It’s every new parent’s biggest fear: putting your baby down to sleep, only for her not to wake up again.
But although cases of SIDS (sudden infant death syndrome) – also known as crib or cot death – are extremely rare, and have decreased significantly in recent years, there are concerns that the figure may be more elevated than necessary in the UAE, due to warm sleeping environments, a lack of awareness about the risks, and the use of certain sleeping materials.
Although it is very difficult to gather accurate data on the rate of SIDS across the world, research from 2008 suggests that the UAE’s SIDS mortality rate is higher than that in other developed countries at 0.66 per thousand live births, compared to a rate of approximately 0.3 in the UK, and 0.5 in the US.
But the good news is that taking the right precautions can go a long way in dramatically reducing the risk of SIDS. Here Pranjul Tandon, Childbirth educator and newborn care coach at Wombandbeyond.info, explains everything you need to know about SIDS in the UAE, from risk factors, to steps to preventing sudden infant death syndrome.
What is SIDS?
Sudden infant death syndrome (SIDS) is defined as the death of a healthy infant (under 1 year of age) with no satisfactory medical explanation for cause of the death. It often leaves the family devastated and the healthcare provider completely baffled.
While SIDS can occur when the child is not sleeping, it happens mostly during sleep and usually between ten at night and ten in the morning. It is commonly known also as cot death or crib death. The heartbreak is aggravated by the fact that despite complete autopsy, review of infant’s medical history and examination of death scene ( to rule out accidents or foul play), doctors are often not able to pin point at the cause of the death.
The exact causes of SIDS are still unclear and research is ongoing. But medical researchers agree that SIDS can be attributed to failure to arouse from deep sleep in case of a life threatening event like nose being pressed against the pillow or sleep apnea or severe acid reflux. It is not completely proven but several studies show that infants exposed to certain risks are more vulnerable than others. Unexpected infant death due to accidents, suffocation or disease cannot be regarded as SIDS.
15 ways to prevent SIDS
Various risk factors have been identified which put infants to risk and modifying these factors can help reduce SIDS victims:
- Put baby to bed on her back :
Belly sleeping infants have a 13 times higher risk of SIDS than back sleeping infants. This is because infants are more likely to have apnea (pauses in breathing), lower oxygen levels and increased body heat when on their stomach. Side sleeping is equally risky as there are chances of the infant rolling on his or her stomach in sleep. Therefore, the US National Institute of Child Health and Human Development (NICHD) strongly encourages parents to have their infants sleep on their backs to reduce the risk of SIDS. Since the launch of its ‘Back To Sleep’ campaign in 1994, incidences of SIDS have declined by more than 50 percent. Babies should be given tummy play time while awake to help them develop neck control and upper body strength, but they should never be left unattended during that time. Also, tummy play time should never be on bed, it should always be on a play mat or floor.
- Keep the crib clear : Your child’s crib should be free from pillows, stuff toys, bumper pads and other stray objects. If you use a blanket then it should be tucked in and not be loose to go over the child’s nose. Some experts also recommend using light cellular blankets (ones with lots of tiny holes in for breathability) or gro bags (sleeping bags that babies wear like a vest to keep them fixed in position).
- Use a firm mattress: Infants should only use a firm mattress in the crib while sleeping. Soft mattresses may cause the infant to be smothered or over heated.
- Be wary of overheating: Care should be taken not to overheat babies. The child should wear clothes appropriately and the room temperature should be comfortable. Overheating can affect the stability and control of child’s breathing. This is particularly relevant in the UAE, where temperatures can rise to such highs during the summer. Experts recommend setting your AC to around 22-24 degrees Celsius, putting babies in only two thin layers of clothing to sleep at night, and using a low-tog blanket or gro bag (around 0.5-1.5 tog).
Read more about ensuring your baby doesn’t overheat: “How to adapt infant sleep routines for life in the UAE”
- Don’t smoke around babies or while pregnant: Research shows that smoking during pregnancy increases the baby’s risk of SIDS due to exposure to nicotine. Smoking around your infant also increases the risk of SIDS. Infants who die of SIDS have higher concentration of nicotine and higher levels of cotinine (a biological marker for secondhand smoke exposure) than infants who die from other causes.
- Breastfeed if possible : Breastfeeding helps lower SIDS risk. It helps fight respiratory infections and gastrointestinal infections which contribute to SIDS risk. Between two to six months of age, baby’s immunity is the lowest, thus increasing the risk of SIDS which can be improved via breastfeeding. It also reduces acid reflux which is linked to SIDS. Breastfeeding also promotes safer sleep as it has calming effect on the baby. It also helps organize the sleep/wake cycles. Breastfeeding increases mother’s awareness and sensitivity to any negative changes in her baby.
- Don’t sedate your little one: Using syrups or medication to sedate your infant should be avoided as failure to arouse from deep sleep may lead to SIDS. Victims may fail to arouse when something severe happens like apnea or esophageal reflux or a pillow or any other object pressed against their face.
- Do not let your baby co-sleep with you or other children: Research shows that infants who died of SIDS were over 5 times more likely to have shared a bed with other children. Sleeping with parents or mother in the same bed is also not recommended.
- But DO sleep in the same room as your baby : Infants should sleep in the same room but not in the same bed as parents. This can help make parents more aware in case of any evident discomfort being experienced by the baby.
- Ensure your baby is well-rested: Babies exposed to sleep deprivation are more likely to experience sleep apnea and are harder to arouse from sleep. Some studies show that SIDS victims were comparatively sleep deprived in the 24 hours prior to the incident.
- Stay alert Parents need to be mentally alert at all times. Situations leading to extreme exhaustion should be avoided along with alcohol and drug induced sedation.
- Familiairise yourself with an emergency response : Emergency medical attention should be provided if the infant is having problem like breathing trouble, gagging, going limp or turning blue.
- Consider swaddling : Swaddling in early weeks can help new-borns sleep more comfortably on their backs. Parents need to take care not to swaddle too loosely as it may come up to baby’s nose or face and accidentally suffocate the child. At the same time, if the child is swaddled too tightly, it can make breathing difficult for the baby. Also, swaddling should be done using light, breathable cloth to prevent overheating of the child.
- Consider pacifiers : Several studies found that pacifiers help reduce the risk of SIDS but care should be taken to introduce pacifiers only once the child has established a comfortable breastfeeding routine.
- Don’t give honey to infants below 1 year of age : Honey in young infants can cause infant botulism which can be associated with SIDS.