Sudden infant death syndrome (SIDS): Nursing

Sudden infant death syndrome, or SIDS, which is also known as cot death, or crib death, refers to the sudden death of an otherwise healthy infant during their first year of life, where no cause of death is identified, even after thorough investigation with an autopsy. SIDS has actually become the leading cause of death in infants between one month and 1 year of age.

Now, there’s no known cause of SIDS, but there are a number of risk factors that seem to correlate with getting SIDS. These mainly have to do with how an infant sleeps, so they include sleeping face down or on the side, under soft or loose bedding like a blanket, pillows, or stuffed toys, and on a soft sleep surface like a couch or chair. Sleeping with parents, or other children or pets, as well as overheating have also been shown to increase the risk for SIDS.

There is also a higher incidence of SIDS among babies two to three months old, those who have been assigned male at birth, as well as among formula-fed babies, those born prematurely or with low birth weight, and those with a family history, so with a sibling that died of SIDS, or history of apnea. In addition, infants of Hispanic, Native American or African descent have the highest rates of SIDS, while infants of Asian descent have the lowest rates of SIDS.

Risk factors related to the pregnancy include complications like placenta previa, placental abruption, or premature rupture of membranes. Other pregnancy-related risk factors include receiving little or no prenatal care, being a teenager or young age, and smoking or substance use during the pregnancy, as well as after birth, exposing the baby. Lastly, alcohol consumption is also thought to be a risk factor because there are more cases of SIDS during weekends, the holidays, and other times of year when drinking is included in celebrations.

Now, although the pathophysiology is unclear, there are some theories as to how SIDS occurs. One such theory is the triple-risk model, where three factors interact and may lead to SIDS. So this model suggests that when a vulnerable infant, such as an infant born prematurely, which is factor number one, gets exposed to a stressor or triggering event such as a prone sleep position, which is factor number two, during a critical period in development, so particularly in the first six months of age, which is factor number three, they may develop SIDS.

Infants with SIDS are typically discovered not breathing or experiencing apnea, blue or cyanotic, lifeless, and with frothy blood-tinged fluid in their nose and mouth. Sometimes the infant may have been tightly gripping the sheets or blankets around them. They may also have a wet or stool filled diaper.

Now, the diagnosis of SIDS is given when no reasonable cause of death can be discovered for a healthy appearing infant under one year of age. After a completed autopsy, a deeper investigation is often needed to make sure that there isn’t an alternative explanation for the infant’s death. These investigations may include history-taking, interviews with caregivers, death scene observations made by emergency responders, and postmortem imaging.

Okay, when caring for a family or caregiver who has just lost their baby to SIDS, your priority nursing goal is to provide compassionate grief support.

Reassure them that they did not cause their baby’s death. Assess the needs of each parent or caregiver, and answer their questions providing appropriate responses, keeping in mind individual and cultural differences in processing grief.