SIDS

the sudden and unexpected death of an apparently healthy infant, not explained by careful postmortem studies. It typically occurs between birth and age 9 months, with the highest incidence at 3 to 5 months. Called also crib death or cot death because the infant often is found dead in the crib.



The incidence rate for SIDS in the United States is approximately 10,000 per year. After the first week of life it is the leading cause of death in one-year-olds, and is second only to accidents as a cause of death in children under the age of 15 years. The disorder occurs throughout the world, is more common in families in the lower socioeconomic classes, and affects males slightly more than females and non-Caucasians slightly more than Caucasians.

Children most at risk for SIDS are those who are premature, have a history of apnea from hyaline membrane disease or a seizure disorder, or have a family history of SIDS (especially among siblings) with or without a history of apnea.

There are many misconceptions about the cause of SIDS, most of which are likely to cause feelings of guilt or anger that only add to the heartache of parents whose children have died of the disorder. Among these misconceptions are the beliefs that the infant has suffocated under blankets or from aspirated vomitus, or that contraceptive pills, fluoridation, radioactive fallout, and even lack of breast-feeding have somehow contributed to the disorder.

Identification of infants at risk for SIDS includes determining whether the infant is subject to periods of apnea and if so, why. Diagnostic studies include pneumogram, chest x-ray, determination of chemoreceptor status, metabolic assessment, electrocardiogram, and cardiac and apnea monitoring.

Treatment and prevention of SIDS are necessarily aimed at identifying infants at high risk and instituting a program of apnea monitoring and resuscitation. If home monitoring is deemed necessary, the parents are taught how to place the electrodes over the baby's diaphragm, how to operate the monitoring equipment, and the basic maneuvers for cardiopulmonary resuscitation. While home monitoring does create problems and stress for family members, it usually is not required for more than a few months or at most a year. Most parents feel that the security it provides and the knowledge that their child can survive periods of apnea are worth the sacrifices necessary.

Through the efforts of the National Foundation for Sudden Infant Death, guilt and misunderstandings of the parents about the cause of their infant's death are being handled in a more sensitive and comforting way. Recent interest in research into causes of SIDS has resulted from pressure from parents and members of the national organizations concerned with child health and development. In 1974 Congress passed a bill to set up diagnostic centers throughout the country, and the National Institute of Child Health and Development now allocates more than half a million dollars annually for SIDS research. The address of the National SIDS Alliance is 10500 Little Patuxent Pkwy., Columbia MD 21044.