent reason at all. The depth of mental shock in parents in this case sometimes exceeds that of the unexpected death of children in car accidents, during natural disasters and other "domestic" accidents. Sudden childhood death almost always puts the mind of an adult before a serious test of stamina: it is no coincidence that this situation was used by Stephen King for the plot of "Pet Sematary" - one of the most spectacular works of the recognized master of the psychothriller. And although it is not easy to talk about this topic without emotion, let's try to look at the problem of sudden infant mortality from a medical point of view - in order to distance ourselves as much as possible from even the very possibility of this terrible tragedy.

In the medical literature, you can find several options for the names of this mysterious phenomenon: sudden infant death syndrome, sudden infant death syndrome, sudden infant death syndrome (SIDS). All these similar terms, in principle, mean the same thing - the sudden death of a child in the first year of life, which cannot be explained either by a detailed study of the baby's medical history or the results of a pathoanatomical study. Most often, SIDS occurs during sleep, which is why it is also called "death in the cradle."

Statistics show that SIDS is the cause of the death of approximately five to six children of the first year of life out of every thousand of their peers. Despite the fact that rather intensive studies of cases of unexpected death of infants did not lead to an explanation of the causes of this phenomenon, in the course of studying the problem, many "character traits" inherent in this pathology were discovered.

According to the National Institute of Child Health and Development (USA), the period between the first and fourth months of life is the greatest danger in terms of sudden death of an infant. It was also found that the largest "harvest" of SIDS is collected in the coldest time of the year - from October to March. Children from Native American and African American families are at twice or even three times the risk of unexpected death as their white peers. Girls die from SIDS somewhat less often than boys.

Experts believe that a certain degree of risk of sudden death during infancy is laid for a child by none other than ... his mother, and even during pregnancy. The fact is that the study of a large number of cases of unexpected infant death made it possible to identify a significant relationship between this phenomenon and some, let's say, the behavior of a pregnant mother. As a result of smoking, taking alcohol and drugs, as well as neglecting the elementary observation of an obstetrician-gynecologist, you can lose a child not only during pregnancy, but also after its seemingly successful completion. It was also noted that more often sudden death overtakes children of young mothers, and also happens in those families where adults consider it quite acceptable to smoke in the presence of a baby.

British pediatricians tend to consider parental negligence and inattention as one of the main causes of SIDS. In their opinion, six out of ten cases of sudden infant death occur precisely as a result of ignorance or unwillingness of mom and dad to follow the elementary rules for caring for an infant. This theory is also supported by the fact that almost half of SIDS cases occur on weekends and holidays, when parents tend to take a break from worries and generally have fun in every possible way.

As another very serious risk factor for the onset of "death in the cradle," scientists tend to consider the position of the baby's body in a dream. Sleeping on your stomach is considered the most dangerous position. Numerous theories existing on this account cannot fully explain the causes of this danger. However, according to experts, there is no doubt that there is a link between sleeping on the stomach and cases of sudden death of babies.

Back in 1992, the American Academy of Pediatrics recommended avoiding laying babies on their stomach during sleep as one of the most important measures to prevent SIDS. Based on this recommendation, a national "Back to Sleep" campaign has been launched in the United States since 1994, designed to convince parents that their babies should sleep on their backs, on their sides, but not on their stomachs. The desired effect was not achieved immediately - habits and family traditions turned out to be very persistent. However, over 4 years of a large-scale educational campaign, the number of little Americans sleeping on their stomachs has almost halved, and the number of cases of "death in the cradle" has been reduced by a factor of three.

The recommendations of the American Academy of Pediatrics regarding possible ways to prevent SIDS were not limited, of course, only to the position of the child in sleep. It seems that it would not hurt us, Russian parents, to get acquainted with these recommendations in more detail.

So, in order to minimize the risk of SIDS, the mother should be very attentive to herself and her child during pregnancy. Smoking, drugs, excessive alcohol consumption by a pregnant mother triples the chances of sudden death of a child in the first year of life. In addition, regular medical supervision during pregnancy is very important for the prevention of SIDS.

In the first year of life, at least until the moment until the child begins to actively roll over, he should not sleep on his stomach. The crib should have a hard mattress and should not have a large and soft pillow. It is unlikely that a child will need toys in a dream, so they need to be removed from the crib.

During sleep, the baby should not be too warmly dressed. In the room where he sleeps air temperature should be comfortable for an adult wearing a short-sleeved shirt. The child during sleep should be covered with a light blanket to shoulder level.

Do not smoke in the presence of an infant. Moreover, if for some reason the baby sleeps next to the father or mother, then the latter should not exude sharp smells of tobacco, alcohol, perfumes, etc.

Mother's milk is good protection against SIDS, as well as from many other problems. Therefore, natural feeding should be continued as long as possible.

Contrary to common misconceptions, vaccination in no way causes SIDS and, on the contrary, protects the baby from many serious problems. In the absence of medical contraindications, the child must be vaccinated.

And the last. Everything that concerns your baby is very individual and unique. Therefore, do not hesitate to ask your questions to the pediatrician.

Sudden Infant Death Syndrome - an unexplained cause of death of children from birth to up to 1 year, sounds like a ridiculous sentence. It turns out that the risk of "death in the cradle" can be reduced by preventing dangerous factors.

Sudden Infant Death Syndrome (SIDS) or "crib death" name the inexplicable cause of the death of an absolutely healthy child. Nothing bothered the kid, he was healthy and cheerful before going to bed.

And after a few hours, the child's heart stopped forever - the baby will never wake up again, will not smile at his mother, will not cry and will not be delighted with the new toy. When shocked, heartbroken parents try to find out the cause of the tragedy, it turns out that the post-mortem examination cannot explain why the child died. Then SIDS becomes the only diagnosis. Posthumously.

Causes of sudden infant death syndrome

SIDS has not been fully studied. Scientists only shrug their shoulders when another tragedy happens to a healthy child from a prosperous family. Therefore, the exact causes of sudden infant death have not yet been determined. We can only talk about the most probable reasons, among which:

sleep apnea
heart rhythm disorder
congenital pathology of the arteries supplying blood to the brain
a combination of a slight deterioration in well-being and a nervous shock
infectious processes in the body
occlusion of the vertebral artery

In addition to the causes of SIDS, it is worth noting some factors that can lead to tragedy:

during pregnancy, the mother smoked, took drugs, drank alcohol
premature baby
intrauterine growth retardation
baby sleep on side or stomach
soft bed, use of a pillow to sleep
the presence of toys, nipples, bottles in the crib
high temperature in the bedroom
parents smoking

Smoking during pregnancy can cause SIDS

IMPORTANT: If it is not possible to eliminate the causes that do not depend on the circumstances and quality of life of the child, then every parent can eliminate most of the risk factors in order to protect the baby from SIDS.

Statistics of sudden infant death syndrome. Research on Sudden Infant Death Syndrome

Based on medical research in recent years, SIDS statistics have appeared:

white children die twice as often as black children
sudden death occurs in 3 out of 1000 children
65% of dead children are male babies
90% of SIDS cases occur between 2 and 4 months of age
The most dangerous age for a baby is 13 weeks.
6 out of 10 cases of SIDS are caused by parents
40% of children on the eve of death showed signs of acute respiratory viral infections (runny nose, slight cough, slight increase in body temperature)
the lowest rates of SIDS in the Netherlands and Israel (0.1 per 1000), the highest in Italy and Australia
most sudden child deaths occur during the cold season (October - March)

IMPORTANT: Even if, according to all indicators, the child is at risk for SIDS, you should not worry too much. It is necessary to make every effort to create favorable and safe living conditions for the baby and just wait out the dangerous period.

Many infants had a slight fever the day before death.

Until what age is Sudden Infant Death Syndrome possible?

SIDS is considered the cause of death in children from newborn to one year. But in fact, the risk of the syndrome is significantly reduced with the advent of the child's ability to independently roll over, sit down, get up in the crib, that is, after six months.

When a child learns to turn, sit and crawl independently, the risk of SIDS will decrease dramatically.

Sudden Infant Death Syndrome: Truth and Myths

The mystery of SIDS has not yet been solved, which is probably why it has acquired all sorts of scary stories and creepy stories, which in most cases are very far from the truth.

Co-sleeping. A common myth about the joint dream of mother and child convinces that a mother can crush an infant in a dream. Therefore, it is not recommended for the baby to sleep with the parents.

Video: Co-sleeping with a child

In fact, co-sleeping with your mother can prevent SIDS. The baby synchronizes his breathing with the mother's breathing and breathes with her during the sleep period. In addition, mothers of babies sleep very sensitively. If the child is nearby, the mother is able to instantly recognize even the slightest deviations in the breathing or behavior of her baby.

Co-sleeping with parents can cause SIDS in exceptional cases

IMPORTANT: In cases where the mother smokes and drinks alcohol, co-sleeping, on the contrary, greatly increases the risk of SIDS.

Swaddling. There is an opinion that children who are not swaddled die in a dream. Can swaddling protect a baby from SIDS? I guess, yes. After all, if the baby’s movements are not limited in any way, he can accidentally roll over or throw a blanket over his head.

IMPORTANT: Don't swaddle your baby too tight as this restricts the baby's breathing and increases the risk of SIDS.

Tight swaddling can cause SIDS

SIDS and pacifier. Many mothers refuse to use pacifiers, because, in their opinion, nothing good can be expected from a piece of rubber. However, the most common pacifier can reduce the risk of SIDS. The nipple will help the air to enter the respiratory system, even if the baby accidentally rolled over on his stomach or covered himself with a blanket.

IMPORTANT: It is best to begin pacifier training when breastfeeding is fully established. However, if the child refuses to take the pacifier, there is no need to insist.

Sudden Infant Death Syndrome and vaccinations

The period of initiation of vaccination coincides with the peak of infant mortality due to SIDS. This fact began to arouse suspicion among anti-vaccination mothers. Still would. If some consider childhood vaccination the source of all the troubles and health problems, why not unknowingly blame it for the death of babies?

But statistics and research results prove otherwise: vaccinated children die in their sleep less often than their unvaccinated peers. In addition, unvaccinated children are much more likely to die from cardiac arrest or sleep apnea during an infectious disease.

SIDS has nothing to do with routine vaccinations

When does infant death syndrome turn out to be murder?

Many child deaths have quite understandable causes. In most cases, the intentional or unintentional careless behavior of their parents leads to the death of infants. When an autopsy and an expert panel reveal violent factors, the diagnosis: "SIDS" is changed to the sentence: "Murder."

Intentional suffocation. There are cases when a baby was deliberately strangled by one of his own parents. Angry at the prolonged loud crying, an adult covered the helpless baby with a heavy pillow, blocking the access of oxygen.

Death due to shaking. At the moments when adults shake the child by the shoulders, trying to calm him down in this way, they do not even imagine that their baby is on the verge of death. The neck of young children is still so weak that even a few sharp, strong head shakes can lead to serious brain damage. The consequences of such shaking are often loss of consciousness, coma and death.

Suffocation in sleep. Occurs unintentionally while mother and baby sleep together. Women who take sleeping pills, are prone to deep sleep, or drink alcohol should not put the baby next to them. People say about such cases: "I slept a child."

Prevention of sudden infant death syndrome

Prevention of SIDS does not give a 100% guarantee that everything will be fine with the baby, because it is impossible to predict the tragedy. But by providing the child with the most favorable conditions, you can significantly reduce the risk of accidental death.

The child should only sleep on his back. Sleeping an infant on its tummy increases the possibility of accidental suffocation several times over. The baby can play for a short time lying on his stomach, but only in the presence of adults
The baby should not be overheated. The optimal temperature in the sleeping room should not exceed 22 ° C
You can not cover the baby with a blanket, it is better to use a baby sleeping bag
Tight swaddling should be avoided, as it squeezes the chest and interferes with normal breathing
It is unacceptable for parents to emit strong smells of tobacco, perfume or alcohol.
You can’t put the child in your bed if the parents are very tired, take alcohol or sleeping pills, they can fall asleep soundly
So that the child does not choke on vomit, before going to bed you need to hold him in a column, giving him the opportunity to burp
Bumpers and canopies should not be used in the arena - all these fashionable and beautiful accessories prevent air from entering the crib
Do not leave toys, rattles and pacifiers in the baby's crib
The child's bed should not be too soft. The best option for baby sleep is a firm mattress
When the child falls asleep, you need to offer him a pacifier. Soothers significantly reduce the risk of SIDS
For at least six months, the child must sleep in the same room with their parents.

The correct position for sleeping a baby is lying on the back

What to do if a child stops breathing?

If parents notice that the baby's breathing has stopped, they need to act immediately. You must immediately take the child in your arms and with one quick movement run your fingers along his spine in the direction from the bottom up, try to wake him up by slightly slowing him down.

Then it follows with intense, but at the same time, gentle movements to massage the earlobes, fingers on the arms and legs of the child. After such actions, breathing should return. After such a case, parents should contact the pediatrician as soon as possible.

IMPORTANT: If it was not possible to return the child's breathing on his own, you need to urgently call an ambulance and start resuscitation: artificial respiration and heart massage.

How to Avoid Sudden Infant Death Syndrome: Tips and Feedback

Tip number 1. Special sensors are used to monitor the condition of infants at risk or suffering from frequent prolonged episodes of apnea. They operate on the principle of a baby monitor, only responding to long stops in the infant's breathing and deviations in the heart rhythm. Also, for the prevention of SIDS, clamps are used that prevent the child from rolling over on his stomach during sleep.

Tip number 2. SIDS can be avoided by paying special attention to the child in such situations:

any disease with fever, deterioration or difficulty in breathing
sluggish state, causeless fatigue, refusal to eat and drink
deep sleep after intense prolonged crying
sleep in a new bed, under unusual conditions
child age 2 - 4 months

Irina, mother of Ruslan (1 year old): I believe that the first prevention of SIDS is breastfeeding. Moreover, the baby should sleep with the mother. Of course, at first you will have to remove all the pillows and blankets away, which will cause some inconvenience. But the child will feel safe, hearing the mother’s breathing, and will be able to “tune in” to the same rhythm with her.

Elena, mother of Yasmina (5 months): I am very afraid of SIDS, so I took all possible measures to prevent it: my daughter sleeps in our room in a separate bed, the mattress is hard, we constantly ventilate the room. In addition, my husband and I lead a healthy lifestyle - we do not drink and do not smoke. Therefore, I think that our baby is not in danger.

Vika, mother of Angelina (7 months): The daughter was born very premature. In the first months of her life, she often had breath holdings in her sleep. I was very afraid of losing the baby, so I literally was on duty at the baby’s bed at night, listening to her breathing. When it seemed to me that she was not breathing, I picked her up in my arms and woke her up. My girl was angry and crying, but I calmed down. Now the apnea attacks have stopped, my daughter has grown stronger and grown up. I'm not so afraid for her anymore.

Parents who have become familiar with the causes and factors contributing to the development of sudden infant death syndrome should try their best to reduce the likelihood of its occurrence. If the mother and father of the baby follow all the rules for caring for the child, we can confidently talk about the minimum risk of SIDS.