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Sudden infant death syndrome (SIDS) is the sudden unexplained
death Death is the irreversible cessation of all biological functions that sustain an organism. For organisms with a brain, death can also be defined as the irreversible cessation of functioning of the whole brain, including brainstem, and brain ...
of a child of less than one year of age. Diagnosis requires that the death remain unexplained even after a thorough
autopsy An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any di ...
and detailed death scene investigation. SIDS usually occurs during
sleep Sleep is a sedentary state of mind and body. It is characterized by altered consciousness, relatively inhibited sensory activity, reduced muscle activity and reduced interactions with surroundings. It is distinguished from wakefulness by a de ...
. Typically death occurs between the hours of midnight and 9:00 a.m. There is usually no noise or evidence of struggle. SIDS remains the leading cause of infant mortality in Western countries, contributing to half of all post-neonatal deaths. The exact cause of SIDS is unknown. The requirement of a combination of factors including a specific underlying susceptibility, a specific time in development, and an environmental stressor has been proposed. These environmental stressors may include sleeping on the stomach or side, overheating, and exposure to
tobacco smoke Tobacco smoke is a sooty aerosol produced by the incomplete combustion of tobacco during the smoking of cigarettes and other tobacco products. Temperatures in burning cigarettes range from about 400 °C between puffs to about 900 °C d ...
. Accidental suffocation from
bed sharing Co-sleeping is a practice in which babies and young children sleep close to one or both parents, as opposed to in a separate room. Co-sleeping individuals sleep in sensory proximity to one another, where the individual senses the presence of othe ...
(also known as co-sleeping) or soft objects may also play a role. Another risk factor is being born before 39 weeks of gestation. SIDS makes up about 80% of sudden and unexpected infant deaths (SUIDs). The other 20% of cases are often caused by
infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
s,
genetic disorder A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosomal abnormality. Although polygenic disorders ...
s, and heart problems. While child abuse in the form of intentional suffocation may be misdiagnosed as SIDS, this is believed to make up less than 5% of sudden death cases. The most effective method of reducing the risk of SIDS is putting a child less than one year old on their back to sleep. Other measures include a firm mattress separate from but close to caregivers, no loose bedding, a relatively cool sleeping environment, using a
pacifier A pacifier is a rubber, plastic, or silicone nipple substitute given to an infant to suckle upon between feedings to quiet its distress by satisfying the need to suck when it does not need to eat. Pacifiers normally have three parts: an elongate ...
, and avoiding exposure to tobacco smoke.
Breastfeeding Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that br ...
and
immunization Immunization, or immunisation, is the process by which an individual's immune system becomes fortified against an infectious agent (known as the immunogen). When this system is exposed to molecules that are foreign to the body, called ''non-se ...
may also be preventive. Measures not shown to be useful include positioning devices and
baby monitors A baby monitor, also known as a baby alarm, is a radio system used to remotely listen to sounds made by an infant. An audio monitor consists of a transmitter unit, equipped with a microphone, placed near to the child. It transmits the sounds by ...
. Evidence is not sufficient for the use of fans. Grief support for families affected by SIDS is important, as the death of the infant is sudden, without witnesses, and often associated with an investigation. Rates of SIDS vary nearly tenfold in
developed countries A developed country (or industrialized country, high-income country, more economically developed country (MEDC), advanced country) is a sovereign state that has a high quality of life, developed economy and advanced technological infrastruct ...
from one in a thousand to one in ten thousand. Globally, it resulted in about 19,200 deaths in 2015, down from 22,000 deaths in 1990. SIDS was the third leading cause of death in children less than one year old in the United States in 2011. It is the most common cause of death between one month and one year of age. About 90% of cases happen before six months of age, with it being most frequent between two months and four months of age. It is more common in boys than girls. Rates of SIDS have decreased in areas with "safe sleep" campaigns by up to 80%.


Definition

The syndrome only applies to infants under one. SIDS is a diagnosis of exclusion and should be applied to only those cases in which an infant's death is sudden and unexpected, and remains unexplained after the performance of an adequate
postmortem An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any d ...
investigation, including: # an
autopsy An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any di ...
(by an experienced pediatric
pathologist Pathology is the study of the causal, causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when us ...
, if possible); # investigation of the death scene and circumstances of the death; and # exploration of the
medical history The medical history, case history, or anamnesis (from Greek: ἀνά, ''aná'', "open", and μνήσις, ''mnesis'', "memory") of a patient is information gained by a physician by asking specific questions, either to the patient or to other peo ...
of the infant and family. After investigation, some of these infant deaths are found to be caused by suffocation,
hyperthermia Hyperthermia, also known simply as overheating, is a condition in which an individual's body temperature is elevated beyond normal due to failed thermoregulation. The person's body produces or absorbs more heat than it dissipates. When extreme ...
or
hypothermia Hypothermia is defined as a body core temperature below in humans. Symptoms depend on the temperature. In mild hypothermia, there is shivering and mental confusion. In moderate hypothermia, shivering stops and confusion increases. In severe ...
, neglect or some other defined cause. Australia and New Zealand shifted to ''sudden unexpected death in infancy'' (SUDI) for professional, scientific, and coronial clarity. In addition, the US
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
have proposed that such deaths be called ''sudden unexpected infant deaths'' (SUID) and that SIDS is a subset of SUID.


Age

SIDS has a four-parameter
lognormal In probability theory, a log-normal (or lognormal) distribution is a continuous probability distribution of a random variable whose logarithm is normally distributed. Thus, if the random variable is log-normally distributed, then has a norma ...
age distribution A population pyramid (age structure diagram) or "age-sex pyramid" is a graphical illustration of the distribution of a population (typically that of a country or region of the world) by age groups and sex; it typically takes the shape of a pyramid ...
that spares infants shortly after birth — the time of maximal risk for almost all other causes of non-trauma infant death. By definition, SIDS deaths occur under the age of one year, with the peak incidence occurring when the infant is two to four months old. This is considered a critical period because the infant's ability to rouse from sleep is not yet mature.


Risk factors

The exact cause of SIDS is unknown. Although studies have identified risk factors for SIDS, such as putting infants to bed on their bellies, there has been little understanding of the syndrome's biological process or its potential causes. Deaths from SIDS are unlikely to be due to a single cause, but rather to multiple risk factors. The frequency of SIDS does appear to be influenced by social, economic, or cultural factors, such as maternal education, race or ethnicity, or poverty. SIDS is believed to occur when an infant with an underlying biological vulnerability, who is at a critical development age, is exposed to an external trigger. The following risk factors generally contribute either to the underlying biological vulnerability or represent an external trigger:


Tobacco smoke

SIDS rates are higher in babies of mothers who smoke during pregnancy. Between no smoking and smoking one cigarette a day, on average, the risk doubles. About 22% of SIDS in the United States is related to maternal smoking. SIDS correlates with levels of
nicotine Nicotine is a natural product, naturally produced alkaloid in the nightshade family of plants (most predominantly in tobacco and ''Duboisia hopwoodii'') and is widely used recreational drug use, recreationally as a stimulant and anxiolytic. As ...
and its derivatives in the baby. Nicotine and derivatives cause alterations in
neurodevelopment The development of the nervous system in humans, or neural development or neurodevelopment involves the studies of embryology, developmental biology, and neuroscience to describe the cellular and molecular mechanisms by which the complex nervous ...
.


Sleeping

Placing an infant to sleep while lying on the belly or side rather than on the back increases the risk for SIDS. This increased risk is greatest at two to three months of age. Elevated or reduced room temperature also increases the risk, as does excessive bedding, clothing, soft sleep surfaces, and stuffed animals in the bed. Bumper pads may increase the risk of SIDS due to the risk of suffocation. They are not recommended for children under one year of age, as this risk of suffocation greatly outweighs the risk of head bumping or limbs getting stuck in the bars of the crib. Sharing a bed with parents or siblings increases the risk for SIDS. This risk is greatest in the first three months of life, when the mattress is soft, when one or more persons share the infant's bed, especially when the bed partners are using drugs or alcohol or are smoking. The risk remains, however, even in parents who do not smoke or use drugs. The
American Academy of Pediatrics The American Academy of Pediatrics (AAP) is an American professional association of pediatricians, headquartered in Itasca, Illinois. It maintains its Department of Federal Affairs office in Washington, D.C. Background The Academy was founded ...
thus recommends "room-sharing without bed-sharing", stating that such an arrangement can decrease the risk of SIDS by up to 50%. Furthermore, the academy has recommended against devices marketed to make bed-sharing "safe", such as "in-bed co-sleepers". Room sharing as opposed to solitary sleeping is known to decrease the risk of SIDS.


Breastfeeding

Breastfeeding Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that br ...
is associated with a lower risk of SIDS. It is not clear if co-sleeping among mothers who breastfeed without any other risk factors increases SIDS risk.


Pregnancy and infant factors

SIDS rates decrease with increasing maternal age, with teenage mothers at greatest risk. Delayed or inadequate
prenatal care Prenatal care, also known as antenatal care, is a type of preventive healthcare. It is provided in the form of medical checkups, consisting of recommendations on managing a healthy lifestyle and the provision of medical information such as materna ...
also increases risk. Low
birth weight Birth weight is the body weight of a baby at its birth. The average birth weight in babies of European descent is , with the normative range between . On average, babies of South Asian and Chinese descent weigh about . As far as low birth weigh ...
is a significant risk factor. In the United States from 1995 to 1998, the SIDS death rate for infants weighing 1000–1499 g was 2.89/1000, while for a birth weight of 3500–3999 g, it was only 0.51/1000.
Premature birth Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between 2 ...
increases the risk of SIDS death roughly fourfold. From 1995 to 1998, the U.S. SIDS rate for births at 37–39 weeks of
gestation Gestation is the period of development during the carrying of an embryo, and later fetus, inside viviparous animals (the embryo develops within the parent). It is typical for mammals, but also occurs for some non-mammals. Mammals during pregna ...
was 0.73/1000, while the SIDS rate for births at 28–31 weeks of gestation was 2.39/1000.
Anemia Anemia or anaemia (British English) is a blood disorder in which the blood has a reduced ability to carry oxygen due to a lower than normal number of red blood cells, or a reduction in the amount of hemoglobin. When anemia comes on slowly, th ...
has also been linked to SIDS (however, per item 6 in the list of epidemiologic characteristics below, extent of anemia cannot be evaluated at autopsy because an infant's total
hemoglobin Hemoglobin (haemoglobin BrE) (from the Greek word αἷμα, ''haîma'' 'blood' + Latin ''globus'' 'ball, sphere' + ''-in'') (), abbreviated Hb or Hgb, is the iron-containing oxygen-transport metalloprotein present in red blood cells (erythrocyte ...
can only be measured during life). SIDS incidence rises from zero at birth, is highest from two to four months of age, and declines toward zero after the infant's first year.


Genetics

Genetics Genetics is the study of genes, genetic variation, and heredity in organisms.Hartl D, Jones E (2005) It is an important branch in biology because heredity is vital to organisms' evolution. Gregor Mendel, a Moravian Augustinian friar wor ...
plays a role, as SIDS is more prevalent in males.Se
CDC WONDER online database
and for data on SIDS by gender in the US and throughout the world.
There is a consistent 50% male excess in SIDS per 1000 live births of each sex. Given a 5% male excess birth rate, there appears to be 3.15 male SIDS cases per 2 female cases, for a male fraction of 0.61. This value of 61% in the US is an average of 57% black male SIDS, 62.2% white male SIDS and 59.4% for all other races combined. Note that when multiracial parentage is involved, infant race is arbitrarily assigned to one category or the other; most often it is chosen by the mother. The X-linkage hypothesis for SIDS and the male excess in infant mortality have shown that the 50% male excess might be related to a dominant X-linked
allele An allele (, ; ; modern formation from Greek ἄλλος ''állos'', "other") is a variation of the same sequence of nucleotides at the same place on a long DNA molecule, as described in leading textbooks on genetics and evolution. ::"The chro ...
, occurring with a frequency of that is protective against transient cerebral anoxia. An unprotected male would occur with a frequency of and an unprotected female would occur with a frequency of . About 10 to 20% of SIDS cases are believed to be due to
channelopathies Channelopathies are a group of diseases caused by the dysfunction of ion channel subunits or their interacting proteins. These diseases can be inherited or acquired by other disorders, drugs, or toxins. Mutations in genes encoding ion channels, wh ...
, which are inherited defects in the ion channels which play an important role in the contraction of the heart. Genetic evidence published in November 2020 concerning the case of
Kathleen Folbigg Kathleen Megan Folbigg (Married and maiden names, née Donovan; born 14 June 1967) is an Australian woman convicted in 2003 for killing her four infant children. She was pardoned twenty years later due to serious doubts that had arisen about her ...
, who is in prison over the death of four of her children, showed that at least two of the children had genetic mutations in the CALM2 gene that predisposed them to heart complications.


Alcohol

Drinking of alcohol by parents is linked to SIDS. One study found a positive correlation between the two during New Years celebrations and weekends. Another found that alcohol use disorder was linked to a more than doubling of risk.


Other

A 2022 study found that infants who died of SIDS exhibited significantly lower specific activity of
butyrylcholinesterase Butyrylcholinesterase ( HGNC symbol BCHE; EC 3.1.1.8), also known as BChE, BuChE, BuChase, pseudocholinesterase, or plasma (cholin)esterase, is a nonspecific cholinesterase enzyme that hydrolyses many different choline-based esters. In humans, it ...
, an enzyme involved in the brain's arousal pathway, shortly after birth. This can serve as a
biomarker In biomedical contexts, a biomarker, or biological marker, is a measurable indicator of some biological state or condition. Biomarkers are often measured and evaluated using blood, urine, or soft tissues to examine normal biological processes, p ...
to identify infants with a potential autonomic
cholinergic Cholinergic agents are compounds which mimic the action of acetylcholine and/or butyrylcholine. In general, the word " choline" describes the various quaternary ammonium salts containing the ''N'',''N'',''N''-trimethylethanolammonium cati ...
dysfunction and elevated risk for SIDS. SIDS has been linked to cold weather, with this association believed to be due to over-bundling and thus, overheating. Premature babies are at four times the risk of SIDS, possibly related to an underdeveloped ability to automatically control the cardiovascular system. A 1998 report found that antimony- and phosphorus-containing compounds used as fire retardants in PVC and other cot mattress materials are not a cause of SIDS. The report also states that toxic gas cannot be generated from antimony in mattresses and that babies had SIDS on mattresses that did not contain the compound. It has been suggested that some cases of SIDS may be related to ''
Staphylococcus aureus ''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive ...
'' and ''
Escherichia coli ''Escherichia coli'' (),Wells, J. C. (2000) Longman Pronunciation Dictionary. Harlow ngland Pearson Education Ltd. also known as ''E. coli'' (), is a Gram-negative, facultative anaerobic, rod-shaped, coliform bacterium of the genus ''Escher ...
'' infections.


Diagnosis


Differential diagnosis

Some conditions that are often undiagnosed and could be confused with or
comorbid In medicine, comorbidity - from Latin morbus ("sickness"), co ("together"), -ity (as if - several sicknesses together) - is the presence of one or more additional conditions often co-occurring (that is, concomitant or concurrent) with a primary ...
with SIDS include: *
medium-chain acyl-coenzyme A dehydrogenase deficiency Medium-chain acyl-CoA dehydrogenase deficiency (MCAD deficiency or MCADD) is a disorder of fatty acid oxidation that impairs the body's ability to break down medium-chain fatty acids into acetyl-CoA. The disorder is characterized by hypoglycemia ...
(MCAD deficiency); * infant
botulism Botulism is a rare and potentially fatal illness caused by a toxin produced by the bacterium ''Clostridium botulinum''. The disease begins with weakness, blurred vision, feeling tired, and trouble speaking. This may then be followed by weakne ...
; * long QT syndrome (accounting for less than 2% of cases); * ''
Helicobacter pylori ''Helicobacter pylori'', previously known as ''Campylobacter pylori'', is a gram-negative, microaerophilic, spiral (helical) bacterium usually found in the stomach. Its helical shape (from which the genus name, helicobacter, derives) is though ...
'' bacterial infections; *
shaken baby syndrome Shaken baby syndrome (SBS), also known as abusive head trauma (AHT), is the leading cause of fatal head injuries in children younger than two years. Diagnosing the syndrome has proved both challenging and contentious for medical professionals, ...
and other forms of child abuse; *
overlaying Overlaying or overlying is the act of accidentally smothering a child to death by rolling over them in sleep. Alleged instances of overlaying were perceived to be one common way of covering up infanticide in Victorian England. Many wet nurses wer ...
, child smothering during carer's sleep For example, an infant with MCAD deficiency might die by "classical SIDS" if found swaddled and
prone Prone position () is a body position in which the person lies flat with the chest down and the back up. In anatomical terms of location, the dorsal side is up, and the ventral side is down. The supine position is the 180° contrast. Etymolog ...
, with its head covered, in an overheated room where parents were smoking. Genes indicating susceptibility to MCAD and Long QT syndrome do not protect an infant from dying of classical SIDS. Therefore, the presence of a susceptibility gene, such as for MCAD, means the infant might have died either from SIDS or from MCAD deficiency. It is currently impossible for a pathologist to distinguish between them. A 2010 study looked at 554 autopsies of infants in
North Carolina North Carolina () is a state in the Southeastern region of the United States. The state is the 28th largest and 9th-most populous of the United States. It is bordered by Virginia to the north, the Atlantic Ocean to the east, Georgia and So ...
that listed SIDS as the cause of death, and suggested that many of these deaths may have been due to accidental suffocation. The study found that 69% of autopsies listed other possible risk factors that could have led to death, such as unsafe bedding or sleeping with adults. Several instances of
infanticide Infanticide (or infant homicide) is the intentional killing of infants or offspring. Infanticide was a widespread practice throughout human history that was mainly used to dispose of unwanted children, its main purpose is the prevention of reso ...
have been uncovered in which the diagnosis was originally SIDS. The estimate of the percentage of SIDS deaths that are actually infanticide varies from less than 1% to up to 5% of cases. Some have underestimated the risk of two SIDS deaths occurring in the same family; the
Royal Statistical Society The Royal Statistical Society (RSS) is an established statistical society. It has three main roles: a British learned society for statistics, a professional body for statisticians and a charity which promotes statistics for the public good. ...
issued a media release refuting expert testimony in one UK case, in which the conviction was subsequently overturned.


Prevention

A number of measures have been found to be effective in preventing SIDS, including changing the sleeping position to
supine In grammar, a supine is a form of verbal noun used in some languages. The term is most often used for Latin, where it is one of the four principal parts of a verb. The word refers to a position of lying on one's back (as opposed to ' prone', l ...
, breastfeeding, limiting soft bedding, immunizing the infant and using pacifiers. The use of electronic monitors has not been found to be useful as a preventative strategy. The effect that fans might have on the risk of SIDS has not been studied well enough to make any recommendation about them. Evidence regarding swaddling is unclear regarding SIDS. A 2016 review found tentative evidence that swaddling increases the risk of SIDS, especially among babies placed on their bellies or sides while sleeping. Measures not shown to be useful include positioning devices and
baby monitors A baby monitor, also known as a baby alarm, is a radio system used to remotely listen to sounds made by an infant. An audio monitor consists of a transmitter unit, equipped with a microphone, placed near to the child. It transmits the sounds by ...
. In the United States, companies that sell the monitors do not have
FDA The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
approval for them as medical devices.


Sleep positioning

Sleeping on the back has been found to reduce the risk of SIDS. It is thus recommended by the
American Academy of Pediatrics The American Academy of Pediatrics (AAP) is an American professional association of pediatricians, headquartered in Itasca, Illinois. It maintains its Department of Federal Affairs office in Washington, D.C. Background The Academy was founded ...
and promoted as a best practice by the US
National Institute of Child Health and Human Development The ''Eunice Kennedy Shriver'' National Institute of Child Health and Human Development (NICHD) is one of the National Institutes of Health (NIH) in the United States Department of Health and Human Services. It supports and conducts research aime ...
(NICHD) "
Safe to Sleep The Safe to Sleep campaign, formerly known as the Back to Sleep campaign, is an initiative backed by the US National Institute of Child Health and Human Development (NICHD) at the US National Institutes of Health to encourage parents to have thei ...
" campaign. The incidence of SIDS has fallen in a number of countries in which this recommendation has been widely adopted. Sleeping on the back does not appear to increase the risk of choking, even in those with
gastroesophageal reflux disease Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases where stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/ ...
. While infants in this position may sleep more lightly, this is not harmful. Sharing the same room as the parents but in a different bed may decrease the SIDS risk by half.


Pacifiers

The use of
pacifier A pacifier is a rubber, plastic, or silicone nipple substitute given to an infant to suckle upon between feedings to quiet its distress by satisfying the need to suck when it does not need to eat. Pacifiers normally have three parts: an elongate ...
s appears to decrease the risk of SIDS, although the reason is unclear. The
American Academy of Pediatrics The American Academy of Pediatrics (AAP) is an American professional association of pediatricians, headquartered in Itasca, Illinois. It maintains its Department of Federal Affairs office in Washington, D.C. Background The Academy was founded ...
considers pacifier use to prevent SIDS to be reasonable. Pacifiers do not appear to affect breastfeeding in the first four months, even though this is a common misconception.


Bedding

Product safety experts advise against using pillows, overly soft mattresses, sleep positioners, bumper pads (crib bumpers), stuffed animals, or fluffy bedding in the crib, and recommend instead dressing the child warmly and keeping the crib "naked." Blankets or other clothing should not be placed over a baby's head. The use of a " baby sleep bag" or "sleep sack", a soft bag with holes for the baby's arms and head can be used as a type of bedding that warms the baby without covering its head.


Vaccination

Infants typically receive several vaccinations between the ages of 2 and 4 months, which is also the peak age for SIDS. Due to this coincidence, a number of studies have investigated the possible role of vaccinations as a cause of SIDS. These have found either no relation between vaccinations and SIDS, or a reduction of the risk of SIDS following vaccination. A 2007 meta-analysis found that vaccinations were associated with a halving of the risk of SIDS, and argued that immunisation should be a part of SIDS prevention campaigns.


Epidemiology

Globally, SIDS resulted in about 22,000 deaths , down from 30,000 deaths in 1990. Rates vary significantly by population from 0.05 per 1000 in Hong Kong to 6.7 per 1000 in Native Americans. SIDS was responsible for 0.54 deaths per 1,000 live births in the US in 2005. It is responsible for far fewer deaths than
congenital disorder A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities ca ...
s and disorders related to short gestation, though it is the leading cause of death in healthy infants after one month of age. SIDS deaths in the US decreased from 4,895 in 1992 to 2,247 in 2004, a 54% decrease. During a similar time period, 1989 to 2004, SIDS as the cause of death for sudden infant death (SID) decreased from 80% to 55%, a 31% decrease. According to John Kattwinkel, chairman of the Centers for Disease Control and Prevention (CDC) Special Task Force on SIDS "A lot of us are concerned that the rate (of SIDS) isn't decreasing significantly, but that a lot of it is just code shifting".


Race

In 2013, there were persistent disparities in SIDS deaths among racial and ethnic groups in the U.S. In 2009, the rates of death range from 20.3 per 100,000 live births for Asian/Pacific Islander to 119.2 per 100,000 live births for Native Americans/Alaska Native. African American infants have a 24% greater risk of having a SIDS-related death, compared to the U.S. population as a whole, and experience a 2.5 greater incidence of SIDS than in Caucasian infants. Rates are calculated per 100,000 live births to enable more accurate comparison across groups of different total population size. Research suggests that factors which contribute more directly to SIDS risk—maternal age, exposure to smoking, safe sleep practices, etc.—vary by racial and ethnic group and therefore risk exposure also varies by these groups. Risk factors associated with prone sleeping patterns of African American families include mother's age, household poverty index, rural/urban status of residence, and infant's age. More than 50% of African American infants were placed in non-recommended sleeping positions, according to a 2012 study completed in South Carolina, indicating that cultural factors can be protective as well as problematic. The rate of SIDS per 1000 births varies among ethnic groups in the United States: *Central Americans and South Americans: 0.20 *Asian/Pacific Islanders: 0.28 *Mexicans: 0.24 *Puerto Ricans: 0.53 *Whites: 0.51 *African Americans: 1.08 *Native American: 1.24


Society and culture

The rate of SIDS varies vastly among different cultures and countries around the world, with SIDS rates lowest among Asian and Pacific Islander infants. Some evidence supports the hypothesis that SIDS is not an ancient phenomenon and that it appears more commonly in western societies. Much of the popular media portrayals of infants shows them in non-recommended sleeping positions.


See also

*
Fading puppy syndrome Fading puppy syndrome (or fading puppy complex) is when a puppy dies within the first few weeks of life without a clear cause of death or clinical signs, that is to say, they fail to thrive. Death usually occurs within the first five days of life, ...
*
Failure to thrive Failure to thrive (FTT), also known as weight faltering or faltering growth, indicates insufficient weight gain or absence of appropriate physical growth in children. FTT is usually defined in terms of weight, and can be evaluated either by a low ...
* Neonatal isoerythrolysis * Newborn care and safety * Sudden unexpected death syndrome * Sudden unexplained death in childhood


References


Further reading

* * *


External links

* * {{Authority control Causes of death Ailments of unknown cause Infant mortality Wikipedia medicine articles ready to translate Sleep disorders Syndromes