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{{short description|Sudden unexplained death of a child who is less than one year of age}} {{Other uses}} {{Cs1 config|name-list-style=vanc}} {{Use dmy dates|date=December 2017}} {{Use American English|date=December 2017}} {{Infobox medical condition (new) | name = Sudden infant death syndrome | synonyms = {{ hlist | Cot death | crib death }} | image = Safe Sleep logo.svg | alt = Safe to Sleep logo | caption = The [[Safe to Sleep]] campaign encourages having infants sleep on their backs to reduce the risk of SIDS. | field = {{ hlist | [[Pediatrics]] | [[Forensic pathology]] }} | onset = One to four months in age<ref name=NIH2013Epi/> | causes = Unknown | risks = {{ ubl | Sleeping on belly or side | Overheating | Exposure to [[tobacco smoke]] | [[Preterm birth]] }} | diagnosis = {{ hlist | Investigation | [[Autopsy]] }} | differential = {{ ubl | [[Infection]]s | [[Genetic disorder]]s | Heart problems }} | prevention = {{ ubl | Sleeping supine | [[Pacifier]] use | [[Breastfeeding]] }} | frequency = 1 in 1,000β10,000 }} <!-- Definition and symptoms --> '''Sudden infant death syndrome''' ('''SIDS'''), sometimes known as '''cot death''' or '''crib death''', is the sudden unexplained [[death]] of a child of less than one year of age. Diagnosis requires that the death remain unexplained even after a thorough [[autopsy]] and detailed death scene investigation.<ref name=CDC2013Diag>{{cite web | work = Centers for Disease Control and Prevention | title = Sudden Infant Death |url=https://www.cdc.gov/sids/ |url-status=deviated |archive-url=https://web.archive.org/web/20130318045725/http://www.cdc.gov/sids/ |archive-date=March 18, 2013 |access-date=March 13, 2013}}</ref> SIDS usually occurs during [[sleep]].<ref name=Kin2009/> Typically death occurs between the hours of midnight and 9:00 a.m.<ref>{{cite book| vauthors = Gilbert-Barness E, Spicer DE, Steffensen TS | chapter = Sudden Death Syndrome |title=Handbook of pediatric autopsy pathology |date=2013|publisher=Springer New York|location=New York, NY|isbn=9781461467113|pages=654|edition=Second| chapter-url = https://books.google.com/books?id=yaPjAAAAQBAJ&pg=PA654|access-date=15 September 2017|archive-date=14 January 2023|archive-url=https://web.archive.org/web/20230114071655/https://books.google.com/books?id=yaPjAAAAQBAJ&pg=PA654|url-status=live}}</ref> There is usually no noise or evidence of struggle.<ref>{{cite book | vauthors = Sethuraman C, Coombs R, Cohen MC |chapter=Sudden Unexpected Death in Infancy | chapter-url=https://books.google.com/books?id=t33sAwAAQBAJ&pg=PA319 | veditors = Cohen MC, Scheimberg I |title=Pediatric & Perinatal Autopsy Manual |publisher=Cambridge |year=2014 |isbn=9781107646070 |pages=319 }}</ref> SIDS remains the leading cause of infant mortality in Western countries, constituting half of all post-neonatal deaths.<ref>{{cite book | vauthors = Raven L | chapter = Sudden Infant Death Syndrome: History |date=2018| chapter-url= http://www.ncbi.nlm.nih.gov/books/NBK513390/ | veditors = Duncan JR, Byard RW | title = SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future |place=Adelaide (AU)|publisher=University of Adelaide Press|isbn=978-1-925261-67-7|pmid=30035955|access-date=2020-09-28|archive-date=27 July 2022|archive-url=https://web.archive.org/web/20220727192826/https://www.ncbi.nlm.nih.gov/books/NBK513390/|url-status=live}}</ref> <!-- Cause and diagnosis --> The exact cause of SIDS is unknown.<ref name=NIH2013Cause>{{cite web|title=What causes SIDS?|url=http://www.nichd.nih.gov/health/topics/sids/conditioninfo/pages/causes.aspx|website=National Institute of Child Health and Human Development|access-date=9 March 2015|date=12 April 2013|url-status=live|archive-url=https://web.archive.org/web/20150402220510/http://www.nichd.nih.gov/health/topics/sids/conditioninfo/pages/causes.aspx|archive-date=2 April 2015}}</ref> The requirement of a combination of factors including a specific underlying susceptibility, a specific time in development, and an environmental stressor has been proposed.<ref name=Kin2009>{{cite journal | vauthors = Kinney HC, Thach BT | title = The sudden infant death syndrome | journal = The New England Journal of Medicine | volume = 361 | issue = 8 | pages = 795β805 | date = August 2009 | pmid = 19692691 | pmc = 3268262 | doi = 10.1056/NEJMra0803836 }}</ref><ref name=NIH2013Cause/> These environmental stressors may include sleeping on the stomach or side, overheating, and exposure to [[tobacco smoke]].<ref name=NIH2013Cause/> [[Overlaying|Accidental suffocation]] from [[bed sharing]] (also known as co-sleeping) or soft objects may also play a role.<ref name=Kin2009/><ref>{{cite web|title=Ways To Reduce the Risk of SIDS and Other Sleep-Related Causes of Infant Death|url=https://www.nichd.nih.gov/sts/about/risk/Pages/reduce.aspx|website=NICHD|access-date=2 March 2016|date=20 January 2016|url-status=live|archive-url=https://web.archive.org/web/20160307132750/https://www.nichd.nih.gov/sts/about/risk/Pages/reduce.aspx|archive-date=7 March 2016}}</ref> Another risk factor is being born before 37 [[Gestational age (obstetrics)|weeks of gestation]].<ref name=NIH2013Epi/> Between 1% and 5% of SIDS cases are estimated to be misidentified [[infanticide]]s caused by intentional [[asphyxia|suffocation]].<ref name="pediatrics-hymel">{{cite journal |last1=Hymel |first1=Kent P. |title=Distinguishing sudden infant death syndrome from child abuse fatalities |journal=Pediatrics |date=July 2006 |volume=118 |issue=1 |pages=421β427 |doi=10.1542/peds.2006-1245 |pmid=16818592 |url=https://pubmed.ncbi.nlm.nih.gov/16818592/ |issn=1098-4275}}</ref><ref name="afp-milroy">{{cite journal | vauthors = Milroy CM, Kepron C | title = Ten Percent of SIDS Cases are Murder - or are They? | journal = Academic Forensic Pathology | volume = 7 | issue = 2 | pages = 163β170 | date = June 2017 | pmid = 31239971 | pmc = 6474533 | doi = 10.23907/2017.018 }}</ref> SIDS makes up about 80% of sudden and unexpected infant deaths (SUIDs).<ref name=Kin2009/> The other 20% of cases are often caused by [[infection]]s, [[genetic disorder]]s, and heart problems.<ref name=Kin2009/> <!-- Prevention --> The most effective method of reducing the risk of SIDS is putting a child less than one-year-old on their back to sleep.<ref name=NIH2013Epi/> Other measures include a firm mattress separate from but close to caregivers, no loose bedding, a relatively cool sleeping environment, using a [[pacifier]], and avoiding exposure to tobacco smoke.<ref name=Moon2012>{{cite journal | vauthors = Moon RY, Fu L | title = Sudden infant death syndrome: an update | journal = Pediatrics in Review | volume = 33 | issue = 7 | pages = 314β320 | date = July 2012 | pmid = 22753789 | doi = 10.1542/pir.33-7-314 }}</ref> [[Breastfeeding]] and [[immunization]] may also be preventative.<ref name=Moon2012/><ref name=NIH2014Pre/> Measures not shown to be useful include positioning devices and [[baby monitors]].<ref name=Moon2012/><ref name=NIH2014Pre>{{cite web|title=How can I reduce the risk of SIDS?|url=http://www.nichd.nih.gov/health/topics/sids/conditioninfo/pages/reduce-risk.aspx|website=National Institute of Child Health and Human Development|access-date=9 March 2015|date=22 August 2014|url-status=dead|archive-url=https://web.archive.org/web/20150227031841/http://www.nichd.nih.gov/health/topics/sids/conditioninfo/pages/reduce-risk.aspx|archive-date=27 February 2015}}</ref> Evidence is not sufficient for the use of fans.<ref name=Moon2012/> [[Grief counseling|Grief support]] for families affected by SIDS is important, as the death of the infant is unexpected, unexplained, and can cause suspicion that the infant may have been intentionally harmed.<ref name=Kin2009/> <!-- Epidemiology --> Rates of SIDS vary nearly tenfold in [[developed countries]] from one in a thousand to one in ten thousand.<ref name=Kin2009/><ref name=Dun2018>{{cite book | vauthors = Duncan JR, Byard RW | chapter = Sudden Infant Death Syndrome: An Overview|date=2018|url=http://www.ncbi.nlm.nih.gov/books/NBK513399/ | veditors = Duncan JR, Byard RW | title = SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future |publisher=University of Adelaide Press|isbn=9781925261677|pmid=30035964|access-date=2019-08-01 |archive-date=2 July 2020|archive-url=https://web.archive.org/web/20200702043737/https://www.ncbi.nlm.nih.gov/books/NBK513399/|url-status=live}}</ref> Globally, it resulted in about 19,200 deaths in 2015, down from 22,000 deaths in 1990.<ref name="GBD2015De">{{cite journal | title = Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015 | journal = Lancet | volume = 388 | issue = 10053 | pages = 1459β1544 | date = October 2016 | pmid = 27733281 | pmc = 5388903 | doi = 10.1016/s0140-6736(16)31012-1 | display-authors = 6 | vauthors = Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, Casey DC, Charlson FJ, Chen AZ, Coates MM, Coggeshall M, Dandona L, Dicker DJ, Erskine HE, Ferrari AJ, Fitzmaurice C, Foreman K, Forouzanfar MH, Fraser MS, Fullman N, Gething PW, Goldberg EM, Graetz N, Haagsma JA, Hay SI, Huynh C, Johnson CO, Kassebaum NJ, Kinfu Y, Kulikoff XR }}</ref> SIDS was the third leading cause of [[infant mortality|death in children less than one year old]] in the United States in 2011.<ref name=CDC2012Epi>{{cite journal | vauthors = Hoyert DL, Xu J | title = Deaths: preliminary data for 2011 | journal = National Vital Statistics Reports | volume = 61 | issue = 6 | pages = 1β51 | date = October 2012 | pmid = 24984457 | url = https://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_06.pdf | url-status = live | archive-url = https://web.archive.org/web/20140202154454/http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_06.pdf | archive-date = 2014-02-02 }}</ref> It is the most common cause of death between one month and one year of age.<ref name=NIH2013Epi/> About 90% of cases happen before six months of age, with it being most frequent between two months and four months of age.<ref name=Kin2009/><ref name=NIH2013Epi/> It is more common in boys than girls.<ref name=NIH2013Epi>{{cite web|title=How many infants die from SIDS or are at risk for SIDS?|url=http://www.nichd.nih.gov/health/topics/sids/conditioninfo/pages/risk.aspx|website=National Institute of Child Health and Human Development|access-date=9 March 2015|date=19 November 2013|url-status=live|archive-url=https://web.archive.org/web/20150402182125/http://www.nichd.nih.gov/health/topics/sids/conditioninfo/pages/risk.aspx|archive-date=2 April 2015}}</ref> Rates of SIDS have decreased by up to 80% in areas with [[Safe to Sleep|"Safe to Sleep" campaigns]].<ref name=Dun2018/>
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