Dec 12, 2016

How to Talk to Your Patients About SIDS

When talking about Sudden Infant Death Syndrome (SIDS) with parents, it’s best to approach this topic in an educational and informative way. By doing this you will equip parents with the knowledge and tools they need to keep their babies as safe as possible without creating a sense of panic.

The cause

While an exact cause for SIDS isn’t known, researchers have discovered certain factors that may increase an infant’s risk. Some of these are physical factors that can’t be changed, including:

  • Being premature. Being born early and having low birth weight increase a baby’s chances of SIDS.
  • Gender. Boys are more likely to die of SIDS.
  • Race. Black, American Indian, and Alaska Native infants are more likely to develop SIDS.
  • Family history. Babies who have had siblings or cousins die of SIDS are at a higher risk.

While this type of information is worth covering with parents, the bulk of the discussion about SIDS should focus on the steps parents can take to help protect their babies.

Sleep environmental factors

The items in a baby’s crib and a baby’s sleeping position can combine with any existing physical risk factors to increase a baby’s risk of SIDS. While there isn’t a guaranteed way to prevent SIDS, avoiding the following sleep environmental risk factors can help.

  • Sleeping on the stomach or side. Babies who are placed on their stomachs or sides to sleep may have more difficulty breathing than those placed on their backs. For this reason, parents should always put babies on their backs for sleep and advise any babysitters or caregivers to do the same.
  • Sleeping on a soft surface or with items in the crib. Quilts, blankets, fluffy padding, pillows, stuffed animals, and toys can all interfere with a baby’s breathing if their face presses against these items. Parents should be advised to keep the crib as bare as possible and use a firm crib mattress.
  • Sleeping with parents. Infants who share a bed with another person are nearly three times more likely to die from SIDS than are infants who sleep alone. Additionally, bed sharing increases the risk of accidental suffocation, which is one of many sleep-related causes of infant death that has been on the rise during the past 10 years.

It’s important to note that the risk of SIDS is lowered if an infant sleeps in the same room as his or her parents. Studies indicate that sharing a room with an infant decreases the risk of SIDS by up to 50 percent and, therefore, sleeping in the same room in a crib or bassinet until age 1 is highly encouraged.

Parents should also be advised not to use baby monitors and other commercial devices that claim to reduce the risk of SIDS as a preventive measure. The American Academy of Pediatrics discourages the use of these devices due to their ineffectiveness.

These important steps for helping to reduce the risk of SIDS can be summarized for parents with the ABCs of safe infant sleep:

  • Babies sleep safest when Alone,
  • On their Backs, and
  • In a safe Crib

Discussion questions

Below are some of the most commonly asked questions from parents about infant sleep to use as talking points in your classes:

Shouldn’t I be concerned about my baby potentially choking if she spits up while sleeping on her back?
Actually, babies are less likely to choke when lying on their backs because the trachea (i.e., the airway to the lungs) is higher up than the esophagus when lying on the back. If a baby spits up or vomits while sleeping, she may swallow it back down, but since the airway is open, it won’t cause a breathing issue.

Are products that market themselves as creating a “womb-like” sleeping experience or “soother” devices that elevate a baby’s head safe to use?
Parents are advised not to use baby monitors and other commercial devices that claim to reduce SIDS. With that in mind, parents need to be cautious about any product they put into their baby’s crib. A product must pass the American Academy of Pediatrics’ definition of a safe sleep environment, being both flat and firm. If it doesn’t meet these criteria, it should not be used.

Is it OK if my baby starts the night sleeping in his crib but sometimes ends up in bed with me for night feedings?
As tempting as it can be for parents to keep their baby in bed with them, especially when they are completely exhausted, sleeping in the same bed should be avoided, even if only for an hour. Tired parents all too frequently fall asleep unintentionally during or after night feedings, putting the baby at risk of suffocation or falling out of bed, increasing the risk of SIDS.

Babies should be placed back in their cribs before parents fall asleep. Parents should set an alarm to ensure they follow through with this or use an upright chair for feeding that’s less likely to induce sleep.

In a nutshell

Though SIDS can be a difficult topic to address, keeping discussions educational and informative and providing parents with specific action items will serve to empower them rather than overwhelm them or create paranoia.

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