SIDS: Back sleeping, breast feeding save lives

Babies are popping out of my friends like popcorn! Even my friends who swore they would never have children now own minivans filled with car seats complete with puke, toys, and diapers.

When I was a medical student (circa 1991), I had a two-week rotation in the newborn nursery. They had a rule, “If you find a baby with a dirty diaper, you have to change it.” Having never changed a diaper in my life, my first experience was like an I Love Lucy episode. I didn’t know baby poop could go everywhere in two seconds flat. I looked like an extra in Willy Wonka and the Chocolate Factory. But in just one day, I became a proficient diaper changer, and when they were all clean, I’d put them on their tummies to sleep.

Was positioning the babies on their tummies dangerous?

In 1992, the American Academy of Pediatrics (AAP) strongly recommended putting all babies on their backs to sleep. Since that recommendation, the incidence of Sudden Infant Death Syndrome (SIDS) has dropped dramatically in the U.S.

SIDS is the number-one cause of death in infants one to twelve months of age in the US. This tragic syndrome occurs in fewer than one per 1,000 live births. The majority of SIDS cases occur before six months of age.

African Americans and American Indian/Alaskan native children are two to three times more likely to die of SIDS.

There is no known cause of SIDS. Infant deaths are considered unexplained after a thorough investigation that includes autopsy, examination of the death scene, and a clinical history.

Premature babies and babies with a low birth weight are at higher risk for SIDS. Mothers who smoke during or after pregnancy add risk to their babies for SIDS. Alcohol and drug use are bad for the baby in every respect as well as increasing the risk of SIDS. Pregnant ladies who don’t get prenatal care or who start prenatal care late in pregnancy have babies with increased risk of SIDS.

Though the incidence of SIDS has gone down in the past 20 years, suffocation, accidental strangulation, and entrapment have all increased. Therefore, on October 13 of this year the Academy updated its guidelines that nothing should be in the crib with the baby. No pillow, blankies, loose beddings, toys, wedges or positioners. Nada. Even bumper pads increase the risk of suffocation, strangulation, and entrapment.

Babies should be bundled up without covering the head to avoid overheating. They should not sleep by a heater, radiator, or in direct sunshine. They should always be placed on a firm surface to prevent suffocating in creases and crevices such as in a comfy sofa. Car seats and other sitting devices are discouraged for routine sleep.

It seems every parent I know has a home monitor or some commercial device, but the Academy doesn’t recommended them. They do recommend having the baby sleep in the same room as the parents– not in the parents’ bed, but his or her own crib– for the first six months.

To prevent a flat head, “Tummy Time” is recommended once a day while the baby is awake and fully supervised.

So what’s a mom to do for her baby? Breast-feed!

Everything I read shows the incredible benefits of mother’s breast milk for the infant, and breast-feeding has been shown to decrease the risk of SIDS. Immunizations have also been shown to decrease SIDS by 50 percent.

SIDS is a horrible tragedy. I can’t imagine going through it. I hope all new babies are healthy and stay safe and grow up to be loving, caring, open-minded people.
Dr. Hook cracks a joke or two, but he’s a respected physician with an interesting website, Email him with your questions!