Generality
SIDS is the so-called Sudden Infant Death Syndrome or cot death.
Rarely enough, SIDS occurs for reasons that doctors do not yet know. The only observations of the latter concern some physical factors and some environmental factors, which seem to favor the occurrence of the aforementioned tragic event.
There are currently no effective anti-SIDS remedies; however, experts believe that some of the following countermeasures are very helpful in reducing the risk of cot death:
- on the cradle or bed, always lay the baby on his back;
- do not overly cover the baby and do not overheat the room in which he sleeps;
- do not smoke during pregnancy or in the presence of the newborn;
- do not sleep with the baby and free the bed in which he sleeps.
What is SIDS?
The SIDS is the acronym that, in the medical field, indicates the unexpected deaths of children under one year of life and apparently healthy.
SIDS is the English acronym for Sudden Infant Death Syndrome, that is in Italian: Sudden Death Syndrome of the Infant.
A fairly common synonym for SIDS, perhaps already known to some readers, is "cot death".
EPIDEMIOLOGY
SIDS is a fairly rare occurrence. For example, in a country like the UK, the annual number of cot deaths is around 300.
In 90% of cases, the victims are children less than 6 months old. As several statistical researches show, the peak of deaths during this first semester is between 2 and 4 months.
Starting from the 6th month, the risk gradually decreases, until complete resolution.
In general - although it is not particularly widespread - SIDS is one of the main causes of death in newborn children.
In 2010, SIDS deaths worldwide were about 22,000, 8,000 fewer than 20 years earlier.
Causes of SIDS
At the present time, doctors ignore the precise cause of SIDS, but they agree that, at the base of this dramatic event, there is always a set of triggering circumstances: some of the children (physical factors) and others of an environmental nature. , capable of causing severe stress to the newborn.
PHYSICAL FACTORS
Several studies have found the existence of a correlation between SIDS and:
- Some congenital brain abnormalities. Autopsy investigations on the brains of certain children who died of SIDS have brought to light the presence of non-functional nerve cells, linked to the communicative mechanism of serotonin.
In other words, doctors have identified inadequately functioning brain areas in the brains of some babies.
These are brain areas that regulate breathing, awakening from sleep (especially blood pressure when waking up) and heartbeat. - Premature birth. Premature babies are subjects who, having been born a few weeks before the expected date, have not completed intrauterine development. Failure to complete intrauterine development usually leads to "immaturity of organs such as the brain and lungs. If immature, these two vital organs may function inadequately and, as in the previous case, alter the normal breathing mechanism and heartbeat.
Premature birth is often accompanied by low birth weight, which, not surprisingly, includes the typical physical characteristics of children who have died of SIDS.
For readers who are unaware, a birth is premature when it takes place at least three weeks before the 40th and final week of pregnancy, while birth weight is low when it is less than 2.5 kilograms.
ENVIRONMENTAL FACTORS
Premise: in medicine, the plural term "environmental factors" indicates the set of circumstances, habits and behaviors that affect an individual and change his life to a certain extent. Two examples of environmental factors are cigarette smoking and the type of diet .
According to numerous medical researches, the environmental factors that affect SIDS are:
- The prone or flank position of the infant during sleep. Babies who sleep with their stomach on the bed or on one of the two hips breathe inadequately, because the two aforementioned positions obstruct the respiratory airways.
All this explains why doctors, especially pediatricians, recommend that new parents always and strictly put their baby to sleep with the belly turned upwards. - Lay or let the baby sleep on a soft, soft surface. As in the previous case, this circumstance can affect the baby's breathing, to the point of causing death.
For similar reasons, situations are just as dangerous: placing the baby on a water bed, leaving the plush toys around the crib and arranging the quilts up over the head. - Sleeping in the company of the newborn. We are referring, clearly, to parents who have the habit of sleeping with their child. The danger of this circumstance arises from the fact that the adult person, in sleep, could move and inadvertently assume a position which prevents the child from sleeping. newborn normal breathing.
- Smoking or inhaling smoke when pregnant. Numerous clinical cases have confirmed that active smoking and passive smoking are extremely dangerous for pregnant women. In fact, in addition to favoring SIDS, they predispose to spontaneous abortion, death of the child at birth, premature birth, low birth weight, the presence of congenital defects in the infant and placental problems in the mother.
- Exposure of the newborn to secondhand smoke. Secondhand smoke is extremely harmful to the health of the child. Several investigations have shown that, among the possible consequences, there is also SIDS.
- Excessive clothing made to wear to the child, to protect him from the cold. Too many clothes, too many blankets and too hot environments can induce hyperthermia in newborns. Hyperthermia means a sharp increase in body temperature; in common parlance, it also takes the name of "heat stroke".
Several researchers have tried to explain how hyperthermia affects SIDS: according to their hypothesis, the excessive increase in body temperature could alter the breathing capacity of the newborn, to the point of causing the death of the latter. - The use of illegal drugs and alcohol by the mother during pregnancy.
WHAT INCREASES THE RISK OF SIDS?
Although it can affect any newborn, SIDS is particularly common among male children and children of black, Amerindian (American Indians) and Eskimo populations.
Furthermore, according to other observations, it seems that the children of mothers under the age of 20 are more at risk.
MYTHS TO BE DISSOLVED
In studying the causes of SIDS, doctors and researchers have also debunked some myths and strange theories relating to the possible triggering effects or possible characteristics of the event.
First of all, cot death is an event impossible to predict; secondly, it is not the result of neonatal vaccinations, it is not a contagious condition, it is not inherited and it is no one's fault (in other words, it just happens).
Third and lastly, it has no association with obstructive sleep apnea and so-called ALTE. ALTE is the English acronym for Apparent Life-Threatening Events, the Italian meaning of which is Apparently Life-threatening Events.
Characterized by sudden changes in breathing, skin color and muscle tone, ALTEs are often the result of some specific conditions, including: respiratory infections, gastroesophageal reflux disease or epilepsy.
SIDS, on the other hand, as someone will remember from the definition, is an event that concerns healthy subjects, without any suspicious signs.
When and how does it occur?
Most SIDS events occur during nighttime sleep or daily naps.
According to some interesting statistics, the time slot most at risk - as the one in which deaths usually occur - is between midnight (00:00) and 9:00 in the morning.
FEATURES OF THE EVENT
By the time it occurs, SIDS is silent in the sense that the baby does not cry and does not exhibit any problems or unusual behavior.
Also, it appears to be very fast, a matter of seconds or minutes.
Complications for parents
To overcome such situations, doctors advise families involved and particularly shocked by the tragedy to:
- Attend support groups, in which people in similar difficulties participate.
- Seek help from experienced psychotherapists.
- Confide in friends, relatives and / or your partner and express all your feelings to them.
- Don't blame yourself for the death.
- Be patient, because time is the best therapy.
Diagnosis
Although the unpredictability of death and the good health of the dead infant are two relevant and particularly significant clues, the confirmation of the occurrence of SIDS requires at least 4 specific tests, which are:
- Laboratory analyzes post-mortem, to exclude the presence of physiological problems, viral infections, bacterial infections, etc.
- The autopsy, for the study of the state of health and development of the brain, lungs and heart.
- The analysis of the circumstances of the death, to rule out infanticide.
- The analysis of the clinical and family history of the newborn, to exclude a predisposition to respiratory problems or similar.
POST-MORTEM LABORATORY ANALYSIS
Laboratory analyzes post-mortem they mainly consist of measuring the electrolyte concentration in the blood and in viral and bacterial cultures.
In the case of SIDS, these analyzes show no abnormalities.
AUTOPSY
A fair part of the autopsies on infants who died of SIDS show the presence of small cerebral, cardiac and / or pulmonary anomalies.
However, it is important to point out two aspects:
- There is currently no evidence to support a consequential relationship between the aforementioned abnormalities and death from SIDS.
- There are many cases of SIDS whose autopsies do not reveal any anomalies.
ANALYSIS OF THE CIRCUMSTANCES OF DEATH
The analysis of the circumstances of the death is an investigation, conducted by competent personnel, which aims to clarify whether there is any criminal responsibility on the part of anyone.
Typically, it includes a "careful inspection of the place where the baby died and a series of interrogations involving the parents, any other family members and close friends.
ANALYSIS OF THE CLINICAL AND FAMILY HISTORY OF THE NEWBORN
Analyzing the clinical history of an individual means reviewing the current and past state of health of the latter. If the patient is an individual of young or very young age, it is essential that those who carry out the aforementioned analysis question the parents and closest relatives.
Analyzing family history, on the other hand, means observing whether, in the past, the patient / victim's family members have suffered from similar disorders or died in similar circumstances.
Prevention
Doctors believe that there is no 100% effective SIDS prevention method.
However, I am of the opinion that the risk of occurrence can be reduced by taking care of certain aspects - such as the position of the child during sleep (or naps), the temperature in the room where the newborn sleeps and the consistency of the bed (or cradle). - and avoiding some completely dangerous behaviors - such as smoking during pregnancy (advice for the mother) or in the presence of the baby and sleeping in the same bed as the baby.
SLEEP POSITION
In the bed (or cradle), the ideal anti-SIDS position is the supine one, that is, with the subject lying on his back.
During the first 5-6 months of life, newborns tend not to move during sleep (WARNING: this is rare, but not impossible!); when they begin to do so, the risk of SIDS - for unknown reason - is no longer as troubling as it used to be.
Therefore, if the child should assume different positions after the first semester of life, it is not necessary to put him back in the supine position nor constantly monitor his movements.
During the first months of life, the prone and flank position should be avoided.
ROOM TEMPERATURE
Overheating the environment in which the child usually sleeps is wrong. In the same way, it is wrong to cover him with too many blankets (ATTENTION: no heating quilts) or to place the cradle near a source of heat (radiator, window on which he "hits" the sun etc.).
According to experts, the temperature of the room in which the baby sleeps is quite safe when it is between 16 and 20 ° C.
A parent can tell if their baby is too hot by the following signs: sweating, damp hair, heat rash, increased number of breaths, and fever.
CONSISTENCY OF THE MATTRESS
The most suitable anti-SIDS mattresses are those with a rigid consistency. Surely, parents must avoid beds and cots that are too soft, in which the newborn can "sink".
BANNING THE SMOKE
During a pregnancy, women who smoke should stop smoking, for the health of the fetus and even their own.
In fact, SIDS is only one of the possible complications of smoking during pregnancy; in fact, as stated earlier, there are many others.
If any family member has a habit of smoking, they should avoid smoking in the presence of the baby or in rooms where the baby spends most of his time.
CLEAR THE BED
To further reduce the risk of SIDS, the bed or cradle in which the infant sleeps must be at the complete disposal of the infant.
Hence, parents should avoid sleeping in her company and remove any toys, soft toys or other objects that may prevent the baby from breathing.
CURIOSITY €
According to some statistical research, among breastfed infants, the incidence of SIDS is lower.
