Sudden Infant Death Syndrome (SIDS): Understanding Risks and Prevention Strategies

Sudden Infant Death Syndrome (SIDS): Understanding Risks and Prevention Strategies

“Baby found dead in the cradle” – such reports are highly frightening for new parents. Even if the causes of crib death have not yet been clarified, several measures can be used to reduce the risk significantly. Although the number of children affected has fallen by more than half since the late 1980s, around 150 children are still found dead in their beds every year. What is particularly disturbing is that this situation has come about suddenly and unexpectedly from total health. Even in hindsight, no explanation for the death is found.

SIDS, near SIDS and ALTE

Slightly more boys are affected (60 per cent), especially in the second to fourth month of life. From the age of nine months, the risk decreases rapidly. Death always occurs during sleep, with it being believed that most deaths occur in the early hours of the morning. Most infants die during the winter months.

Another term for sudden infant death syndrome is SIDS, the abbreviation for the English term “sudden infant death syndrome”. There is also Near-SIDS (“near sudden infant death syndrome”) or ALTE  (“apparent life-threatening event”). These terms describe a sudden life-threatening condition of the infant, mostly of unknown cause, which, in contrast to sudden infant death, was survived.


Causes and risk factors

The exact cause is still unknown. Numerous theories have been and are being discussed, ranging from an immature respiratory drive with longer breathing pauses (which is even more noticeable in the prone position) to a disturbed conduction of impulses in the heart, metabolic disorders, overactivity in specific nerve cells to infections (e.g. of the respiratory tract). And various bacteria (e.g. Staphylococcus aureus and Escherichia coli) or viruses.

But there is probably more than one specific trigger; several unfavourable factors must come together.

Experts largely agree on risk factors that increase the risk of sudden infant death syndrome, such as sleeping on the stomach and smoking in pregnant/lactating women. This, in turn, allows parents to take some preventive measures to reduce the likelihood.

Due to improved preventive care, the number of small children who died of sudden infant death syndrome has decreased by about a tenth between 1990 and 2011.

preventive measures

  • By far, the most critical measure is sleeping on your back. The lateral position is risky if turning in a prone position is not reliably prevented. However, once your child turns on their own, you no longer have to force them to lie on their back.
  • Using a sleeping bag instead of an extra bed also helps reduce the risk – this way, the child’s head cannot slip under the covers. Use a rather hard mattress without “accessories” such as pillows and sheepskin, preferably loose fluffy things such as nests, spit diapers, and cuddly toys near the head.
  • The bedroom temperature must be appropriate and not too high – around 18 degrees Celsius is appropriate. Do not place the bed right next to the heater. Do not pack your baby too warm, or use a hot water bottle or electric blanket! Ventilate well or set up a fan – according to an American study, the risk of cot death in children’s rooms with a fan is 72 per cent lower than in bedrooms without a fan.
  • Sleeping in the parent‘s bedroom, but not in the parent’s bed (especially for parents who smoke) also seems to lower the risk.
  • Cigarette smoking during pregnancy and in the child’s household is one of the most significant risk factors, which also potentiates the dangerousness of others. Therefore, it should be smoke-free, especially in the bedrooms, preferably the whole house.
  • Exclusive breastfeeding for at least four months not only promotes the health of the baby but also helps to protect against sudden infant death syndrome. Pacifiers also seem to have a positive effect, presumably because they increase oxygen flow to the brain. However, do not wear a pacifier chain – your child could strangle himself with it in his sleep.


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