Sudden infant death syndrome (SIDS) - unexpected death in appearance healthy child under the age of 1 year as a result of respiratory arrest for an unexplained reason.

Description of sudden infant death syndrome

Cases of infant death due to unexplained causes have been repeatedly described in the medical literature, but SIDS was introduced as a post-mortem diagnosis only in the late 60s of the twentieth century.

Sudden death in a dream occurs due to various factors (the presence of developmental defects in the child, infectious diseases and injuries undetected by parents), but these factors can be identified by studying the history of the disease and an autopsy. When the research carried out does not allow us to explain the cause of the baby’s death, SIDS is indicated in the death certificate (this is a diagnosis of exclusion).

ICD 10 classifies sudden infant death syndrome as a class of conditions characterized as unspecified, arising from an unknown cause (code R95.0 with an autopsy indication, and code R95.9 without such an indication).

Analyzing the causes and risks of this phenomenon in children under one year of age, pediatricians around the world began to conduct campaigns in the 80s to help reduce the number of deaths in the cradle. Medicine is still not able to answer why sudden infant death occurs during sleep, but thanks to the recommendations of pediatricians, the number of cases of SIDS in the United States has dropped by half, and in Russia has decreased by 75%.

Statistics

Some researchers believe that the problem is an “achievement” of civilization, since the number of SIDS in developed countries is much higher than in third world countries.

An active search for the cause of the unexpected death of children has been carried out since the 80s, but general statistics are missing. According to studies from 1999 in some developed countries, per 10,000 children under the first year of life, there are:

• Germany – 8 cases;
• Italy – 10;
• Russia – 4;
• USA – 8;
• Sweden – 5.

Data changes every year; in developed countries, pediatricians and parents learn to prevent the death of children under one year old due to SIDS. Statistics over the years indicate a decrease in the number of deaths: in 1963 in Europe, the mortality rate of children from SIDS was 2-3 cases per 1000, by 2000 - 4 cases per 10,000.

Thanks to a careful study of tragic situations, some patterns have been established:

• In 90% of cases, sudden death of children occurred before reaching six months of age;
• SIDS is more common during the cold season;
• In 60% of cases, SIDS victims are boys;
• Sudden infant death syndrome is not associated with vaccinations.

According to the results of studies, sudden infant death in 92% of cases occurs in babies sleeping separately from their parents. The data is indirectly confirmed by statistics - unexplained deaths in infants in African and Asian countries, where traditional co-sleeping between mother and child is practiced, is detected 2 times less often than in Europeans, where a newborn usually sleeps alone.

Etiology

The death of a baby is always a tragedy, and parents do their best to prevent it by eliminating possible preconditions. Without knowing the cause of the phenomenon, it is impossible to exclude negative factors, and this instills panic in mothers of absolutely healthy children.

There are several hypotheses explaining the mechanism of SIDS, causes and risk factors. It is precisely established that the phenomenon arises as a result of a lack of synchronization of the respiratory and cardiovascular activities of the child’s organism, which is imperfect from the point of view of physiology. According to doctors, disorders develop:

1. As a result of an increase in the Q-T interval (this is the contraction of the ventricles of the heart and the ejection of blood from the ventricles into the aorta and pulmonary trunk, recorded by ECG). Physiological electrical instability is recorded in children under 6 months (the peak occurs at 2 months). An increase in the Q-T interval was detected in 30-35% of cases of sudden death of a child under one year of age.
2. Due to cessation of respiratory movements. Periods of sleep apnea (lasting 3-20 seconds) occur in many healthy babies. Due to such a delay, oxygen does not reach the brain; as a result of a long pause, the heart rhythm is disrupted. A significant increase in the interval between respiratory movements is usually observed in premature infants. When caring for such children, it is recommended to use a special device (breath recorder). It has an effect on the problem with the duration of apnea and maternal smoking.
3. Due to a deficiency of serotonin receptors (a neurotransmitter called the “happiness hormone”). Although the autopsy does not give a clear answer as to why the sudden death occurred, according to doctors, the causes of death may lie precisely in the lack of serotonin receptors in the area of ​​the brain responsible for the synchronous activity of the cardiovascular and respiratory systems.
4. As a result of imperfect thermoregulation observed in children under 3 months of age. The immaturity of a certain group of brain cells leads to instability of body temperature, so the slightest change in the microclimate in the bedroom can provoke overheating of the child and affect the activity of his cardiovascular and respiratory systems.

There are other hypotheses for the origin of SIDS - genetic (variations in the NOS1AP gene associated with the syndrome have been found), infectious (symptoms of some diseases are observed in children 1-2 weeks before the tragedy). The sudden death of a child in the cradle may be associated with compression of the vertebral artery, etc.

Risk factors

SIDS has not been studied enough, but thanks to the studies conducted, the following risk groups have been identified:

1. Children sleeping on their stomachs. Previously, due to the immaturity of the digestive tract and colic, pediatricians advised placing the baby on his stomach while sleeping. After a change in the official recommendation, the supine position became the norm for sleeping babies; “death in the crib” is 2 times less common in Western Europe and the USA.
2. Overheating and hypothermia during sleep. It is recommended to replace the baby blanket as a contributing factor to overheating with a specially designed overnight bag.
3. The likelihood of developing SIDS increases in babies whose crib has a soft base (the interaction of these factors has not been fully studied, but statistics confirm the presence of a high risk in this group).
4. A family history of the problem of causeless cardiac and respiratory arrest in the newborn's siblings.
5. Artificial feeding.
6. Prenatal stress.
7. Babies infected before the age of six months with human respiratory syncytial virus (which is a major factor in lower respiratory tract diseases in children younger age, epidemics in temperate climates often occur in winter).

The SIDS risk group also includes children born:

• premature;
• as a result of long (more than 16 hours) or complicated labor;
• after a short period (less than a year) after the previous birth;
• a mother with bad habits (smoking, drinking alcohol, drugs);
• in a woman who was not observed by a doctor during pregnancy, or the gestation period was accompanied by an infectious disease.

The high-risk group includes infants under 6 months, the maximum number of cases was recorded in children from 2 to 4 months. The likelihood of sudden infant death is present in babies under one year of age (the second dangerous age is the 9th month of life).

The death of a newborn in the first hours and weeks of life often occurs due to asphyxia, infections, malformations and birth injuries, and low birth weight (80% of cases).

Many women who survived the tragedy consider these factors questionable, since they were preparing for the birth of the baby, healthy image life, and the child had high Apgar scores. However, this only indicates insufficient knowledge of the interaction of risk factors and respiratory and cardiac arrest (the main cause of death among newborns).

An analysis of reports on sudden infant mortality for 2006-2008 shows that in each case of SIDS, the baby’s breathing stopped as a result of simultaneous exposure to four risk factors more often than one.

Prevention Methods

Prevention of SIDS begins before the baby is born: expectant mother should stop drinking alcohol, not smoke and follow the recommendations of the doctor monitoring her during pregnancy. Activities after the birth of the baby are reduced to eliminating possible risk factors and include:

1. Properly equipped sleeping place for the child. The mattress must be firm, the use of a pillow is not allowed, and toys should be removed from the crib while sleeping. It is recommended to replace the blanket with a sleeping bag, but if this is not possible, the child should be placed at the foot of the crib to eliminate the possibility of accidentally limiting oxygen access.
2. Correct baby position during sleep. Until the child has learned to roll over well on his own (this happens after 4-5 months, that is, during the period when the risk of SIDS decreases), he should be put to sleep on his back, and not on his side, and especially not on his stomach.
3. Maintaining optimal temperature conditions. The baby should not be overcooled or overheated; it should not be swaddled so as not to impair breathing.
4. Long-term continuation of breastfeeding (at least up to 4 months). According to statistics, the lack of milk in the mother and an early transition to artificial feeding often provokes the occurrence of SIDS.
5. Strengthening the immune system. For the full development of the baby, parents should carry out daily gymnastics, hardening and give the child a massage.
6. Eliminating harsh stimuli for a while baby sleep(loud sounds, intense smells, bright lights).

A mandatory preventive measure is for all family members not to smoke in the same room as the newborn baby. Tobacco smoke, even from passive smoking, passes into breast milk; a nursing mother should avoid inhaling it.

Let's look at it in detail:

Co-sleeping as a method of prevention

According to research, the likelihood of infant death is directly related to co-sleeping. These data are quite contradictory - according to statistics, the occurrence of SIDS is more often observed in those countries where the child sleeps alone (the baby’s crib can be in the parent’s room or in different rooms). But there is also evidence that co-sleeping is dangerous for babies. The researchers did not take into account the influence of other factors (parental smoking, prone position, pillow and soft mattress, etc.), did not provide convincing arguments, and simply stated an increase in cases depending on the mother and baby sleeping together.

Based on these data, it was concluded that the baby should sleep alone. To control your baby's breathing and heart rate, it is recommended to use a baby monitor. If it is not possible to purchase a device, the child is given a separate crib located near the mother’s bed.

Co-sleeping is allowed if parents have the opportunity to completely eliminate dangerous factors, properly arrange the child’s sleeping place and comply with the basic condition - the baby’s head should not be covered under any circumstances, even an adult’s hand prevents the flow of air.

Symptoms and first aid

Lack of breathing is the first and main symptom of SIDS. If it does not resume within 5 seconds, artificial respiration must be performed. The chest of a baby lying on his back should rise while air is blown.

The likelihood of SIDS cannot be predicted; the baby may die unexpectedly even if the recommendations are fully followed, so at least one parent should be able to provide first aid. If at some point the baby suddenly stopped breathing, and the actions of adults helped restore breathing, an ambulance must still be called.

Komarovsky about SIDS

Content

Sudden death occurs as a result of a fast-flowing latent or clinically pronounced painful condition. As medical practice shows, sudden death in adults often occurs due to acute coronary insufficiency, congenital or acquired cardiac and vascular pathologies. Find out what symptoms may indirectly indicate a hidden threat.

What is sudden death

According to international medical recommendations, a person’s death within 6 hours after the appearance of the first symptoms of a pathological condition is considered sudden. Instant death, or translated into English sudden death, occurs without a known cause. In addition, there are no morphological signs on the basis of which an appropriate diagnosis of the patient’s sudden death can be made at autopsy.

However, during a post-mortem examination of a person, a pathologist, having compared all available data, can make a logical conclusion about the instantaneous or violent death of the person. In most cases, instant death is supported by changes in organs in which continuation of life for the shortest period of time is impossible.

Causes of sudden death

Statistics show that the main cause of most deaths is heart disease: ischemic pathology, the onset of ventricular fibrillation. At the same time, when answering what causes instant death, experts often name chronic illnesses that occur in a latent form for a long time, after which they suddenly worsen and lead to the unexpected death of a person. One of these deadly diseases is cancer.

In most cases, oncology develops asymptomatically and makes itself felt when the patient is often considered hopeless. Thus, malignant liver disease is the main cause of unexpected deaths in China. Another insidious disease that can lead to sudden death is AIDS, which claims millions of lives in Africa every year. In addition, it is worth mentioning separately about Mexico. This is the only country in which cirrhosis of the liver occurs main reason high mortality rate of the population.

At a young age

Today, young men and women are exposed to the negative influence of modern lifestyle every day. From TV screens and the covers of fashion magazines, the cult of a slender (often dystrophic) body, accessibility and promiscuity is imposed on young people. Therefore, it is quite understandable that the mortality rate of people just beginning their life journey will increase over time. The main causes of instant death among boys and girls under 25 years of age are considered to be:

• alcohol;
• smoking;
• promiscuity;
• drug addiction;
• Not proper nutrition;
• psychological sensitivity;
• hereditary diseases;
• severe congenital pathologies.

In a dream

Unexpected death in this condition occurs due to the loss of special cells responsible for the contractility of the lungs. Thus, scientists from the USA were able to prove that people die in their sleep in most cases due to central sleep apnea. In this case, a person may even wake up, but still leave this mortal world due to oxygen starvation caused by a stroke or cardiac arrest. As a rule, elderly people are susceptible to this syndrome. There are no specific treatments for central sleep apnea.

Sudden infant death

This syndrome was first described in the early 60s of the last century, although cases of instant death of infants were recorded earlier, but they were not subjected to such a thorough analysis. Young children have very high adaptive abilities and incredible resistance to a variety of negative factors, therefore death infant is considered to be an exceptional situation. However, there are a number of external and internal reasons that can lead to sudden child death:

• prolongation of the Q-T interval;
• apnea (the phenomenon of periodic breathing);
• deficiency of serotonin receptors;
• overheat.

Risk factors

Due to the fact that the main cardiogenic cause of instant death is ischemic disease, it is quite logical to assume that the syndromes accompanying this heart pathology can be fully attributed to conditions that can increase the likelihood of sudden death. With all this, it has been scientifically proven that this connection is mediated through the underlying disease. Clinical risk factors for the development of clinical death among patients with ischemic syndrome are:

• acute myocardial infarction;
• post-infarction macrofocal sclerosis;
• unstable angina;
• heart rhythm disturbance due to ischemic changes (rigid, sinus);
• ventricular asystole;
• myocardial damage;
• episodes of loss of consciousness;
• damage to the coronary (heart) arteries;
• diabetes mellitus;
• electrolyte imbalance (eg, hyperkalemia);
• arterial hypertension;
• smoking.

How does sudden death occur?

This syndrome develops in a matter of minutes (less often hours) without any warning in the midst of complete well-being. In most cases, instant death affects young men aged 35 to 43 years. Moreover, often during the pathological examination of the deceased, vascular causes of sudden death are discovered. Thus, studying the increasing cases of instant death, experts came to the conclusion that the main provoking factor in the occurrence of this syndrome is a violation of coronary blood flow.

For heart failure

In 85% of cases, immediate death is recorded in individuals with structural abnormalities of the organ that pumps blood into the vessels. In this case, sudden cardiac death looks like a lightning-fast clinical variant of coronary artery disease. Medical practice shows that a quarter of people who died instantly, before the onset of primary symptoms bradycardia and episodes of asystole are observed. Death from cardiac arrest occurs due to the launch of the following pathogenetic mechanisms:

• Reducing left ventricular fractional ejection by 25-30%. This syndrome greatly increases the risk of sudden coronary death.
• Ectopic focus of automatism in the ventricle (more than 10 ventricular extrasystoles per hour or unstable ventricular tachycardia), arising as a consequence of ventricular arrhythmias. The latter mostly develop against the background of acute transient myocardial ischemia. An ectopic focus of automatism is usually classified as a risk factor for sudden arrhythmic death.
• The process of spasm of the blood vessels of the heart, which leads to ischemia and contributes to the deterioration of the restoration of blood flow to damaged areas.

It is worth noting that tachyarrhythmia is a particularly significant electrophysiological mechanism resulting in sudden coronary death in a person with heart failure. At the same time, timely treatment of this condition using a defibrillator with a modified pulse configuration significantly reduces the number of deaths among patients who have suffered sudden cardiac arrest.

From a heart attack

Blood enters the heart through the coronary arteries. If their lumen closes, the formation of primary foci of necrosis and ischemia in the heart occurs. Acute manifestation of cardiac pathology begins with damage to the vascular wall with further thrombosis and spasm of the arteries. As a result, the load on the heart increases, the myocardium begins to experience oxygen starvation, which affects its electrical activity.

As a result of a sudden coronary spasm, ventricular fibrillation occurs, a few seconds after which a complete cessation of blood circulation to the brain occurs. At the next stage, the patient experiences respiratory arrest, atony, and absence of corneal and pupillary reflexes. After 4 minutes from the onset of ventricular fibrillation and complete cessation of blood circulation in the body, irreversible changes occur in the brain cells. In general, death from a heart attack can occur in 3-5 minutes.

From a blood clot

In the venous bed, these pathological formations arise due to the uncoordinated work of the coagulation and anticoagulation systems. Thus, the onset of the appearance of a clot is caused by damage to the vascular wall and its inflammation against the background of thrombophlebitis. Perceiving the appropriate chemical signal, the coagulation system is activated. As a result, fibrin threads form near the pathological area, in which blood cells become entangled, creating all the conditions for the blood clot to break off.

In arteries, the formation of clots occurs due to narrowing of the vascular lumen. Thus, cholesterol plaques block the path of free blood flow, resulting in the formation of a lump of platelets and fibrin threads. It is important to note that in medicine a distinction is made between floating and mural thrombi. Compared to the first type, the latter has a slight chance of breaking off and causing a blockage (embolism) of the vessel. In most cases, the causes of sudden cardiac arrest from a blood clot are due to the movement of a floating thrombus.

One of severe consequences the separation of such a clot results in blockage of the pulmonary artery, which is expressed in severe cough, bluishness of the skin. Often there is a breathing disorder followed by cessation of cardiac activity. An equally serious consequence of the detachment of a blood clot is a violation of cerebral circulation due to embolism of the main vessels of the head.

Diagnosis of sudden death

A timely physical examination is the key to the success of further cardiopulmonary resuscitation (CPR) measures. Diagnosis of instant death is based on symptoms characteristic of the patient's natural death. Thus, absence of consciousness is determined if no external stimuli cause reactions on the part of the person being resuscitated.

Diagnosis of breathing disorders is noted when within 10-20 s. observation fails to detect coordinated movements of the sternum and the noise of the air exhaled by the patient. In this case, agonal breaths do not provide adequate ventilation of the lungs and cannot be interpreted as spontaneous breathing. During ECG monitoring, pathological changes characteristic of clinical death are detected:

• ventricular fibrillation or flutter;
• cardiac asystole;
• electromechanical dissociation.

Clinical manifestations

In 25% of cases, sudden death occurs instantly without any warning signs. Some patients, a week before clinical death, complain of various prodromal manifestations: increased pain in the sternum, general weakness, shortness of breath. It is important to note that today there are already methods for preventing heart attacks based on early diagnosis warning symptoms of this condition. Immediately before the onset of sudden death, half of the patients experience an anginal attack. Clinical signs of a patient’s imminent death include:

• loss of consciousness;
• absence of pulse in the carotid arteries;
• dilated pupils;
• lack of breathing or the appearance of agonal breaths;
• change in skin color from normal to gray with a bluish tint.

Medical care for sudden death

Typically, most cases of unexpected cardiac arrest occur outside the hospital. For this reason, it is extremely important to master the technique of providing emergency care in case of sudden clinical death. This is especially true for subjects of society who, due to their job responsibilities come into contact with a large number of people. Remember, competent resuscitation actions immediately in the first minutes after the onset of symptoms of cardiac arrest will help gain time until medical workers arrive.

Urgent Care

The main problem that arises in unconscious persons is obstruction of the airways by the root of the tongue and the epiglottis due to muscle atony. It must be said that this condition develops in any position of the body, and when the head is tilted forward, it develops in 100% of cases. Therefore, the first thing that needs to be done is to ensure proper airway patency. For this purpose, you need to use P. Safar’s triple technique, consisting of the following sequential actions:

1. Throwing back the head;
2. Moving the lower jaw forward;
3. Opening the mouth.

Once airway patency is ensured, you should proceed to artificial pulmonary ventilation (ALV). When providing first aid, this activity is carried out using the mouth-to-mouth method. So, one hand is placed on the victim’s forehead, while the other pinches his nose. Then the resuscitator fixes his own lips around the mouth of the person being revived and blows air, while controlling the excursion of the patient's chest. When it is visible, you need to release the victim’s mouth, giving him a chance to exhale passively.

At the next stage, artificial maintenance of blood circulation is carried out, to ensure which an algorithm for performing indirect cardiac massage or chest compression is used. For this purpose, you need to correctly lay the person being resuscitated on a flat surface. Next, you should determine the compression points: by palpating the xiphoid process and moving away from it 2 transverse fingers upward.

The hand must be placed on the border of the middle and lower part of the sternum so that the fingers are parallel to the ribs. Pushes are performed with the limbs straightened at the elbows. Chest compression is performed at a frequency of 100 compressions per minute with a break for artificial ventilation. The depth of the shocks is about 4-5 cm. Measures to restore cardiac activity should be stopped if:

1. A pulse appeared in the main arteries.
2. The actions taken do not have the desired effect within 30 minutes. The exception is the following conditions that require prolongation of resuscitation:

• hypothermia;
• drowning;
• overdose medicines;
• electrical injury.

Resuscitation measures

Today, the concept of CPR is based on strict rules that ensure complete safety of the activities carried out for human life. In addition, an algorithm for the resuscitator’s actions in case of sudden cardiac arrest or sudden loss of respiratory function in the injured person is presented and scientifically substantiated. In the development of these conditions, time plays a major role: only a few minutes separate a person from death. The algorithm for performing cardiopulmonary resuscitation involves performing the following actions:

1. Determining the condition of the victim, on the basis of which the range of measures necessary for revival is selected;
2. Early start CPR, which involves performing two manipulations: chest compressions and artificial ventilation.
3. If the second stage is ineffective, they proceed to defibrillation. The procedure involves applying an electrical impulse to the heart muscle. In this case, direct current discharges should be applied only if the electrodes are correctly installed and good contact with the skin of the victim.
4. At this stage, as a rule, the victim is provided with specialized medical care, including the following early treatment measures:

• artificial ventilation with tracheal intubation;
• drug support, involving the use of:
• catecholamines (adrenaline, atropine);
• antidiuretic hormones (Vasopressin);
• antiarrhythmic drugs (Cordarone, Lidocaine);
• fibrinolytic agents (Streptokinase).
• intravenous drip administration of electrolyte or buffer solutions (for example, sodium bicarbonate is administered for acidosis)

Video

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make treatment recommendations based on individual characteristics specific patient.

Found an error in the text? Select it, press Ctrl + Enter and we will fix everything!

Discuss

Causes of sudden death are heart disease, thrombosis and hereditary factors

Sudden infant death syndrome (SIDS) is the sudden death of a practically healthy child under the age of 1 year as a result of cessation of breathing and cardiac arrest, the cause of which cannot be determined by pathological examination. The syndrome is sometimes called "crib death" or death without cause. However, there are reasons or risk factors for the development of this little-studied phenomenon, and parents, by eliminating them from their lives, can save their child’s life and health.

SIDS is not a disease, it is a post-mortem diagnosis that is made when neither the results of the autopsy nor the analysis of the child’s medical record make it possible to determine the cause of death. Such a diagnosis is not made in the event of a previously undetected malformation or death as a result of an accident.

Cases of sudden death among infants have been known since ancient times, but no explanation has been found for them to this day, despite the fact that scientists around the world are working on this problem. For unknown reasons, death in the cradle is not typical for children from Asian families. Sudden death of a child occurs 2 times more often in families of people of the white race than in African Americans and Indians.

Most often, SIDS occurs while the baby is sleeping without showing any symptoms the day before. Cases of SIDS are registered in 5-6 children out of a thousand of their peers.

As a result of studying cases of infant death without cause, some patterns of this ominous and mysterious phenomenon were identified:

• SIDS in 90% of cases occurs before the baby is 6 months old (usually from 2 to 4 months);
• Previously, deaths occurred in the cold season (the highest mortality rate was in January); Currently, the probability of death does not depend on the time of year;
• boys die in 60% of cases;
• SIDS cannot be predicted or prevented;
• SIDS is not associated with preventive vaccinations.

Risk factors for SIDS

It is believed that sudden death syndrome is caused by infants sleeping in the prone position.

When studying cases of SIDS, a number of factors contributing to its occurrence (risk factors) were identified:

• position when the baby sleeps on his stomach;
• using soft bedding for the child: mattress, pillow, blanket;
• overheating the child (using cotton blankets or excessive heating in the room);
• prematurity (the younger the baby’s gestational age, the greater the risk of SIDS);
• low birth weight of the baby;
• multiple pregnancy;
• a large number of pregnancies in the mother and short intervals between them;
• cases of SIDS or stillbirth of previously born children from these parents;
• late onset or lack of medical supervision during pregnancy;
• and fetal hypoxia;
• recent illness in the child;
• mother's age is under 17 years;
• maternal smoking, drug or alcohol use;
• poor economic or social conditions in the family (overcrowding in the apartment, lack of regular ventilation, smoking of family members, unemployed parents, lack of knowledge about caring for a baby);
• the birth of a child to a single mother;
• maternal depression in the postpartum period.

I would like to separately point out the danger of death in the cradle due to parental smoking. Studies have shown that if pregnant women did not smoke, the incidence of SIDS would decrease by 40%. Both active and passive smoking during pregnancy and after the birth of a baby are dangerous. Even smoking in the next room with an open window or a fan is harmful.

Possible causes of SIDS

SIDS has not been fully studied. But still, some of the mechanisms that occur when it occurs are described. There are several theories explaining the mechanism of SIDS.

Respiratory dysfunction

During normal sleep, respiratory dysfunction periodically occurs and breathing stops for a short time. As a result of such a stop in respiratory activity, an insufficient amount of oxygen is formed in the blood (hypoxemia), which normally causes awakening and restoration of breathing. If breathing does not resume, the child dies.

Due to the immaturity of regulatory mechanisms, short-term pauses in breathing (apnea) in infants are common. But if such breath holdings occur more than once per hour, and they last longer than 10-15 seconds, you should immediately contact your pediatrician.

Cardiac dysfunction

Some scientists believe that the leading factor in SIDS is not apnea, but rather cardiac arrest (asystole). These scientists call heart rhythm disturbances such as extrasystoles and blockades on the electrocardiogram, a decrease in the number of heartbeats less than 70 per minute (bradycardia), and frequently changing heart rate as risk factors.

In support of this theory, scientists cite their discovery in some cases of SIDS of mutations in the gene responsible for the structure of sodium channels in the heart muscle. It is the change in these structures that leads to heart rhythm disturbances.

Heart rhythm disturbances up to a short-term cessation of heartbeat can also occur in healthy children. But if such stops are noticed in a baby, you should immediately consult a doctor and have the child examined.

Changes in the brain stem

Both the respiratory center and the vasomotor center, which is responsible for the functioning of the heart, are located in the medulla oblongata. Research has revealed, in some cases, disturbances in the synthesis of enzymes and the formation of acetylcholine receptors in the cells of the medulla oblongata when exposed to tobacco smoke or its components. These changes contribute to the occurrence of SIDS.

In some children, victims of SIDS, structural lesions and changes in cells in the canteen part of the brain were detected, which arose during intrauterine development due to hypoxia.

Ultrasound echography performed on children who were saved after respiratory arrest revealed pathology in the arteries that supply blood to the brain stem in 50% of cases. This may indicate a cerebrovascular accident, which is the cause of SIDS in some children.

Poor circulation occurs due to compression of the artery at a certain position of the baby's head. Since the neck muscles are not yet sufficiently developed, the child cannot turn his head on his own. Only after the baby reaches four months does the baby reflexively turn it to a safe position.

The blood supply to the brain worsens when the baby is put to sleep on its side, but the blood flow to the brain is even more reduced when the baby is positioned on his stomach. During studies in such situations, a weak pulse was noted and breathing slowed sharply.

Stress

Confirmation that SIDS develops as a result of severe stress for the child’s body is a whole set of pathological changes found in all absolutely victims of the syndrome.

These are changes such as: small hemorrhages in the thymus gland, lungs, sometimes in the outer lining of the heart, traces of ulceration of the digestive tract mucosa, wrinkled lymphoid formations, decreased blood viscosity. All these phenomena are symptoms of nonspecific stress syndrome.

Clinical manifestations of this syndrome include signs such as runny nose, discharge from the eyes; enlarged tonsils, liver and; ; weight loss. These symptoms occur 2-3 weeks before SIDS in 90% of children. But many researchers do not consider them to be significant for subsequent death. It is likely that stress, combined with any disturbances in the child’s development, leads to dire consequences.

Immune theory and infectious mechanism of SIDS

Most children who died suddenly had symptoms of some kind of infection within a week or on the last day of life. The children were examined by a doctor, some of them received antibiotics.

Proponents of this theory believe that microorganisms secrete toxins or cytokinins, which cause disruption of the body's defense mechanisms (for example, awakening from sleep). As a result, the presence of risk factors for infection is aggravated. Toxins from microorganisms (most often posthumously isolated Staphylococcus aureus) provoke and intensify the inflammatory response. And the baby’s body is not yet able to regulate its own defensive reactions.

Other researchers have compared the types of antibodies to microbes in children who died from other causes and from SIDS. It was revealed that a significant number of children who died in the cradle had IgA antibodies to the toxins of enterobacteria and clostridia. Healthy children also have antibodies to these microorganisms, but of different classes (IgM and IgG), which indicates the body’s immune defense against this toxin.

The data obtained allowed the researchers to conclude that such toxins affect all children, but risk factors (overheating, exposure to tobacco smoke components, and others) lead to disruption of defense mechanisms. The resulting combination of infection and risk factors leads to death.

Recently there have been reports of the discovery of the SIDS gene when studying the DNA of healthy children and babies who died from SIDS. It turned out that the risk of sudden infant death increases threefold in children who have a mutant (defective) gene responsible for the development of immune system. However, scientists believe that the presence of such a gene leads to death in the presence of other factors, that is, only in combination with them.

A number of studies indicate that the cause of SIDS may be the causative agent of peptic ulcer disease (Helicobacter pylori). This conclusion is justified by the fact that this microorganism is much more often isolated in the tissues of the stomach and respiratory tract in children who died from SIDS, compared to those who died from other causes. These microbes can cause ammonium synthesis, which causes breathing problems and SIDS. It is assumed that if, when regurgitating, a child aspirates (inhales) a certain amount of microbes contained in the vomit, then ammonium is absorbed into the blood and causes respiratory arrest.

Is swaddling a baby a risk factor?

Experts have different opinions. Some of them believe that it is necessary to swaddle the baby, because he will not be able to roll over and cover his head with a blanket, which means that the risk of SIDS is less.

Proponents of the opposite opinion argue that swaddling interferes with the development of the baby's physiological maturity. Due to tight swaddling, restrictions in movements arise (the child cannot take a comfortable position), which disrupts thermoregulation processes: heat transfer from the body increases in a straightened position.

Breathing is also limited, which means swaddling increases the risk of pneumonia and SIDS, and subsequently the child’s speech develops worse. With tight swaddling, the baby will have less close contact with his mother, which is also important for his development.

Will a pacifier help prevent SIDS?

According to some researchers, using a pacifier when putting your baby to sleep at night and during the day can reduce the risk of SIDS. Experts explain this effect by saying that the pacifier circle will help air penetrate the child’s respiratory organs even if he accidentally covers his head with a blanket.

It is better to start using a pacifier when the baby is one month old, when it has already been adjusted breast-feeding. But you should not be persistent if the child refuses and does not want to take the pacifier. You need to wean your child off the pacifier gradually, before the age of 12 months.

Is it safe for a baby to co-sleep with his mother?

It is believed that co-sleeping with the mother reduces the risk of developing sudden death syndrome by 20%, provided that the mother does not smoke.

Co-sleeping between a baby and its mother (or both parents) is also interpreted ambiguously by different scientists. Of course, such sleep promotes longer breastfeeding. Studies have shown a 20% reduction in the incidence of SIDS when co-sleeping with parents. This can be explained by the fact that the baby's sensitive body synchronizes its heartbeat and breathing with the mother's heartbeat and breathing.

In addition, in a dream, the mother subconsciously controls the sleep of the child nearby. The risk of sudden death especially increases when, after loud crying, the baby falls asleep soundly. During this period, it is safer for the child not to be isolated in his crib, but to be close to his mother, who will notice the cessation of breathing and provide timely assistance.

But on the other hand, the risk of SIDS increases significantly when sleeping together if the parents smoke. Even if they do not smoke in the presence of the child, then during sleep the components that make up tobacco smoke, which are so dangerous for the baby, are released in the air exhaled by the smoker. The same applies to the use of alcoholic beverages and drugs, when the danger for the child of being crushed by one of the soundly sleeping parents increases. You should also not overuse perfume if you sleep with your child.

The risk associated with co-sleeping also increases if the baby is born before 37 weeks' gestation or weighs less than 2.5 kg. You should not co-sleep with your baby if the mother is taking medication that makes you drowsy or feels very tired. Therefore, it is safest to place the baby in a crib after feeding, which is located in the mother’s bedroom, next to her bed.

What should a child's bed be like? What's the best way to put him to sleep?

It is best to place the crib in the mother's room, but not near a radiator, fireplace or heater, to prevent the baby from overheating. The mattress should be firm and even. You can lay an oilcloth on the mattress, with a well-stretched sheet on top. It is better not to use a pillow at all. The bed should be so hard that the child's head does not leave an indentation.

A blanket in the cold season should be wool, not down or cotton. Do not use a thermal blanket. Cover the child with a blanket no higher than the shoulders, so that the baby does not accidentally cover his head. The child should rest his feet on the bottom side of the crib.

When using a sleeping bag, you must select it strictly in size so that the child cannot go downstairs in it. The temperature in the child's room should not exceed 20˚C. When the baby overheats, the brain's control over the functioning of the respiratory center deteriorates.

To make sure that your baby is not cold, touch his tummy, not his arms or legs (they can be cold even if the baby is warm). When you return from a walk, undress your baby, even if he wakes up in the process.

The baby should only be placed on his back to sleep. To prevent regurgitation and subsequent aspiration (inhalation) of vomit in the supine position, it is necessary to hold the child in an upright position for 10-15 minutes before lying down. This will help him remove air swallowed with food from his stomach.

The prone position increases the risk of SIDS for a number of reasons:

• deeper sleep (as the threshold for awakening increases);
• ventilation of the lungs is impaired; this is especially important for infants at 3 months of age, when the reflexes that promote ventilation weaken;
• there may be an imbalance between the sympathetic and parasympathetic nervous systems;
• physiological control over the functioning of the heart, lungs, and autonomic functions weakens (including awakening during sleep).

The stomach position is especially dangerous for children, who, as a rule, sleep on their backs and accidentally roll over onto their stomachs in their sleep. Babies who like to sleep on their stomach should be placed on their back after they fall asleep. The side position is also less safe than the back position. You should not put soft toys in the crib.

In the second half of the baby’s life, when he can roll over in bed, you can be allowed to take a position that is comfortable for him while sleeping. But you still need to put him to sleep on his back. If the child is on his stomach, it is better to turn him onto his back.

Although cases of sudden death occur more often at night and in the early morning, children should not be left unattended during nap times. A portable cradle is convenient because the mother can do housework and at the same time be in the same room with her sleeping baby.

Will a baby monitor help?

Modern methods of preventing tragedy offer special devices (monitors) to monitor the breathing or jointly the breathing and heartbeat of the baby from the moment of birth until one year. The monitors are equipped with warning systems that turn on when breathing stops or the heart rhythm is abnormal.

These devices cannot prevent or protect a child from SIDS, but they will sound an alarm and parents will be able to provide timely assistance to the child. Such monitors are especially important for children who are at increased risk of SIDS, or if the child has had breathing problems.

Breast milk or artificial milk formula?

Breastfeeding significantly reduces the risk of an infant developing SIDS.

Studies by many authors have confirmed the importance of breastfeeding for the prevention of SIDS: breastfeeding only up to 1 month increased the risk of SIDS by 5 times; breastfeeding only up to 5-7 weeks – 3.7 times. Mixed feeding of children did not increase the risk of sudden death.

The positive effect of mother's milk is explained by the presence in it not only of immunoglobulins, but also of omega fatty acids, which stimulate the maturation of the baby's brain.

Breastfeeding helps strengthen the baby's immunity and prevent respiratory infections, which can be a trigger for SIDS.

If the mother does not breastfeed her baby and also smokes, the risk of death in the crib increases even more.

Most at risk age for SIDS

Sudden death is unusual for an infant less than one month old. Most often it occurs from the second to the fourth months of life (most often in the 13th week). 90% of crib deaths occur before six months of age. After a child reaches the age of 1 year, cases of SIDS are extremely rare, although cases of sudden death have also been described in practically healthy adolescents (while running, during physical education lessons, and even at rest).

How to help a child?

If a child suddenly stops breathing, you should quickly pick him up, move your fingers vigorously along his spine from bottom to top, massage his earlobes, arms, feet, and shake the child. Usually after this breathing is restored.

If there is still no breathing, you need to immediately call an ambulance and, without wasting time, give the child artificial respiration and cardiac massage before the doctor arrives. Every parent should have the skills to carry them out.

Summary for parents

Unfortunately, it is impossible to completely exclude the possibility of sudden death of an infant, since the causes of its occurrence are not fully understood. But it is possible and necessary to reduce the risk of “death in the crib” to a minimum.

A significant degree of risk of sudden death of the unborn child is laid by the mother during pregnancy. Bad habits (smoking, drug and alcohol use), neglect of medical supervision during pregnancy lead to changes in the fetus, which can then cause SIDS.

Doctors are sounding the alarm. Around the world, cases of unexplained death of young people aged 18 to 30 are increasingly being recorded. The concept of “sudden infant death syndrome” has been known to science for quite some time, but experts insist that the time has come to introduce a new term into medical reference books – sudden adult death syndrome.

From history

The term sudden death first appeared in 1917 in the Philippines, where the syndrome was called “bangungut”. Then, in 1959, Japanese doctors called it “smoke”; specialists from Laos, Vietnam and Singapore also wrote about a similar phenomenon.

But as an independent disease, sudden cardiac death syndrome began to stand out in the 80s of the 20th century, thanks to American researchers. At this time, the American Center for Disease Control in Atlanta recorded an unusually high mortality rate (25 cases per 100,000 people) among young people of Southeast Asian descent. It was noted that their deaths mostly occurred at night, and all the dead were men aged 20 to 49 years. Moreover, most of them were outwardly absolutely healthy, did not suffer from excess weight and did not have bad habits(alcohol, smoking, drugs).

Having compared the data obtained with information from colleagues from the countries of the Far East and Southeast Asia, the researchers found that it is in these regions that cases of this pathology are very common, and more often among young people. At the same time, such a syndrome practically does not occur among African-Americans.

Causes of sudden death in a dream

Scientists have found that sudden cardiac death is typical in the predawn and early morning hours. The fact is that in a lying position, the flow of venous blood to the heart increases, as a result of which the heart muscle requires even more oxygen. If a person has any heart disease, the heart is obviously not sufficiently supplied with oxygen and in this case may simply not withstand the load.

Harbingers of the syndrome may include pressing or squeezing pain behind the sternum or in the heart area, tachycardia (rapid heartbeat) or bradycardia (rare heartbeat), decreased blood pressure, bluish skin, and weak pulse. A fairly common symptom is stopping breathing during sleep (apnea).

Sudden death itself can be suspected by the following manifestations: sudden loss of consciousness, convulsions, slowing of breathing until it stops. Within three minutes after the onset of unexpected cardiac arrest, irreversible changes develop in the cells of the central nervous system.

Risk factors for sudden cardiac death

It is difficult to say for what exact reason a person’s heart suddenly stops beating during sleep. As a rule, autopsies in such situations do not show serious violations of the structure and structure of the heart. However, doctors are prepared to warn with a list of the most common causes of heart failure, which significantly increases the risk that you will experience sudden cardiac death at night.

First of all, this is a violation of blood flow in the heart area, coronary heart disease, disruption of the structure and function of the main heart muscle, blood clots and blockage of arteries, congenital and chronic diseases of the cardiovascular system, excess weight and diabetes. A separate group of risk factors includes previous heart attacks or cardiac arrest, and frequent episodes of loss of consciousness.

Official statistics claim that all cases of unexpected death during sleep can be divided into three big reasons: primary arrhythmia (47%), ischemic factors (43%) and failure of the pumping function of the heart (8%).

Precursors of sudden cardiac death

Cardiologists and physiologists have compiled a small list of conditions that may precede sudden arrhythmic death and should seriously alert both the person and his loved ones.

• unexpected cases of severe weakness, sweating and dizziness, which quickly end.
• unnatural pallor of a person against the background of surges in blood pressure.
• pallor after physical activity, during stress and emotional overexcitement.
• reduced, not high blood pressure after any physical activity.

If at least one such episode occurs, you should seek help from a cardiologist and carry out the necessary examinations and, if necessary, treatment.

Cardiac nocturnal death in healthy people

When a person dies unexpectedly and, at first glance, for no reason at night, it leaves his loved ones in shock and complete bewilderment. However, pathologists are convinced that the concept of “health” in this case is quite subjective.

Forensic pathologist and medical examiner in Dallas County (USA), Dr. Candace Schopp believes that the frequency of cases where apparently healthy people die in their bed at night depends on how these people themselves understand the word “healthy”.

According to him, the causes of sudden death are often obesity, coronary insufficiency or clogged arteries. Such diagnoses during life may not bother the patient, or the person simply does not find the time and opportunity to see a doctor, mistakenly believing himself to be healthy.

First aid

If you find yourself near a person who is suddenly having a life-threatening attack, call immediately. emergency assistance, open the windows in the room (to increase the access of oxygen), ask the person not to move under any circumstances and try to remain conscious for as long as possible.

If possible medical care in case of unexpected cardiac death, it should be provided as early as possible - in the first 5-6 minutes after cardiac arrest and disappearance of signs of life.

Resuscitation measures include indirect cardiac massage (rhythmic pressure on the chest with a certain frequency, which helps push out blood and all cavities of the heart), artificial respiration (mouth to mouth). In a medical facility, it is possible to carry out defibrillation (applying electrical shocks to the chest with a special device), which is a very successful way to restore heart rhythm.

If measures to provide first aid to the patient are successful, he is hospitalized in the cardiology or intensive care unit for examination and identification of the causes of this condition. In the future, such people should regularly attend appointments with a cardiologist and follow all preventive recommendations.

Non-drug prevention of the causes of cardiac death can be considered giving up any bad habits, proper nutrition and exercise, positive emotions, avoiding stress and emotional stress.

You might be interested

Psychiatrists have found that lack of sleep provokes mental disorders in children.




Insomnia: why it occurs and how to help yourself




Microsleep or how we can sleep while awake




8 hours of good use: is it possible to study in your sleep and who needs a silk pillowcase




Dangerous fashion or why you should give up e-cigarettes




What are the benefits and dangers of flax seeds

1 Comment

Blah, blah, blah... Lots of medical indicators that don't explain anything. Yes, and this is understandable. I escaped death while sleeping. Therefore, I know this process from the inside, at the level of the average person. It's very simple. I've experienced it and avoided it. But everything is very complicated. You must know how this happens if you want to avoid it. But!!! ... if you want to die, then this is contraindicated for you to know. This is dangerous knowledge. There is a way out. Simple enough.

What is this

Phantom pains are uncomfortable sensations in different frequent bodies, which are either absent or have lost their sensitivity due to injury or illness. Typically, phantom pain develops after amputation (in 65-80% of cases). They can last from several minutes to hours, and can be either one-time or chronic.

The reason for phantom pain is that the brain and spinal cord still receive impulses from the limbs along the nerve fibers, but their character is different and they turn into pain. The nature of such pain can be different: burning, shooting, stabbing, pulsating, etc. There may also be a feeling of itching or simply warmth and heaviness of the missing limb.

Is the pain real

Yes, phantom pain is absolutely real and worth accepting. This is a kind of short circuit in the central nervous system. It is very important that such patients do not hush up their problems, but consult a doctor and, together with him, look for ways to deal with this condition. When a person suffers from pain, it makes no difference whether it is real or “imaginary”, the main thing is that it exists. Pain is a conscious phenomenon, and it makes no difference what kind of pain we are talking about.

Try to convince yourself that your tooth doesn’t hurt when you can’t sleep from the pain for the second night. It is unlikely that you will succeed. And people with phantom pain are in exactly the same situation. They are unable to help themselves, so the main thing they can do for their own well-being is to seek help in time.

How to treat

Both drug and non-drug methods are used to treat phantom pain. Special means there is no such thing, so painkillers with different mechanisms of action are simply prescribed (analgesics, non-steroidal anti-inflammatory drugs, antidepressants, etc.).

Non-drug methods include: any distracting activity, exercise therapy using a mirror device, wearing glasses virtual reality, transcutaneous electrical nerve stimulation, acupuncture, cognitive behavioral therapy, etc. In particularly difficult cases, it is recommended to install electrodes for electrical stimulation of the spinal cord.

When choosing a therapy, it is important to be patient while you find the method that is right for you.

Unfortunately, as of today still no effective method to combat phantom pain, so research in this area continues.

Doctors say: how to properly overcome vitamin D3 deficiency and is it really dangerous?

People are talking about this vitamin literally everywhere today. It has been proven that its deficiency leads to serious problems in the functioning of the body. Today we will figure out what problems a lack of vitamin D3 threatens you with and how to prevent it.

The effectiveness of vitamin D3 for bone health has the best evidence base. It is known to be involved in the absorption of calcium and phosphorus, which affect bone density. Vitamin D3 deficiency most often manifests itself as problems with bones and muscles. Children with a lack of vitamin D3 may develop rickets.

It’s a paradox, but the effectiveness of medications with vitamin D3 has been proven only if the disease already exists; there is not yet enough research on the benefits of preventive doses.

How to avoid shortcomings?

In our climate, almost all people have vitamin D deficiency, so it’s worth remembering. To avoid deficiency, in addition to taking vitamin D supplements, you should follow other recommendations.

Be in the sun

It is quite difficult to name the exact time and conditions; it is important to maintain a balance between the production of sufficient amounts of vitamin D and the risks of melanoma and skin cancer. According to some data, it will be enough to be in the sun twice a week for 5 to 30 minutes between 10 and 15 hours. It is important that your arms or legs, back and face are exposed. Ideally, you should not apply sunscreen to your skin.

There are products with vitamin D3

These are fatty fish, liver, cheese, egg yolks. If the sun and diet do not provide you with the required amount, you should think about taking additional medications.

How do you know if medications are needed?

It's pretty difficult question, therefore, most often doctors are guided by the principle “it can’t get worse” and prescribe drugs with this vitamin to almost everyone.

The norms for our latitudes are as follows: up to 50 years old - 600-800 IU, after 50 - 800-1000 IU, for pregnant and lactating women - 800-1200 IU.

Infants who are on natural feeding, it is important to get between 400 and 1000 IU because breast milk contains very little vitamin D.

Shouldn't I increase the dose?

This is a bad idea because an overdose of vitamin D3 is dangerous and can cause severe poisoning. And chronic intoxication provokes pain and a lack of minerals in the bones. Vitamin D is fat-soluble, so its excess is not excreted in the urine, but accumulates in the body.

A dose of 4000 IU daily is considered toxic for people over 9 years of age. The only exceptions are patients with vitamin D malabsorption, but they should take increased doses only under the supervision of a physician.

Is it possible to get an overdose of vitamins in the sun?

No, even very long exposure to the sun does not lead to an overdose of vitamin D.

In what form is it better to take vitamin D3?

Medical recommendations do not indicate specific forms of the drug. You can choose the form yourself, but pay attention to what you are buying - a medicine or a dietary supplement. Remember that the production of the latter is not checked as carefully as the production of drugs.

What is the active form?

There is a separate range of drugs (containing the active form of vitamin D3). Colecalciferol is not a final substance that is absorbed by our body; it is transformed into an active form in the kidneys and liver. There are also drugs that contain an already active form of vitamin D, but they are prescribed only to patients in whom the process of converting vitamin D in the body is complicated.

But at the same time, their safety, as well as side effects, are much more difficult to track, so they should not be taken without serious indications.

Is it true that you need to take vitamin D with vitamin K?

There is no confirmed data yet.

Is it possible to go to the solarium?

Not worth it. This is effective in terms of vitamin D production, but dangerous in terms of the risk of melanoma and skin cancer.

Is it worth getting tested in advance?

You should not take a blood test for 25-OH vitamin D levels on your own initiative. Both with and without analysis, for people without any particular risks, the doctor will make approximately identical prescriptions. The test is usually prescribed to patients at risk: those who rarely go out, people over 70 years of age, patients after gastric bypass and those who have problems with fat absorption, people with obesity and osteoporosis.

If your doctor prescribed vitamin D3 for you, be sure to take it, otherwise everything is at your discretion. Just be aware of the risk of overdose and choose the right drug. And then taking vitamin D3 will definitely not harm you.

Sudden infant death syndrome (SIDS) is not a disease. Rather, it is a diagnosis made when a healthy child dies unexpectedly without any cause. If, after an autopsy, a detailed study of the location of the incident and the medical history of the child, doctors cannot determine the cause of death, they diagnose SIDS.

Such a death may be reported as SIDS (sudden infant death syndrome), sudden infant death syndrome (SIDS), death from unknown causes, or simply death in a crib. SIDS is not reported as the cause of death unless another cause is found, such as an accident, infection, or a previously undetected congenital disorder (genetic abnormality).

According to statistics in Russia, the SIDS rate per 1000 children born is 0.43. In 1991, the Infant Mortality Research Foundation launched a campaign to reduce the risk of SIDS, and cot deaths fell by 75%. But it still remains a common cause of death in children.

What is the cause of sudden infant death syndrome (SIDS)?

Nobody knows why some children die like this. Research is ongoing, and doctors believe a combination of factors is at play. It is believed that some children have problems in the part of the brain that controls breathing and waking up, so they may react inappropriately to situations where, for example, their nose and mouth are covered with a blanket while sleeping.

When does death in the cradle occur?

Most often, but not always, cot death occurs during sleep. At night in a crib, or during daytime sleep - in a stroller or even in the arms of one of the parents. Crib death occurs more often in winter, although the reasons for this are not fully identified.

Which babies are at greatest risk for SIDS?

Death in the cradle is not common among infants less than one month old. It most often occurs in the second month of life and about 90% of cases occur in children under six months of age. How older child, the lower the risk - after a year such cases are extremely rare.

For unknown reasons, this syndrome is not common in Asian families.

Most often, death in a crib occurs in families in which the mother was not yet 20 years old at the time of the birth of the child.

There are factors that put your baby at risk for SIDS that you can't do anything about. These factors include:

male sex - death in a crib is more common among boys: about 60% of cases occur in male children

birth ahead of schedule(up to 37 weeks of pregnancy)

birth with low body weight (less than 2.5 kg)

How can I reduce my baby's risk of SIDS?

Sadly, there is no way to prevent crib death. There are some measures you can take to try to reduce your risk of SIDS. The Ministry of Health recommends the following measures:

Place your baby to sleep on his back in his crib in your room

At five to six months of age, babies begin to roll over, and at this age the risk of developing SIDS decreases, so you can let your baby find a comfortable sleeping position on his own. But still, put him to sleep on his back and if you suddenly notice that the baby has turned over on his stomach in his sleep, turn him back onto his back, although, of course, you should not deliberately wake up at night and check how the baby is sleeping.

Do not smoke during pregnancy and do not allow anyone to smoke in the presence of the baby. If you smoke during pregnancy or after giving birth, your baby's risk of developing SIDS increases. Cot deaths are more common in families where mothers smoked, were exposed to second-hand smoke during pregnancy, or smoked in the presence of children. One study confirms that if pregnant women did not smoke, cot deaths would be reduced by 40%.

Do not smoke during pregnancy and do not allow others to smoke in the presence of the baby, even in an adjacent room with an open window, fan and air ionizer. Ask guests to go outside to smoke and keep the air around your child free of tobacco smoke.

Don't let your baby overheat

Overheating also increases the risk of SIDS. Maintain a comfortable temperature in the room where the child sleeps (between 16 and 20 C, ideally 18 C). Children should not sleep near a radiator, heater or fireplace, or in direct sunlight. Do not use a hot water bottle or thermal blanket for heating.

Place the baby in the crib so that his legs rest against the side of the bed and he cannot slide down and cover his head with the blanket. Tuck the blanket no higher than shoulder level. If you use a sleeping bag, make sure it fits properly so your baby can't slide down inside it.

Signs that your baby is overheated are sweaty wet hair, prickly heat, rapid breathing, restlessness and fever. Feel your baby's belly or neck to check if he's cold or hot and select the appropriate blanket. You should not touch the arms and legs for this purpose - they can be cold, even if the baby is warm.

After returning from a walk, immediately remove any additional clothing from your baby, even if this means waking up your baby.

Never sleep on a sofa or chair with a child

After rocking or feeding, place your baby in the crib. The safest place for a baby under six months to sleep is in a crib in your room.

Let your baby sleep on a smooth, firm mattress that matches the size of the crib. Waterbeds, ottomans and the like are not suitable places for children to sleep. The mattress upholstery should be waterproof and covered with a single layer of sheets.

For bedding, use regular sheets and baby blankets or special sleeping bags, rather than duvets. Sleeping bag It should not be too large so that the baby does not get confused in it.

If your baby is hot, remove one blanket; if he is cold, add one (remember that a blanket folded in half equals two blankets). Do not use down or cotton duvets, as well as bed bolsters and pillows.

Breastfeed

Some recent studies have shown that breastfeeding reduces the risk of SIDS. Breast milk provides your baby with all the nutrients he needs during the first six months of life and also protects the baby from infections.

Take your child to the doctor regularly

Keep up with vaccinations that reduce the risk of SIDS, and seek advice from your doctor if your baby gets sick.

What about daytime naps?

One recent study showed that it is important to follow advice about children's sleep safety not only at night, but also during the day. You should place the baby on his back and be sure that the baby is not covered with a blanket over his head while sleeping. This study also confirms the importance of having your baby in the same room with you during naps. A wicker cradle and a portable cradle are suitable for baby's daytime sleep, and you can go about your business.

What advice do you have regarding using a pacifier?

Some studies suggest that using a pacifier at bedtime (even during the day) reduces the risk of SIDS. One theory to explain this effect is that the pacifier circle helps air penetrate the baby's airways, even if he accidentally covers his head with a blanket. If you decide to use a pacifier, wait until breastfeeding has established itself, usually when your baby is one month old. Gradually wean your baby off the pacifier between 6 and 12 months.

Don't worry if your baby's pacifier falls out of his mouth while he's sleeping. And don’t insist if the child doesn’t want a pacifier.

Can a baby sleep monitor help?

Healthy children do not need a breathing monitor. This is an electrical device that sounds an alarm if the baby's breathing is interrupted for a certain period of time. When using it, you may need to attach the sensor to the baby's body, place an ultrasonic transmitter or a special mat in the crib.

very tired

The risks associated with co-sleeping also increase if your baby:

born prematurely (before 37 weeks)

born with low birth weight (less than 2.5 kg)