SIDS,Sudden infant death syndrome

Sudden infant death syndrome (SIDS) is the sudden and unexpected death of a human baby which is unexplained even after an autopsy and investigation. SIDS is sometimes referred to as cot death or crib death.

The name is only applied to cases where the baby is less than one year old. By definition, SIDS deaths occur under the age of one year. Most happen when the infant is 2 to 4 months of age. This is a critical period because the infant's ability to arouse from sleep is not yet mature.SIDS is defined as a syndrome.

Babies are at the highest risk for SIDS during their sleep. Male infants die more often than female infants; about 60% of the cases are male infants. Infants also die more often during winter months.

The reason for SIDS are unknown, but there are different theories:

Problems with blood flow to the brain
Problems with levels of serotonin
Effects of the bacterium Clostridium botulinum (which causes botulism)
Toxic gases
Vaccinations do not increase the risk of SIDS, and may reduce the risk slightly.
Infanticide and child abuse cases may be misdiagnosed as SIDS due to lack of evidence. and caretakers of infants with SIDS are sometimes falsely accused. Accidental suffocations are also sometimes misdiagnosed as SIDS and vice versa. Grief support for families affected by SIDS is particularly important. The death of the infant is typically sudden, without witnesses, and requires an investigation.

Treatment for SIDS,Sudden infant death syndrome

Observations made by EMS personnel at the scene may assist in the investigation. Such observations should include the following:

Location and position of the infant, including the type of surface on which the body lies, the body temperature, the degree of rigor mortis (if present), and any marks and bruises
Type of bed or crib used and any defects
Amount and position of clothing and bedding materials
Presence of toys, pillows, or other objects that may cause asphyxiation
Condition of the residence
Temperature of the room in which the infant was found
Type of ventilation and heating
Presence of children or others
Reactions of caretakers and others at the scene
In the ED, post-ALTE care includes resuscitation and general stabilization. The patient should be placed on cardiac and respiratory monitoring, including arterial oxygen saturation. The blood glucose level should be determined; hypoglycemia may be associated with apnea, with or without seizure.

The objectives of the workup are to identify “serious” ALTEs and to attempt to establish the cause of the ALTE. ALTE alone is not a definitive diagnosis; a more specific final diagnosis (eg, ALTE secondary to seizure) is preferred. In many instances, however, such specificity cannot be achieved, and the final diagnosis is idiopathic ALTE or ALTE of undetermined etiology. On a cautionary note, the diagnosis of ALTE secondary to reflux is one of exclusion. Ideally, this diagnosis should be made only after a period of observation and reflux monitoring.