What causes sudden infant death–and can a parent prevent it? | Lifestyle.INQ

OCTOBER 27, 2022

Do you remember that biblical story of the two mothers and King Solomon? It’s about two women who went to sleep with their respective newborns. In the morning, one baby is found lifeless and the two mothers proceed to claim the one who is alive as their own.


The king then applies his “Solomonic” decision—cutting the child into two so each woman could have “half” of the baby.


The first woman sees this as a fair solution and agrees; but the other violently protests and begs the king to let the baby live and simply give the baby to the first one.


This act of selfless love is what King Solomon is looking for, and he immediately returns the baby to his rightful mother, knowing that she would never allow any harm to come to her child.


This story has always haunted me, even as a child. The idea of waking up next to a lifeless child sounds straight out of a horror movie!




Unfortunately, Sudden Infant Death Syndrome (SIDS) has been happening since time immemorial.


These thoughts stayed with me to the day I became a mother myself.


Have I told you about the first time I slept with my eldest child? I was still in the hospital, and my daughter Adriana was about two days old.


As the nurse parked my newborn’s bassinet at my bedside for the night, I was suddenly struck by thoughts of SIDS, and since I had no idea how to prevent such a tragedy, I did the only thing I could think of—keep watch.


I brought out my trusty old phone and set the alarm to go off every half hour—the whole night! That was the first and last time I tried that strategy. Since then, I’ve come across articles and tips on SIDS, so waking up every half hour is no longer necessary.


According to the Safe to Sleep Campaign, 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.”


You cannot tell if a baby is at risk because, in layman’s words, an “underlying vulnerability” means the baby shows no signs or symptoms to warn you of problems, and has no medical history.


Many times, accidental suffocation or strangulation has been misdiagnosed as SIDS and vice-versa, but experts continue to remind us that they are not the same. Technically, SIDS can occur at any age, and is usually associated with babies until age 1, but the period of greatest risk is between one and four months, because at this stage, an “infant’s ability to rouse from sleep is still immature.”


Even if a baby is past the “greatest risk stage,” there is still risk.


“SIDS is a diagnosis of exclusion,” which means that it is used as a “cause of death” only after a thorough postmortem investigation determines the death of the baby to be “sudden and unexpected” with no known causes.


However, despite having no known causes, SIDS does have the “external triggers” or risk factors which can easily be avoided.




Let’s start with tobacco smoke. Smoking during pregnancy has always been known to have adverse effects on an unborn child, ranging from a lower amount of oxygen available to you and your baby, to an increase in miscarriages, stillbirths, premature and low birth weight, birth defects, and respiratory and brain formation problems.


Adding to this list of consequences is the increased risk of SIDS. It is hard to say whether it is the nicotine, carbon monoxide or any of the 4,000 chemicals—yes, that’s right, 4,000 chemicals—in the baby’s bloodstream, the 60 cancer-causing toxins, or the increased amount of harmful chemicals released from secondhand smoke that give rise to SIDS.




Whichever it may be, doctors agree that this is a definite trigger which parents must avoid.


Another deadly trigger lies in the infant’s sleeping position. While many people leave infants to sleep on their stomach or side to avoid choking on their spit, especially for babies with gastroesophageal reflux disease, experts advice against this, reminding parents that the risk of SIDS outweighs the risk of choking.


The American Academy of Pediatrics strongly recommends that parents put their babies to sleep on their backs. Always remember that “Back is Best” in helping ensure that infants are able to breathe properly and normally while sleeping.


A room’s temperature is also considered a risk factor. Highly elevated (very warm) or reduced (very cold) room temperatures increase the risk, as parents may overheat a baby by overdressing him/her for warmth and comfort.


‘Sleep sack’


One deceptively innocent-looking trigger is excessive bedding. I admit that coordinated crib linens, pillows, comforters, blankets, stuffed animals and bumpers are adorable, but beware of the dangers they pose.


Babies don’t need anything in bed with them other than a tight sheet over a firm mattress.


While keeping warm is necessary, it is important to do it safely. The use of a baby “sleep sack” is one of the safest alternatives to a blanket. This is a fabric bag with special holes for the arms and head and a zipper in the front and center of the bag to open or close around the baby.


Sleep sacks have protective effects. They have been shown to reduce the baby’s tendency to turn on his/her stomach while sleeping. As long as it is correctly worn and the correct size, sleep sacks are also recommended because they prevent loose beddings from accidentally covering the infant’s face, which may lead to increased temperature, carbon monoxide breathing and suffocation.


Choose a brand that is safety certified to ensure a proper fit. One choice would be Halo Sleep Sacks, certified by a number of medical groups as having passed safety standards.


Preventive measure


Sleeping in an adult bed has also been discussed as risk trigger. As a co-sleeping advocate, there is nothing I love more than sleeping with my family, but I believe that when it comes to babies below the age of one, co-sleeping is best limited to sleeping in the same room but in separate beds from parents and siblings.


This is especially necessary if one or both parents are using drugs or alcohol or are smokers.


Another preventive measure is breastfeeding and pacifiers. It is not very clear to me how these two help prevent SIDS, but if they help, then by all means, why not?


Eliminating these external triggers and putting these preventive measures in place will greatly reduce the risk of SIDS, though it will not completely eliminate them.


The sudden and unexpected loss of a child, whether an infant or adult, is always devastating for any parent. In case you know anyone whose family has experienced SIDS, offer emotional support and advice them to undergo counseling to help them with their grief.

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