Sudden Infant Death Syndrome (SIDS)
So Many Missing Puzzle Pieces

Did you know that SIDS is the leading cause of death of children under one year of age? Every week in Canada, six infants die of SIDS. Seemingly healthy babies fall asleep in their cribs, strollers, car seats or parents' arms and never wake up.

There are no tests to predict a child's susceptibility to SIDS and there are no detectable warning signs. Death is the first sign of SIDS. Sudden Infant Death Syndrome, as a cause of death, can only be confirmed after an autopsy rules out any possible reason for the baby's death. Researchers do not know what causes SIDS or how to prevent it.

So far, this is what we do know about SIDS --

• The peak age for SIDS is between two and four months of age, although it can occur anytime during the first year of life.
• SIDS occurs more often in the winter.
• Aboriginal infants' risk of SIDS is to three to four times higher than it is for non-aboriginal infants.

• caused by neglect or abuse
• contagious or infectious
• considered hereditary.

• low birth weight babies
• children of multiple births
• boys, slightly more than girls
• babies born to mothers who did not receive prenatal care, or who smoked or abused drugs during their pregnancy
• children of teenage mothers
  (The Canadian Foundation for the Study of Infant Deaths, 1994).

It is important to keep in mind that, even though we know that some infants may be more at risk, they still make up the smallest percentage of all the infants who die of SIDS. Most have none of these attributable factors.

Several practices have been identified that may reduce the risk of SIDS in all infants:

• Position infants on their backs or sides for sleep, not on their tummies. There are certain health conditions that may warrant positioning on the tummy and physicians will instruct parents in these instances. It is not necessary to place infants in this sleeping position once they are able to turn on their own from back to tummy.
• Attempt to eliminate infants' exposure to second-hand smoke before and after birth.
• Keep children comfortable but not overheated. If the room temperature is comfortable for you, then an infant should fine, too. Avoid overdressing babies or covering them with too many blankets while they sleep.
• Breastfeeding has significant benefits (Health Canada, et al., 1993).

Researchers have made some headway into understanding the central nervous system and the regions of the brain that control breathing, heart rates and the monitoring of carbon dioxide and oxygen levels in the body. Unfortunately, their findings cannot answer parents' questions about why their healthy baby died. SIDS research has much to explore.

Considerations for Centre Caregivers

Caregivers, like parents and physicians, cannot do anything to prevent a SIDS death. Parents must know that centre staff and emergency response personnel did everything possible to try to save their child's life.

Infants nap once or twice a day, usually for more than an hour at a time. Caregivers should regularly check sleeping infants -- don't rely on baby monitors. An autopsy should not reveal that an infant had been dead for some time before he/she was found by caregivers. Of course, no one is suggesting that parents get up throughout the night to check on their sleeping babies.

When an infant is found dead, caregivers must start cardiopulmonary resuscitation (CPR) and call 911 (or the emergency medical services' phone number in their commmunity). Caregivers and directors are encouraged to refer to Well Beings for recommended procedures on dealing with the death of a child in a day care centre (pages 240 to 244).

For more information about SIDS, bereavement support groups, local chapters, October SIDS Awareness Month and the 1995 video SIDS: A Special Report, contact The Canadian Foundation for the Study of Infants Deaths, National Office, 586 Eglinton Avenue East, Suite 308, Toronto, Ontario M4P 1P2. Telephone: (416) 488- 3260 or 1-800-END-SIDS. Fax: (416) 488-3864. Also check your local telephone directory.

Written by Deborah Kernested, RN, Health Consultant, Toronto, Ontario. Telephone: (416) 536- 9349. Co-author of Healthy Foundations in Child Care (1996) with Barb Pimento. Toronto: Nelson Canada.

This article first appeared in Interaction Spring, 1996 published by the Canadian Child Care Federation

Posted by: the Canadian Child Care Federation, September 1996.

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