Sudden Infant Death Syndrome is the sudden, unexpected and unexplained death of a seemingly healthy baby less than 1 year old. SIDS is sometimes called crib death because it usually occurs when babies are asleep in their cribs. SIDS is a silent killer.

About 2,300 babies die of SIDS each year in the US. It is the most common cause of death in babies between the ages of 2 weeks to 1 year. It most often occurs in babies between 2 months and 4 months old. It occurs more often in African American and Native American babies than in Caucasian babies and is slightly more common in boys than in girls.

SIDS doesn’t have any recognizable symptoms. It happens to babies that appear healthy. A diagnosis of SIDS is one of exclusion. The diagnosis is generally made if no clear cause of death can be determined after a thorough investigation that includes an autopsy.

There are certain factors that increase a baby’s risk of dying from SIDS. The most important is laying down a baby to sleep on the stomach or side rather than the back. Other factors that increase risk include:

• A family history of SIDS.
• Being overheated with blankets or a high room temperature.
• Co-sleeping (sharing a bed with a parent or caretaker).
• Having a mattress that’s too soft.
• Having soft objects in the crib, such as stuffed toys, bumper pads, quilts and pillows
• Being born prematurely or having a low birth weight.
• A mother younger than 20 years old.
• A mother who received inadequate or no prenatal care.
• A mother who smoked, drank alcohol or took drugs during pregnancy.
• Exposure to secondhand smoke.

The cause of SIDS is unknown but researchers are studying certain theories. Many believe that SIDS is related to a baby’s inability to arouse from sleep when not getting sufficient oxygen from breathing. As a result, carbon dioxide builds up in the bloodstream. A high level of carbon dioxide can lead to death. Some researchers believe this occurs because the center in the baby’s brain that controls arousal is not fully developed.

The proposed “Triple-Risk Model” suggests that three factors combine to cause SIDS. This theory holds that SIDS occurs when an underlying brain abnormality and a triggering event, such as a poor sleep position (sleeping on the stomach), occur during a vulnerable stage in a baby’s development, essentially the first six months of life.

It may be frightening to know that there’re no symptoms to be alert for and no clear cause of SIDS, so there’s no way to prevent it from happening. But there are some tips for reducing a baby’s risk for SIDS. These include:

• Lay your baby on his or her back when putting him or her down for a nap and at night.
• Avoid overheating your baby. Don’t tightly swaddle your baby in a blanket and keep the room temperature at a level that’s comfortable for a lightly clothed adult.
• Don’t co-sleep with your baby or let your baby sleep with other children or adults.
• Choose a firm, safety-approved crib mattress and use a fitted sheet.
• Keep toys, bumper pads, fluffy blankets, quilts and pillows out of the crib when the baby is sleeping.
• Don’t smoke, drink or take drugs while pregnant and if breastfeeding.
• Get proper prenatal care during pregnancy.
• Don’t let anyone smoke around your baby.
• Set up your baby’s sleep area close to you but separate from your bedroom or those of other children.

In addition, make sure everyone who cares for your baby – including grandparents and other relatives, babysitters and friends – knows these recommendations. And consider sharing these tips with other parents and caregivers of infants.

Patti DiPanfilo

According to the Centers for Disease Control and Prevention, birth defects affect one in every 33 babies born in the US, which is about 3 percent of all babies. The CDC also reports that birth defects are the leading cause of infant death in the US, accounting for 20 percent of all infant deaths. This blog takes a closer look at birth defects and offers a few strategies to prevent them.

A birth defect is a problem that forms when a baby is developing in the womb, so it is present at birth. Every 4½ minutes, a baby is born with a birth defect in the US. A birth defect can affect how the baby’s body looks, works, or both. Some birth defects are relatively harmless and require little or no treatment. Others require immediate surgery and a lifetime of care.

The March of Dimes notes that birth defects can occur at any time during a woman’s pregnancy, but most happen during the first three months, or the first trimester. During that time, the baby’s organs are developing. But birth defects can occur later in pregnancy as well as the organs continue to grow and develop.

In many cases, birth defects are the result of genetics, as mutated genes get passed from the parents to the baby. The mother’s behavior during pregnancy, such as smoking, using illicit drugs, or drinking alcohol; exposure to certain medications or toxic chemicals; having certain types of infections during pregnancy, including sexually transmitted infections; or a combination of these factors, can also lead to birth defects. The cause of some birth defects is unknown.

Being 34 years old or older may put you at an increased risk for having a baby with a birth defect, as can having certain health conditions such as diabetes, high blood pressure and seizure disorders.

Birth defects can be structural or developmental. Structural defects include conditions involving body parts that are missing or malformed. Common structural birth defects include:

• Heart defects – The walls, valves, or blood vessels of the heart form abnormally. This affects how well the heart can pump blood through the body.
• Cleft lip and cleft palate – If the tissues of the roof of the mouth or lip don’t merge properly during development, an opening or split can result.
• Spina bifida – This is a neural tube defect, which involves the brain and spine. With spina bifida, the spine does not form and close properly, affecting the spinal cord and nerves.
• Clubfoot – A shortened Achilles tendon causes the foot to point inward and under instead of forward.
• Sickle cell disease – The normally round red blood cells are shaped like sickles or crescent moons. These sticky cells get stuck in the small blood vessels, which blocks blood flow and oxygen delivery to organs and tissues.

Down syndrome is a common developmental birth defect. Down syndrome, in which an extra chromosome 21 is present, causes delays in physical and mental development. Another developmental birth defect is cerebral palsy. This condition is most often caused by abnormal brain development before birth. It affects movement, balance, and posture.

Some birth defects can be detected during pregnancy using prenatal ultrasound. Your doctor may employ a more sensitive test such as amniocentesis or chorionic villus sampling (CVS) to look for birth defects before your baby is born. Most birth defects can be positively diagnosed through a physical exam and newborn screening test after birth, but some defects are not detectable until the child is older.

If something is detected on your baby’s newborn screening test, more in-depth testing, called diagnostic testing, will be needed to determine if there’s a problem. If the diagnostic testing is positive for a defect, your doctor will guide you through the next steps. When a birth defect, such a heart defect, is found early, it can often be treated and more serious problems can be prevented.

Not all birth defects can be prevented, but there are steps you can take before and during pregnancy to reduce the risk. The CDC suggests that women Commit to Healthy Choices to Help Prevent Birth Defects. Here are some of the CDC’s tips:

• Manage health conditions, such as diabetes and high blood pressure, and adopt healthy behaviors, including quitting smoking and stopping alcohol, before becoming pregnant. Continue these behaviors during pregnancy.
• Strive to reach and maintain a healthy weight. Women who are obese before pregnancy are at a higher risk for complications during pregnancy. Obesity also increases the risk of several serious birth defects.
• Take 400 micrograms of folic acid every day one month before and during pregnancy. Folic acid can help prevent major birth defects of the developing brain and spine.
• See your health care provider regularly when planning a pregnancy and begin prenatal care as soon as you suspect that you are pregnant. Be sure to tell your provider about any medications that you are taking.
• See your provider regularly throughout your pregnancy. Talk to your provider about any vaccinations you may need. The flu vaccine and the Tdap (tetanus, diphtheria and pertussis) vaccine are specifically recommended during pregnancy to protect women against infections that can cause birth defects.