Sudden Unexpected Infant Death &
Sudden Infant Death Syndrome
Southwest SIDS Research Institute
230 Parking Way, Lake Jackson, Texas 77566
800-245-7437
Sudden Unexpected Infant Death
(SUID) & Sudden Infant Death
Syndrome (SIDS)
A simple child
That lightly draws its breath
And feels his life in every limb
What should it know of death?
-William Wordsworth
Welcome and Introduction
Welcome to the Southwest SIDS
Research Institute’s SIDS Educational
Program.
Today we will be reviewing what SUID
& SIDS are and the latest theories of
why they occur.
This program will offer simple yet vital
information in the areas of infant care
and prenatal care to help reduce the
risk of infants succumbing to
SUID/SIDS.
Program Outline
 SIDS◦ Clinical Definition and what SIDS is




NOT.
Who SIDS affects◦ Infants susceptible to SIDS.
◦ Individuals affected by SIDS.
Theories◦ Latest theories on why SIDS occurs.
Reducing the risk
◦ Back to sleep Campaign
◦ Safe Sleep
◦ Other addressable risk factors
Tips for child-care providers.
What is Sudden Infant Death
Syndrome?
Sudden Infant Death Syndrome (SIDS) is the
sudden, unexpected death of an apparently
healthy infant, for which no cause can be
identified even after:
• A thorough death scene investigation
• An autopsy
• A review of the infant and family’s medical
records.
(Willinger et al., NSIDRC, 1991)
SIDS Characteristics
SIDS is:
◦ Sudden and silentInfants appear healthy
◦ Currently
unpredictable
◦ Designated as a
diagnosis of exclusion
SIDS is not:
◦ Caused by vomiting,
choking, or by minor
illnesses such as colds
or infections
◦ Contagious
◦ Child abuse
(NSIDRC 2004)
Statistics on SIDS
 In 2004, 2,246 infants died from
SIDS making it the number 1
cause of death for infants between
1 month and 1 year of age.
 SIDS claims more American babies
every year than all childhood
cancers, leukemia, heart disease,
cystic fibrosis, AIDS, and child
abuse combined.
(HRSA 2004)
Year
Infant
Mo rt alit y
To t al
Infa nt
Mo rt a lit y
Rate
SID S
To t a l
SID S
Rate
1990
3 8 ,3 5 1
9 .2
5 ,4 1 7
1 .3 0
1991
3 6 ,7 66
8 .9
5 ,3 4 9
1 .3 0
1992
3 4,6 2 8
8 .5
4,8 9 0
1 .2 0
1993
3 3 ,4 6 6
8 .4
4,6 6 9
1 .1 7
1994
3 1 ,7 10
8 .0
4,0 7 3
1 .0 3
1995
2 9 ,5 0 5
7.6
3 ,3 9 7
0 .8 7
1996
2 8 ,4 1 9
7.3
3 ,0 5 0
0 .7 8
1997
2 7,9 6 8
7.2
2 ,9 9 1
0 .7 7
1998
2 8 ,3 2 5
7.2
2 ,8 2 2
0 .7 1
1999
2 7,8 6 4
7.0
2 ,6 4 8
0 .6 6
2000
2 7,9 6 0
6 .9
2 ,5 2 3
0 .6 2
2001
2 7,5 2 3
6 .8
2 ,2 3 4
0 .5 5
2002
2 8 ,0 3 4
7.0
2 ,2 9 5
0 .5 7
2003
2 8 ,0 2 5
6 .8
2 ,1 6 2
0 .5 2
2004
2 7,9 3 6
6 .7
2 ,2 4 6
0 .5 5
Infants Susceptible to SIDS
 SIDS occurs across all racial, ethnic and socio-economic boundaries.
ANY BABY IS SUSCEPTIBLE TO SIDS!
 SIDS rates are higher among African Americans and American
Indians.
 SIDS rates are lowest among Asians and Hispanics.
 Most SIDS deaths, 70%, occur before four months and another
20% occur before six months.
 Males are 50% more likely to die of SIDS than females.
(Horchler and Morris, 1994)
SIDS Risk Factors
Risk factors for SIDS include:
•
•
•
•
•
•
•
•
Overheating
Placing an infant in an at risk sleeping environment and/ or position
Smoking or abusing drugs or alcohol during or after pregnancy
Exposure to secondary smoke after pregnancy
Prematurity
Sibling of a SIDS infant or high risk infant
Teen pregnancy
Late or no prenatal care
ANY CHILD, REGARDLESS OF THE PRESENCE OF RISK
FACTORS, IS SUSCEPTIBLE TO SIDS.
Individuals Affected by SIDS
 It is estimated that one hundred individuals are affected by
every SIDS death including:
 Parents and siblings
 Relatives Grandparents
 Aunts and uncles
 Friends
 Church family
 Medical care providers
 Child care service providers
Theories on SIDS
 There are over 400 theories on
what causes SIDS.
(Horchler and Morris, 1997)
 Two Popular Schools of Thoughts
suggest:
 Infants are born abnormal and
are predisposed to SIDS.
(Filiano and Kinney, NSIDRC, 2004)
 Infants are normal yet succumb
to SIDS through an abnormal
event in their phases of
development.
(Horchler and Morris, 1997)
The Triple-Risk Model
Many scientists are adopting this model in their
search for the cause of SIDS. When all three
elements interact a sudden infant death may occur.
 Vulnerable Infant- An infant with an underlying
defect or abnormality making the baby vulnerable.
 Critical Development Period- The first 6 months
of an infant are filled with developmental changes
that may temporarily effect the infant’s biological
systems.
 Outside Stressor(s)- Environmental factors that
may effect an infant. (ex. Overheating, prone
sleeping, smoke exposure).
(Filiano and Kinney, NSIDRC, 2004)
SIDS
Reducing The Risk!
Back To Sleep Campaign
 In 1992, the American
Academy of Pediatrics
recommended that babies be
placed on their backs while
sleeping.
(National Institutes of Health 2005)
Back To Sleep
In 1994, the National Institute of Health began it’s “Back To Sleep” campaign promoting that
all infants be placed on their backs while sleeping. SIDS rates fell 50 % in the U.S. alone
following the campaign.
Back to Sleep to Reduce the Risk
 Provide the infant with “tummy time” while
awake and observed to avoid “flat” heads and so
the infant may develop strong shoulder
muscles.
 Change the direction that your baby lies in the
crib from one week to the next. For example,
have the baby’s feet point toward one end of the
crib for a few days, and then change the
position so his or her feet point toward the
other end of the crib. This change will help
make sure the baby is not resting on the same
part of his or her head all the time.
 Avoid too much time in car seats, carriers, and
bouncers while awake. Also, get “cuddle time”
with the baby by holding him or her upright
over one shoulder often during the day.
Safe Sleep to Reduce the Risk
The sleeping environment of an infant can  Keep the infant’s room temperature
have a drastic effect on reducing the risk of
comfortable for YOU (avoid overheating).
SIDS. Reduce risks by:
 Keep the environment SMOKE-FREE before
 Placing the baby’s crib in the same room with
you (but NOT bringing the baby in your bed
to sleep with you)
and after pregnancy.
 Offer a pacifier at nap or bed-time (never
coat the pacifier with Karo syrup or honey).
 Placing the baby on a FIRM mattress with
TIGHT fitting sheets and no cracks or
crevices he/she can get trapped in.
 Avoid commercial positional devices
designed to reduce the risk of SIDS.
 NEVER placing bumper pads quilts, pillows,
or fluffy toys in the baby’s cribs.
 DON’T place your baby on a couch, water
bed, or bean bag chair to sleep.
A Safe Sleep Environment
Tips for Child Care Providers
 Educate staff on SIDS
 Always place infants Back to Sleep
 Create a Safe Sleep Environment for infants
If you follow these measures you will reduce –
but not totally eliminate - the risk of a baby dying
of Sudden Infant Death Syndrome.
Sudden unexpected infant death
Accidental Suffocation
 Unintentional suffocation is the leading cause of injury death
among children under 1 year old in the United States.
 Since 1984, an estimated fourfold increase has been observed
in accidental suffocation and strangulation in bed, with many
of these deaths linked to unsafe sleep environments. (CDC)
 After ruling out confounding factors, the apparent cause of
most infant deaths due to accidental suffocation was bedsharing, also known as co-sleeping.
Review of statistics shows the
distribution of potentially preventable
unsafe sleep practices:
IN THE 80’S A DEADLY TREND
STARTED SPREADING RAPIDLY
ACROSS THE UNITED STATES.
 THE PRACTICE OF CO-SLEEPING
WAS RISING – AND INFANTS
WERE DYING IN INCREASING
NUMBERS WHEN SLEEPING WITH
THEIR PARENTS OR
CARETAKERS.
AFTER REVIEWING NATIONAL
STATISTICS, THE TEXAS
DEPARTMENT OF FAMILY AND
PROTECTIVE SERVICES
STUDIED INFANT DEATHS IN
OUR STATE AND
DISCOVERED A FRIGHTENING
REALITY…
Like U.S. statistics,
AN INCREASING
NUMBER OF TEXAS
BABIES WERE DYING
WHILE CO-SLEEPING.
A CO-SLEEPING BABY
DEATH OCCURS IN TEXAS
~EVERY 2 DAYS.
THESE DEATHS ARE
LARGELY
PREVENTABLE.
Total Texas Infant Deaths Where Bed-Sharing was a Factor
YEAR (Fiscal Year: 9/01 -8/31)
NUMBER OF FATALITIES
2015 (As of 11/03/14)
16
2014
197
2013
169
2012
167
2011
174
2010
166
http://www.dfps.state.tx.us/Room_to_Breathe/bed_sharing.asp
In an effort to reverse this trend,
The American Academy of
Pediatrics (AAP) recommends roomsharing without bed-sharing, stating
that:
“there is evidence that this
arrangement decreases the risk of
SIDS by as much as 50%.”
(Pediatrics Vol. 128 No.5 Nov 1,2011
pp e1341 – e1367)
The AAP further states:
“There is insufficient evidence to
recommend any bed-sharing
situation in the hospital or at home
as safe; devices promoted to make
bed-sharing “safe” are not
recommended.”
Risk Factors vs. Age
A study of 8,207 deaths:
73.8% of deaths in infants less than 4 months of age occurred
with bed-sharing.
Risk Factors vs. Age
A study of 8,207 deaths:
Older babies (greater than or equal to 4 months of age) were
more likely to have an object (stuffed toy, bumper pads) in their
sleep environment.
In Conclusion….
 We can reduce the risk of SIDS AND SUID by
implementing safe sleep practices.
 Alone, on their Back, and in their Crib is the
safest way to position an infant.
 Together, we look forward to that day
when all babies at risk are
identifiable and their deaths
preventable.

Contact Information
The Southwest SIDS Research Institute is dedicated to assisting those who are
victims and to search for the cause(s) of sudden death during infancy, identify
ways to reduce the risk, disseminate this information, and, ultimately, to
prevent these tragic losses.
With your help we can make this mission a reality.
For more information or to order literature on SIDS, contact Brenda Onopa at:
SOUTHWEST SIDS RESEARCH INTSTITUE
230 Parking Way
Lake Jackson, TX 77566
(979)297-2101
References

Center Of Disease Control & Prevention (CDC). Infant Mortality Statistics From the 2004 Period Linked Birth/Infant Death
Data Set.Trends in Preterm-Related Infant Mortality by Race and Ethnicity: United States. News release, CDC. 1999-2004.

Horcheler, J., Morris, R. The SIDS Survival Guide: Information and Comfort for Grieving Family & Friends & Professionals Who Seek To
Help Them. SIDS Educational Services Inc, Second ed, 1997.

Guntheroth, W., Spiers, P. Thermal Stress in Sudden Infant Death: Is There an Ambiguity With the Rebreathing Hypothesis?
PEDIATRICS Vol. 107 No. 4, April 2001, http://pediatrics.aappublications.org/cgi/content/full/107/4/693

National Institute of Child Health and Human Development. Safe Sleep ForYour Baby: Reduce the Risk of Sudden Death Infant
Syndrome (SIDS). National Institute of Health, Pub No. 05-7040, November 2005.

National Institute of Child Health and Human Development. What Does a Safe Sleep Environment Look Like? Lower the Risk of
Sudden Infant Death Syndrome. National Institute of Health, Pub. No. 06-5759, January 2006.

National SIDS/Infant Death Resource Center (NSIDRC). Sudden Infant Death:What Is SIDS? Health resources and Services
Administration. Revised 2004.

“Sleep Environment Risks for Younger and Older Infants”, Jeffrey D. Colvin, Vicki Collie-Akers, Christy Schunn and Rachel
Y. Moon, Pediatrics; originally published online July 14, 2014; DOI: 10.1542/peds.2014-0401.
Resources

American Academy of Pediatrics. www.aap.org
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American SIDS Institute. www.sids.org
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Association of SIDS and Infant Mortality Programs. www.asip1.org

C.J. Foundation for SIDS. www.cjsids.com
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First Candle/SIDS Alliance. www.firstcandle.org 1-800-221-7437
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National Center for Cultural Competence. www.georgetown.edu/research/gucdc/nccc
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National SIDS Resource Center. www.sidscenter.org 1–866-866-7437
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National SIDS and Infant Death Program Support Center. www.sids-id-psc.org

National SIDS and Infant Death Project IMPACT. www.sidsprojectimpact.com

National Institute of Child health and Human Development /NIH Back to Sleep Campaign.
www.nichd.nih.gov/sids/sids.cfm