THE SICK BABY AND CHILD: SUDDEN INFANT DEATH SYNDROME (SIDS) CAUSE AND CLINICAL FEATURES
Sudden infant death syndrome is the name given to the phenomenon of the unexpected and unexplained death of a baby. This usually occurs when the baby is between the ages of 1 and 6 months, and is rare beyond 1 year of age. The typical circumstances are mat an apparently normal baby is put to bed in the evening and is found dead in the cot during the night or in the morning (hence the alternative and previously used term ‘cot death’). There is usually no indication that anything was wrong, and no sign during the night that the baby was distressed or that anything was remiss. In some instances a parent is sleeping in the same room, but hears nothing. The death apparently occurs very rapidly. Sometimes the baby will have had a very mild cold in the days prior to the death.
SIDS affects about 1 in every 500 infants, although the incidence has dropped in the past few years all over the world. It is generally more common in winter, in colder climates, in families from lower socio-economic groups, and in babies who have been born very prematurely.
Cause
The exact cause of SIDS is unknown, despite an enormous amount of research. There have been literally dozens of theories advanced over the years, but none have been found to explain adequately why an apparently normal baby dies suddenly. The most common theories have been to do with the possible role of viral infections, the immaturity or vulnerability of the baby’s breathing control centre, or the erratic control or regulation of the baby’s sleep patterns. It is likely that SIDS is due to a number of different causes, one or more of which may be responsible in an individual case.
Clinical features
There are no specific features, before the death or afterwards, that either predict the event or explain why it happened. In about half the cases parents report a mild cold — perhaps a snuffly or runny nose or mild fever — in the days preceding the event, but in most instances this has been so mild that they have not been concerned enough to seek medical attention. Some have been seen just before the event by a doctor or community nurse, and the parents have been assured that all is going well.
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