SIDS - The silent killer...
"Better a thousand times careful than one dead" ~ Proverb
Like the name says, SIDS - Sudden Infant Death Syndrome, is sudden and silent as it is not usually accompanied by known symptoms. According to the NHS, it is the sudden, unexpected and unexplained death of an apparently healthy baby. Although there are no statistics in Nigeria, and may therefore not seem very common, it is the most common cause of death in babies under 1 year in the United States (higher risk between 0-4 months).
I think what is worrying about SIDS (also known as cot death) is that it is unclear what
the exact cause is, as examination or investigation following death shows no clear or specific causes.
So what could cause it?
There has been a lot of research into the cause of SIDS, and research is still on-going. However, possible factors that could increase the risks of SIDS include:
- Some experts believe that there may be poor development in some part of a baby's brain that controls breathing and waking, and since they are vulnerable at this stage, they are unable to react to anything that could obstruct their breathing.
- Pre-term babies may be at higher risk of SIDS.
Since the exact cause is unknown, and death mostly occurs during sleep, experts have advised that care be taken to keep a baby's sleep environment as safe and free from danger as possible. This will help reduce the risk of SIDS.
- Sleep alone: Babies should sleep alone as much as we can allow it to prevent the risk of rolling over and suffocating. My friend just had a baby, and has been complaining about having to constantly get up in the middle of the night to get her baby out of her cot to breastfeed, and I can totally imagine how stressful it is. But then I got her to understand that because she could really get exhausted sometimes, there is the possibility of sleeping off and rolling over or suffocating the baby;
- Sleep positions: Experts advise that babies be put to sleep on their backs, not on their bellies or their sides as is very common here. Placing babies to sleep on their backs does not increase the risk of choking as some people believe (yeah, I had an argument about this with someone recently). Their airways are clearer when placed on their backs and the risk of choking or aspiration is much less. As they grow older, they are able to roll by themselves and this is perfectly fine;
- Proper fitted mattress: Mattresses should be firm and fit snugly on the cots or cribs with no gaps or spaces. Quick test here: if you can fit two fingers (together) between mattress and crib/cot, it is unsafe. Broken cribs with screws and loose parts can cause babies to get caught when side rails come off. For cots or cribs with multiple levels, mattresses should be lowered as soon as babies can push up on hands and knees to prevent them from climbing and falling over;
- Clothing for sleep: One thing I have noticed is that we love to wrap our babies up so much here in Nigeria. I mean sometimes I see a baby in a sleep suit, some additional clothing, socks, hat, and wrapped up further in a shawl. I'm not sure why we think we need to cover babies up so much. There seems to be this general belief that the more covered up they are, the better they feel or the safer they are. Sometimes the babies even break out in rash under these 'comfortable' conditions. The truth is that children don't need that much clothing, not especially here in the tropics. And putting them to sleep with all those blankets and coverings could be quite dangerous, could actually cause overheating and increase the risk of SIDS. For bedtime, a one piece sleepwear is okay. A rule of thumb here is that if the room feels comfortable for you, it's comfortable for the baby wearing light sleep clothing. If it gets chilly, a light blanket tucked in at the edge of the cot can be used to provide additional cover. With the blanket, babies should be placed towards the end of the cot (called 'feet to foot' position) and tucked in. This will prevent them from wriggling underneath the cover/blanket and getting suffocated;
- Electronics: I'm not sure how common the use of baby monitors and other similar devices is in Nigeria, but it not advisable to rely on electronic products to keep our babies safe during sleep. Some of these are placed under mattresses to help detect baby movement, while some apps in smartphones can be used with other smartphones or tabs (camera-equipped devices) as monitors. As with socket safety plugs, there are a lot of products that claim to decrease the risk of SIDS; it is good to apply caution. There are concerns about baby monitors emitting dangerous wireless radiation since the monitors are usually placed very close to babies. I mean it's bad enough that we have to worry about mobile phones and all; let's not add monitors to the list of worries;
- Free cots and cribs: When I worked at a retail store that sold mother and baby products, I used to really like looking at cots decorated with bumpers, cot mobiles, soft toys etc and put on display. I used to have this picture of putting my baby in there and watching her sleep, but I have since learnt that this doesn't come without dangers. Keeping babies' cot free from any other material, soft toys, blankets, baby bumpers, cot mobiles, etc. helps to reduce the risk of SIDS. The danger here is that babies, especially when still very young, are not capable of reacting to danger and getting themselves out of situations that could threaten their breathing, etc, so it is safe to keep the cots free. This means no pillows or any additional items in the cribs.
- Tummy time: (This is just an extra). After hours of laying babies to sleep on their backs, giving them a bit of tummy time helps to exercise and strengthen their neck, shoulders and trunk. These muscles help them to sit up and scoot around later on as they grow. Note that this should be done when the baby is awake and under supervision. It could begin with short 3-5 mins sessions 3 times a day, and as they get older, increased gradually. Toys can be placed around them so they can try to reach out.
In summary, this is what a safe sleep environment should look like:
To read up more on this post, please check the following links:
The Baby Analyst.