164754934Sudden infant death syndrome, or SIDS, is a poorly understood condition that causes an infant to stop breathing and die. The condition occurs in infants less than 12 months of age and is most common in infants 3-5 months of age. Many theories abound regarding the cause of SIDS including prone sleeping, cigarette exposure during pregnancy, immature brainstem development associated with increased levels of carbon dioxide and anemia.

There is currently controversy about whether the term “SIDS” is misleading, since a “syndrome” usually has a single cause and sudden infant death in sleep seems clearly to have many different possible causes. Some experts therefore prefer the term “SUID”, which stands for Sudden Unexpected Infant Death.

In Vermont, the Chief Medical Examiner, who is ultimately responsible for determining the cause of death in such cases, has not used the term SIDS over the past decade or more. Over this period it has become increasingly clear that many cases of SUID are associated with an unsafe sleep environment or position. In Vermont, 4-6 infants die each year related to an unsafe sleep environment; in the last 5 years, 23 infants have apparently died due to these conditions. The good news is that, even while the cause of SIDS/SUID is unknown, there is much that parents can do to decrease the risk of their infant dying in his/her sleep.

What is an unsafe sleep environment and why is this so dangerous? An unsafe sleep environment involves placing an infant in a place other than an approved infant crib or bassinet or other similar firm safe surface. Also, if the infant is placed in any position other than on its back, this is considered to be an unsafe sleep position. It is especially dangerous to bed share with an infant as a parent can accidentally roll over on the infant causing suffocation. When an infant shares a bed with a parent, it is also possible for the infant to get caught between the bed and the wall, under a pillow or entangled in blankets leading to accidental suffocation.

Because we don’t know all the causes of SIDS/SUID it can be difficult to prevent it. But, since we do know that unsafe sleep environments are very dangerous, there are some simple precautions that every parent can take to help prevent the unexpected death of their infant.

  1. Put your baby down to sleep in an approved crib or bassinet and always place the infant on his/her back.
  2. Do not put any bumper guards, blankets, pillows, mattress padds or stuffed toys in the crib with the infant as these can also cause accidental suffocation.
  3. Do not bring your infant into bed with you to sleep. If you breast feed in bed, be sure to put the infant back in his/her crib or bassinet after feeding.
  4. Never take a nap with your infant while lying on the couch or sitting in a chair. The infant can roll into the back of the couch or become trapped between you and the side of the chair causing accidental suffocation.
  5. Never put the baby down for a nap on the couch or on an adult bed, even if they are sleeping alone.
  6. Remember that bed sharing is very dangerous.
  7. Also remember that alcohol or drug use by a parent increases the danger of bed sharing greatly.

Fortunately SIDS/SUID is very rare. So if you can follow these simple precautions, you should be able to have a peaceful sleep while keeping your baby safe.

Karyn Patno, MD, is clinical director of the Child Safe Clinic and pediatrician at The University of Vermont Children’s Hospital; Eliot Nelson, MD, is a general pediatrician at The University of Vermont Children’s Hospital; Wendy Sue Davis is former Commissioner of Health at the Vermont Department of Health and pediatrician at The University of Vermont Children’s Hospital.

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