Cot death: Everything you need to know about SIDS (sudden infant death syndrome)

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  • Sudden Infant Death Syndrome, which is commonly referred to as SIDS or 'cot death', is a worry that all parents tend to have when they first bring a baby home.

    Mainly affecting infants in the first six months of their lives, SIDS or ‘cot death’ kills just under 300 babies in the UK every year. It’s characterised by the sudden, unexpected and unexplained death of an apparently healthy baby.

    A baby’s safety in bed is one of parents’ primary concerns and this is mainly because of the risk of SIDS. It’s especially unnerving as the exact cause of SIDS is unknown currently, but research suggests that the condition is slightly more common in baby boys and premature babies are at a higher risk.

    There are also no symptoms that parents can look out for, but there are a few guidelines they should be aware of on what measures to take to avoid SIDS and lower the risk to their child.

    Ways to help prevent cot death

    The Lullaby Trust, a charity that specialises in expert advice on safer baby sleep and raises awareness on sudden infant death, has a handy video that outlines the do’s and dont’s of keeping your baby safe while sleeping.

    Thankfully, enough is now known about sudden infant death syndrome for parents to dramatically reduce the risk. The following tips will help to reduce the risk of ‘cot death’ and put your mind at rest.

    1. Lie your baby down on their back to sleep.

    2. Place them ‘feet to foot’. Their feet should reach the end of the cot, with blankets to their chest and firmly tucked in bedding.

    3. Don’t let your baby overheat: never place a cot next to a radiator; don’t use a duvet or any headwear and keep your baby’s room between 16-20 degrees.

    4. Don’t smoke in pregnancy or around a young baby.

    5. Keep baby’s cradle or cot in your room for the first six months and ensure that it meets the UK’s cot safety guidelines.

    6. Use firm, flat mattress for your baby. No pillows, bean bags or water beds.

    7. Don’t fall asleep on an armchair or sofa with your baby – you might smother them.

    8. If your baby is unwell, contact your doctor promptly.

    9. Keep your baby’s head uncovered, don’t tuck their blanket too high and make sure it’s never above their shoulders.

    10. Breastfeed if possible.

    What causes cot death?

    We don’t entirely know what causes Sudden Infant Death Syndrome (SIDS), often called cot death because the infants often sadly die in their cots. But we do know it’s the unexplained death of an infant, usually while they are sleeping. The babies are also often seemingly healthy and less than one year old.
    Dr Nauf AlBendar, Medical Scientist & founder of The Womb Effect says, “Although the cause is still unknown, evidence suggests that a combination of physical and environmental factors can make an infant more vulnerable to SIDS.
    “Researchers refer to the Triple-Risk Model to explain this concept. In this model, all three factors have to occur for an infant to die from SIDS. These are:
    • Being at risk: When the baby has an unknown problem such as having a defect in the portion of their brain that controls breathing, heart rate, blood pressure, temperature, and waking from sleep.
    • Being in a sensitive time of development: During the first 6 months after birth, infants go through many quick phases of growth that can change how well the body controls or regulates itself, as they learn how to respond to their environment.
    • Stressors in the environment: These can include sleeping on the stomach, overheating during sleep, having things in the cot that could interfere with breathing and exposure to second hand smoke.”

    So while the exact causes of SIDS have yet to be discovered, there are some things you can do to reduce the risk. This could include having a suitable and safe cot for your baby to sleep in the same room as you (you could also have them sleep in a good quality moses basket), and remove any extra items from their cot which could create a hazard.

    At what age does cot death stop being an issue?

    While having a young baby that could be vulnerable to SIDS is a worrying thing for parents, our expert Dr AlBendar says that infants are most vulnerable between the second and fourth months of life.

    She says, “It tends to decrease after 6 months, and it’s extremely rare after the age of one.”

    Are there any warning signs of SIDS?

    Unlike some other conditions which affect newborns in their first few months of life, there are not many obvious warning signs of SIDS. But Dr AlBendar tells GoodtoKnow, “There are some factors to consider such as the baby being low birth weight or preterm. This could increase the likelihood of its brain not having matured completely, thus having less control over automatic processes such as breathing and heart rate.
    “Respiratory infections is another which could contribute to breathing problems. And factors such as race and gender should be taken into account.”
    Our expert says the best way to help your baby to sleep more safely is by following the safety regulations for SIDS prevention, such as “placing the baby to sleep on his or her back and in the same room, keeping the cot as bare as possible and avoiding overheating the baby.”
    If you are worried about your baby, the best thing to do is to visit your GP or health practitioner who will be able to give more insight into the condition and offer solutions to other baby sleep problems.

    Is it okay to swaddle my baby?

    Credit: Getty

    Swaddling is a traditional practice of wrapping a baby in a blanket tightly, to keep them from moving too much during the night. Recent research has found that this could potentially be harmful, and a possible contributing factor to SIDs.

    Dr Anna Pease, lead author of a study at University of Bristol that looked into the causes of SIDs, said, “We tried to gather evidence of whether there was an association between swaddling for sleep and SIDS.

    “The risk of SIDS when placing infants on the side or front for sleep increased when infants were swaddled.”

    The current recommendation advises not placing your child on its side or front for sleep, and this would appear especially important if you have swaddled your baby.

    Anna advises parents that, “most babies start being able to roll over at about four to six months.

    “On a practical level what parents should take away from this is that if they choose to swaddle their babies for sleep, always place them on their back, and think about when to stop swaddling for sleep as their babies get older and more able to move.”

    Can co-sleeping with my baby increase the risk of SIDS?

    Bed sharing with your baby, otherwise known as co-sleeping, increases the risk of SIDS and the risk is particularly increased when:

    • Either parent smokes even if they don&’t smoke in the bedroom or anywhere in the house
    • Either parent has consumed alcohol or taken drugs (including medication that may make you drowsy)
    • The baby is premature
    • The baby was a low birth weight

    The safest place for a baby to sleep for the first six months is a separate cot or Moses basket in the same room as the parents.

    Will giving my baby a dummy reduced the risks of SIDS?

    baby with dummy

    Credit: Getty

    Dummies aren’t a means of prevention as such, but they are associated with a reduced risk of ‘cot death’. These recent findings are slightly confusing for parents, but basically mean that if your baby uses a dummy, they should carry on doing so.

    Experts don’t yet know why dummies help in babies who are used to them, but the statistics prove they do. And dummy-users who suddenly stop are at increased risk of SIDS.

    So if your baby has a dummy, be sure to use it every night. It’s thought that it may help by creating more air space if a baby’s face gets under a blanket. But this doesn’t wholly explain the difference between users and non-users, so there’s no reason for you to introduce a dummy as a means of prevention.

    On the whole, even the best quality sleep aids won’t prevent SIDS but ones such as black-out blinds and night lights could help your baby get a better night’s sleep without interfering with their sleeping space.

    Does formula increase the risk of SIDS?

    Although research has demonstrated that exclusively breastfeeding and even combination feeding (breast milk and formula) for up to four months can reduce SIDS risk by 40 per cent, Dr AlBendar says, “No, if you follow the safety regulations for SIDS prevention, then chances are extremely low.”

    So you can go ahead with formula feeding without worrying about an increased risk of SIDS.

    Seeking medical advice if your baby is unwell

    There are lots of minor illnesses that babies can suffer from that are absolutely nothing to be seriously worried about. But if your little one is showing some of the following symptoms you should dial 999 for an ambulance:

    • Stops breathing or turns blue
    • Struggling for breath
    • Unconscious and seems dazed
    • Won’t wake up
    • Has a fit

    The Lullaby Trust also has a helpful guide called the Baby Check booklet which includes a checklist of symptoms to help you understand if your baby is ill.

    If you are in any doubt about your child’s health, be sure to book an appointment ASAP with your GP or local health practitioner.

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