Sudden Infant Death Syndrome is defined as the “sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history” (Willinger et al., 1991).
Newborns under one year of age are at risk for SIDS. Most deaths occur between two and four months of age, but the risk is present for the first year of life.
A death is diagnosed as SIDS only after all other alternatives have been eliminated: SIDS is a diagnosis of exclusion. Before a SIDS death is diagnosed, a thorough investigation takes place. This usually includes an autopsy, death scene investigation, and a review of the family and infant medical history.
SIDS cannot be predicted or prevented. No doctor, parent, or child care provider can predict if an infant will die of SIDS. SIDS is not caused by suffocation, vomiting, or choking. A SIDS case is not a case of injury, abuse, or neglect.
In the United States, SIDS is one of the leading causes of infant mortality and the leading cause of postneonatal (28 to 364 days) mortality. Each year, approximately 3,000 infants die of SIDS. Connecticut has experienced a recent decline in SIDS rates from a rate of 0.90 (per 1,000 live births) in 1994 to 0.44 (per 1,000 live births) in 1997. Experts believe that this decline can be attributed to the national “Back To Sleep” Campaign launched in 1994 by the National Institute of Child Health and Human Development.
Since the “Back To Sleep” campaign was initiated in 1994, SIDS rates have dropped over 40 percent nationwide.
“Back To Sleep” is a national, public education campaign encouraging health care providers and the public to put infants to sleep either on their backs or their sides. After the campaign was launched, further research indicated that the back position was the optimal sleep position for infants and the best protection against SIDS. Consequently, in 1996 the American Academy of Pediatrics (AAP) supported the back sleeping position because of an associated lower risk for SIDS.
It is important to recognize that SIDS deaths can occur in any family and across all racial, ethnic, and socioeconomic groups. However, while SIDS crosses all racial and ethnic boundaries, data indicate that African American infants are about two times more likely than Caucasian infants to die of SIDS. Native American infants are about three times more likely to die of SIDS. These trends are evident both nationally and in Connecticut. More boys are SIDS victims than girls. The male to female ratio of SIDS deaths is 60-to-40.
More deaths are reported in the fall and winter months, possibly due to overbundling and overheating of the infant.
Research suggests that the majority of SIDS deaths occur in the early morning. In most cases, SIDS deaths occur during sleep, and there is usually no sign of the infant having struggled. SIDS deaths are also associated with no signs of pain or suffering