Preventing crib death

I’m a father again. Our fourth child was born last month as first light broke over Saipan. With the birth of every child there is joy and hope and thoughts of one’s own responsibilities as a parent. As we gathered our things to leave the Commonwealth Health Center that afternoon, we were handed a list of papers that included a sheet on “Preventing SIDS.” SIDS is the acronym for “Sudden Infant Death Syndrome,” or what used to be called “Crib Death.” SIDS is the sudden unexplainable death of a child under one year of age. It is the leading cause of death among this age group. Most SIDS deaths occur between ages of 2 and 4 months. It is a scary thing to think about, as you take a new child home from the hospital, but it is helpful to know that as parents there is much we can do to prevent SIDS.

In the decade between 1994 and 2004, the rate of SIDS in the United States was dramatically cut in half by the “Back to Sleep” campaign. Although we are not sure what causes SIDS, we do understand that there are some things that increase the risk of SIDS. One of the major risk factors for SIDS is to let a baby sleep on their belly, or face down. The “Back to Sleep” campaign encourages parents to place their babies on their backs when they sleep. This simple step can decrease the risk of SIDS significantly, as we have seen. As I was changing my new son’s diapers, I was pleased (well, as pleased as one can be while changing a diaper) to find the words “Back to Sleep” printed on the front of his diaper. The “Back to Sleep” campaign has been a major step in decreasing the tragedy of SIDS. So that’s one key piece of information for all new parents—put your infants on their backs when they sleep, even for naps.

What other things can parents do to decrease the risk of SIDS? It has been found that babies that sleep on soft mattresses or with soft, fluffy or loose bedding and stuffed toys are at increased risk for SIDS. These things can easily gather around the baby’s face and cause them to re-breath air that is low in oxygen. So, use firm mattresses, and take all those extra cute stuffed animals and loose blankets out of the baby’s sleeping area.

Warm body temperature has also been linked to SIDS. Although you do not need to keep the baby cool, it is important to let her sleep in clothing that will not cause her to overheat. Avoid bundling the baby.

Bed sharing is another factor that has been implicated in SIDS. It is certainly easier to breastfeed while the baby is sharing the bed with mom, but other children should not share the same bed with the baby. If the baby is sleeping with adults, it is important that the adults not be impaired by drugs or alcohol.

Smoking by the mother during pregnancy is also a major risk factor for SIDS. Studies have also shown that smoking around the baby after it is born is a separate risk factor for SIDS. Smoking has repeatedly been linked with various health disorders. Decreasing the risk of SIDS can be a potent motivator for mothers trying to quit smoking.

Finally, babies who are born prematurely or with low birth weights are also at increased risk of SIDS. Regular prenatal care can decrease this risk, but if your baby was born prematurely, it is even more important to follow the guidelines that decrease the risk of SIDS.

So, in summary, make sure everyone who cares for your baby knows how to place the baby on their back during sleep. Make sure she is on a firm mattress, and all loose bedding and soft toys are removed from her sleep area. Keep your baby’s face uncovered while he sleeps. Make sure your baby does not get too warm while she sleeps. Avoid bed sharing. Do not smoke during pregnancy, and do not smoke around the baby. And get regular care during your pregnancy. All of these can help to prevent the tragedy of crib death.

(David Khorram, MD is a board certified ophthalmologist, and director of Marianas Eye Institute. Questions and comments are welcome. Call 235-9090 or email davidkhorram@hotmail.com. Copyright © 2005 David Khorram.)