00:01
Now, we'll cover sudden infant
death syndrome, or SIDS.
00:05
sudden infant death syndrome is the
unexplained death, usually during sleep,
of a seemingly healthy
baby less than a year old.
00:12
It's sometimes known as crib death because
the infants often die in their cribs.
00:16
There are some infant risk factors
and maternal risk factors
that contribute to SIDS.
00:21
First, boys.
00:22
They're more likely to suffer from SIDS.
00:24
This happens more often in babies
in the 2nd-4th month of life,
and non-white babies are more likely.
00:31
If there's a family history
of a sibling dying of SIDS,
this puts the other siblings
at an increased risk.
00:38
Babies who are exposed to secondhand smoke
and babies who are born early are
also at increased risk for SIDS.
00:44
Now, there are some maternal risk
factors that also contribute.
00:47
If the mother is < 20 years old, if she
smokes cigarettes, uses drugs or alcohol,
or has inadequate prenatal
care, this can contribute.
00:57
So what causes SIDS?
Well, we don't really know.
01:00
The etiology is unknown.
01:01
It's a combination of physical
and sleep environmental factors
that can make an infant
more vulnerable to SIDS.
01:07
These factors can vary from child to child.
01:10
Here are the physical factors.
01:12
We know that babies who have brain
defects, are born at a low birth weight,
and have current respiratory infections
are more likely to suffer from SIDS.
01:21
Combine that with some sleep
environmental factors,
such as babies who sleep
on their stomach or side,
babies who sleep on a soft surface,
babies who share a bed or co-sleep,
or babies who get too warm and
overheat while they sleep.
01:33
You can combine these genetic risk
factors and the maternal risk factors,
and this gives you a vulnerable infant.
01:40
These babies have impaired
autonomic regulation
and this is what controls the
breathing rate and the heart rate.
01:46
If the baby's also at an at-risk age
group, remember 2 month-4 month olds,
and you add in some environmental risk
factors, such as their sleep position,
co-sleeping, increased heat, and head covering,
this puts the baby more
likely to suffer from SIDS.
02:02
So what's happening during SIDS?
Well, the baby becomes apneic.
02:06
They go into respiratory failure.
02:08
They completely stop breathing and then
this causes cardiovascular failure.
02:13
And when these babies are found,
there's a bit of a paradox.
02:16
The baby is observed to be
clean and well-cared for,
and they look like they're in
an excellent state of health,
development, nutrition, and hydration.
02:25
Externally, on the post-mortem exam, you
may note moderate amounts of cyanosis.
02:30
This is blue discoloration of the skin.
02:32
The baby may have a mucoid fluid
in their mouth and nostrils.
02:35
This is seen in about 50% of the cases.
02:38
And usually, the babies are
found with a soiled diaper.
02:41
Internal findings.
02:43
The baby may have intrathoracic petechiae,
and these are those small,
pinpoint hemorrhages.
02:47
And those are observed more
consistently in SIDS cases
than in any other cases at this age.
02:53
The baby may have pulmonary
congestion and edema,
and inflammation of the upper
respiratory tract because,
remember, upper respiratory
infections increase the risk.
03:02
So, how do we diagnose SIDS?
Well, SIDS is the diagnosis of exclusion,
that means we've ruled out other things.
03:08
And this combines information
from the post-mortem exam,
assessment of the scene, and interviews
with the parents and caregivers.
03:16
So how do we prevent SIDS?
This is all about prevention.
03:20
It's key that the baby sleeps alone.
03:23
We don't want babies exposed
to secondhand smoke,
and the baby should not have any
pillows, stuffed animals, toys,
or a bumper pad in their
surrounding environment.
03:32
If the baby has a blanket,
it should be tucked in and only
as high as the baby's chest.
03:38
The blankets should not be heavy
and they should not be loose.
03:41
The crib sheet should be pulled
tightly over the mattress and,
the mattress should be firm.
03:47
The baby should be in a safe
infant bed, not too hot,
and always put to sleep on their back.
03:54
The foot of the baby should
be to the foot of the bed.