Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
There is currently no way to predict which infants are at risk for SIDS. SIDS has been linked to certain risk factors. Therefore, eliminating or preventing these factors has reduced the risk of SIDS for many infants.
Sleep position and the local sleep environment:
Educate babysitters, day-care providers, grandparents, and everyone who cares
for your baby about SIDS risk and the importance of observing the advice
offered in the "Back to Sleep" campaign.
Back to sleep: You should place your baby on his or
her back to sleep at night and nap time.
You should avoid fluffy, loose bedding in your
baby's sleep area.
Keep your baby's face clear of coverings.
Be careful not to overheat your baby by
overdressing or adding unnecessary covers.
Don't allow anyone to smoke around your baby.
Use a firm mattress in a safety-approved crib. Avoid the use of infant positioning devices.
Do not allow your baby to sleep alongside another
person. The risk of unintentional smothering is too great.
Keep all "well-child" appointments with your health-care provider, including immunizations.
Home monitoring: The use of home cardiorespiratory monitoring for infants perceived to be at risk of SIDS is still controversial. Doctor-prescribed monitors are available that sound an alarm if the baby's breathing or heartbeat stops. The transthoracic electrical impedance monitors are by far the most frequently used and have the widest availability in the United States. These documenting event monitors detect the respiration and heart activity by using three electrodes. In case of breathing irregularities or decreased heart activity, the device gives off an audible and/or visual alarm. The choice of electronic monitor may measure heart rate, respiratory rate, and pulse oximetry (blood oxygen saturation), or any combination of these three parameters. The information recorded should be downloaded periodically and examined by a doctor.
Current studies still echo the National Institutes of Health Consensus Report on SIDS. To date, no reports scientifically
demonstrate the effectiveness of home monitoring for siblings of SIDS
victims (babies born after a family has had a child die of SIDS).
Currently, certain guidelines exist for use of home
Infants with one or more life-threatening
episodes in which the baby turned blue or became limp requiring
mouth-to-mouth resuscitation or vigorous stimulation
preterm infants with apnea of prematurity
Infants with certain diseases or conditions that
include central breathing irregularities
If families have questions related to the use of home monitors, they should seek assistance from their child's primary medical-care provider.
Recent studies have evaluated the effect of back sleeping on an infant's motor
development. Babies younger than 1 year of age who slept on their backs showed
slightly decreased upper trunk strength as reflected in mild delays in their
ability to crawl, sit upright unassisted, or pull to stand.
However, it is important to emphasize that face-up sleepers still attained these milestones within the accepted time range for normal development. No significant difference in gross motor development was seen by the time either infant group started to walk.
Parents should incorporate a certain amount of tummy time while the infant is awake and observed. This type of play while baby is on his or her tummy is recommended for developmental reasons and may also help to prevent flat spots (plagiocephaly) from developing or persisting on the back of the head.
Sudden infant death syndrome (SIDS) is defined as the sudden death of an infant younger than 1 year that remains unexplained after a thorough case investigation, including the performance of a complete autopsy, examination of the scene of death, and review of the clinical history.