Risk Factors
While Sudden Infant Death can strike any infant, researches have noted several factors that may increase a baby's risk.
- Certain risk factors have been identified during the pregnancy. To prevent possible risk factors, maintain a healthy pregnancy by getting early and consistent prenatal care, staying within the overall weight gain goals, and stop smoking, drinking alcoholor using “street" drugs.
- Several factors increase a baby's risk of Sudden Infant Death. Some risk factors may be reduced by maintaining a healthy pregnancy, a smoke free homeand providing a safe sleep environment.
- Certain environmental aspects and baby positioning also provide risks for Sudden Infant Death.
- The Triple-Risk Model describes three conditions, that when combined, may lead to a death from SIDS.
Research indicates that some infants are at a higher risk of SIDS because of certain risk factors identified during the pregnancy:
- Mothers who have inadequate prenatal care
- Abnormal placenta
- Low weight gain during pregnancy
- Maternal age under 20 years old
- Anemia
- History of infections like sexually transmitted diseases or a urinary tract infection
- History of drug use, smokingor alcohol use during or after pregnancy
Several factors increase a baby's risk of Sudden Infant Death Syndrome.
- Low birth weight infants
- Premature infants
- Sex of the baby-boys have a higher incidence of SIDS
- Race: African American, American Indian or Native Alaskan babies have a higher risk for SIDS
- Babies who sleep on their stomachs
- Babies used to sleeping on their back are switched to sleep on their stomachs
- Secondhand smoke
- Baby's age Increased vulnerability to SIDS when they are 1 to 6 months old with the peak time during 2-3 months of age.SIDS may occur up to one year of age.
- Overheating / over dressing your baby Increased risk of SIDS
- Evidence of a recent respiratory infections within four weeks of death was commonly revealed on autopsies
- Siblings of a baby who died of SIDS have a small risk of SIDS possibly linked to a genetic disorder.
2009 State of Nebraska Child Death Review Team Report:
| Sudden Unexpected Infant Death by Race/Ethnicity | Total | % |
| White | 16 | 69.6% |
| African-American | 5 | 21.7% |
| Native American | 2 | 8.7% |
| Asian/Pacific Islander | 0 | 0.0% |
| Total (N) | 23 | 100% |
| | | |
| Hispanic Ethnicity | 2 | 8.7% |
| Sudden Unexpected Infant Death | Total | % |
| Male | 15 | 65.2% |
| Female | 8 | 34.8% |
| Total (N) | 23 | 100% |
Sleep-Associated Death Risk Factors | Total | % |
| Prenatal or postnatal smoke exposure | 16 | 64% |
| Age–inappropriate sleep surface | 15 | 60% |
| Found on side or stomach | 13 | 52% |
| Bed–sharing | 12 | 48% |
| Bedding–related issues | 11 | 44% |
| Put to sleep on side or stomach | 9 | 36% |
| Current/recent respiratory infection | 9 | 36% |
| Prenatal drug exposure | 3 | 12% |
| No known risk factors | 0 | 4% |
Definitions for above risk factors
- Prenatal or postnatal smoke exposure: 64% of infants had documented exposure to tobacco smoke either while mom was pregnant or after infant was born.
- Age inappropriate sleep surface: 60% of infants were sleeping in or on something other than a safety-approved crib, playpen or baby bed.
- Found on side or stomach: At time of death, 52% of infants were positioned on his/her side or stomach.
- Bed sharing: At the time of death, close to half of infants, 48%, were sleeping with an adult or other child.
- Bedding-related issues include: blankets and/or sheets found over the infant's head or around their mouth or nose, stuffed animals in the bed, or having been placed on a pillow etc. 44% of babies has bedding-related issues at the time of death.
- Put to sleep on side or stomach: 64% of infants were reported to have been found on their backs. 36% of babies were found on side or stomach.
- Current/recent respiratory infection: 36 % of infants were reported to have a current or recent (within the past 2 weeks) respiratory infection. Respiratory infection is a likely contributor to impaired breathing.
- Prenatal drug exposure: 12 % of babies had prior drug exposure during pregnancy before they were born.
Researchers use the Triple-Risk Model for examining Sudden Infant Death Syndrome (SIDS). The Triple-Risk Model defines three conditions, that when combined, may lead to a death from SIDS.
Critical Development
During the baby's first 6 months of life, there is rapid change and development in the brain. This growth may be evident like the sleep and awake patterns, or very subtle changes may be seen like changes in respiration, blood pressureor temperature. The peak incidence of SIDS occurs between 1 – 4 months of age; 90% of cases occur before 6 months of age. Babies continue to be at risk for SIDS up to 12 months.
Vulnerable Infant
Many of the babies that die of SIDS have had some form of upper respiratory infection in the prior 4 weeks. Babies born early (premature) are at a higher risk. Research shows that at the time of death, some SIDS babies have decreased levels of serotonin. An underlying brain abnormality may also make the baby vulnerable.
Outside Stressors
Most babies can survive environmental stressors like second hand smoke, over-heating, and sleeping on their stomachs. However, babies that are vulnerable may not be able to overcome these outside stressors. “Although these stressors are not believed to single-handedly cause infant death, they may tip the balance against a vulnerable infant's chances of survival."(5)
All three conditions of the Triple Risk Model need to be present for SIDS to occur:
- Undetected vulnerability in the baby
- The baby is in a critical developmental period of growth
- Outside stressors are present
Risk reduction means removing as many challenges from the baby's environment as possible during their first year of life. Position the baby on their back to sleep or remove second hand smoke. Eliminating one or more of the outside stressors can reduce the risk of SIDS.
Protective Factors
Researchers have discovered some protective measures you can take to help protect your baby from SIDS. Breastfeeding and a safe sleep environment can help.
What does a safe sleep environment look like? On their back, in their own crib, every time. Print Safe Sleep Environment.
Breastfeeding studies have shown a decreased incidence of SIDS in breastfed babies. Breastfeeding is the normal way of providing babies with the nutrition needed for healthy growth and development. “Virtually all mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system and society at large".(6) The World Health Organization recommends breastfeeding exclusively for the first 6 months of life, with continued breastfeeding along with doctor recommended baby food up to two years of age or beyond. Breastfeeding reduces the risk of hospitalization with gastrointestinal and respiratory infections.
A meta-analysis of 23 studies published up to 1997 examining the relationship between SIDS and breastfeeding found the overall risk of SIDS twice as great for formula fed infants compared with breastfed infants. Infant sleep studies have shown that breastfed infants are more easily aroused than formula-fed infants, which may be a mechanism for the protective effect of breastfeeding against SIDS.(7)
Breast-feeding reduces the risk for sudden infant death syndrome (SIDS) by approximately 50% at all ages throughout infancy. Exclusive breast-feeding at age 1 month was associated with half the risk for SIDS. Both partial breast-feeding and exclusive breast-feeding were linked to a reduced risk for SIDS. Ever breastfeeding was associated with a reduced risk of SIDS.
The advice to breastfeed should be included as a prevention measure.Mothers need to be cautious about breastfeeding in bed or any situation where you may fall asleep while breastfeeding your baby. Always place the baby back in his or her crib or bassinet after breastfeeding.(8) On their back, in their own crib, every time.
Documents used in the development of this content:
- About Sudden Unexpected Infant Death and Sudden Infant Death Syndrome. Centers for Disease Control and Prevention. [Online] 07 07, 2014. About SUID and SIDS
- Safe to Sleep. National Institute of Child Health and Human Development. [Online] 07 07, 2014. [Cited: 07 07, 2014.] NICHD
- Sudden Infant Death Syndrome (SIDS). KidsHealth. [Online] [Cited: 07 07, 2014.] Kids health
- SIDS Risk Factors and Causes of SIDS. SIDS America . [Online] [Cited: 07 07, 2014.] SIDS America
- Research on Possible Causes of SIDS. Safe to Sleep Public Education Campaign. [Online] 09 23, 2013. [Cited: 07 09, 2014.] NICHD
- Safe Sleeping Recommendations from the American Academy of Pediatrics
- Fern Hauck, MD, MS, et al. Breastfeeding and Reduced Risk of Sudden Infant Death Syndrome: A Meta-analysis. Pediatrics. July 1, 2011, 2011, Vol. 128, 1
- World Health Organization. Health Topics Breastfeeding.07/10/1
FAQs
Prenatal/pregnancy factors:
What are the risk and protective factors associated with SIDS? ›
The main risk factors identified were the presence of soft objects in the crib (93.6%) and bed sharing (58.7%). Predominant protective factors were breastfeeding (95.2%) followed by updated immunization (90.5%).
What are the three SIDS factors? ›
A triple risk model for the sudden infant death syndrome (SIDS) as described by Filiano and Kinney involves the intersection of three risks: (1) a vulnerable infant, (2) a critical developmental period in homeostatic control, and (3) an exogenous stressor(s).
What protects babies from SIDS? ›
The safest sleep position is on the back. Babies who sleep on their backs are at lower risk for SIDS than babies who sleep on their stomachs or sides. If baby usually sleeps on their back, putting them on the stomach or side to sleep, like for a nap, increases the risk for SIDS by up to 45 times.
What are 3 physical factors associated with SIDS? ›
Infant factors that have been associated with increased SIDS risk include low birth weight, low Apgar scores, recent viral illness, Native American or African American ancestry, and male sex.
Who is most vulnerable to SIDS? ›
Most deaths happen during the first 6 months of a baby's life. Infants born prematurely or with a low birthweight are at greater risk. SIDS also tends to be slightly more common in baby boys. SIDS usually occurs when a baby is asleep, although it can occasionally happen while they're awake.
When is SIDS no longer a risk? ›
SIDS is less common after 8 months of age, but parents and caregivers should continue to follow safe sleep practices to reduce the risk of SIDS and other sleep-related causes of infant death until baby's first birthday. More than 90% of all SIDS deaths occur before 6 months of age.
When can you stop worrying about SIDS? ›
After 6-months old, babies are typically able to lift their heads, roll over, or wake up more easily, and the risk of SIDS decreases dramatically. However, 10% of SIDS happens between 6 and 12 months of age and safe sleep recommendations should be followed up to a baby first birthday.
Can you stop SIDS while it's happening? ›
Even though the thought can be deeply unsettling, experts agree that there aren't any warning signs for SIDS. And since SIDS isn't diagnosed until after an infant has died and the death has been investigated, you can't catch SIDS while it's happening and stop it, for instance, by performing CPR.
Can you 100% prevent SIDS? ›
While there's no way to completely prevent SIDS, one thing you can do to lower your baby's risk is to make sure they see their healthcare provider for all of their routine well-baby care visits. At these appointments, your baby's provider will make sure your baby is healthy and developing as expected.
It may be because babies don't sleep as deeply when they have a pacifier, which helps wake them up if they're having trouble breathing. A pacifier also keeps the tongue forward in the mouth, so it can't block the airway.
What reduces the probability of SIDS? ›
Here's how parents can help reduce the risk of SIDS and other sleep-related deaths: Get early and regular prenatal care. Place your baby on a firm, flat mattress to sleep, never on a pillow, waterbed, sheepskin, couch, chair, or other soft surface. Cover the mattress with a fitted sheet and no other bedding.
Why does room sharing reduce SIDS? ›
Goodstein said, when babies sleep in the same room as their parents, the background sounds or stirrings prevent very deep sleep and that helps keeps the babies safe. Room sharing also makes breast-feeding easier, which is protective against SIDS.
What is the triple risk factor for SIDS? ›
According to the Triple Risk Model,9,10,11,12 SIDS can occur when three elements come together: an infants critical development period, a vulnerable infant and exogenous stressors.
Are there any warning signs of SIDS? ›
What are the symptoms? SIDS has no symptoms or warning signs. Babies who die of SIDS seem healthy before being put to bed. They show no signs of struggle and are often found in the same position as when they were placed in the bed.
Which of the following is a risk factor for SIDS? ›
Risk factors for SIDS include: placing a baby on his side or stomach to sleep, rather than on his back. premature or low birth weight babies. overheating the baby during sleep.
What is SIDS risk? ›
Who Is at Risk for SIDS? Most SIDS deaths happen in babies between 1 and 4 months old, and cases rise during cold weather. Babies might have a higher risk of SIDS if: their mother smoked, drank, or used drugs during pregnancy and after birth.
Which of the following is a risk factor for SIDS Quizlet? ›
Rationale: Factors that increase the risk of SIDS include infant prematurity, infant exposure to smoke, co-sleeping, and a family history of SIDS.
What are the risk factors for SIDS Pubmed? ›
The potential factors that contribute to the occurrence of SIDS include inadequate prenatal care, low birth weight (<2499gr), premature infants, intrauterine growth delay, short interval between pregnancies and maternal substance use (tobacco, alcohol, opiates).
