Sudden Infant Death Syndrome (SIDS) (Nursing)

00:01 Now, we'll cover sudden infant death syndrome, or SIDS.

00:05 sudden infant death syndrome is the unexplained death, usually during sleep, of a seemingly healthy baby less than a year old.

00:12 It's sometimes known as crib death because the infants often die in their cribs.

00:16 There are some infant risk factors and maternal risk factors that contribute to SIDS.

00:21 First, boys.

00:22 They're more likely to suffer from SIDS.

00:24 This happens more often in babies in the 2nd-4th month of life, and non-white babies are more likely.

00:31 If there's a family history of a sibling dying of SIDS, this puts the other siblings at an increased risk.

00:38 Babies who are exposed to secondhand smoke and babies who are born early are also at increased risk for SIDS.

00:44 Now, there are some maternal risk factors that also contribute.

00:47 If the mother is < 20 years old, if she smokes cigarettes, uses drugs or alcohol, or has inadequate prenatal care, this can contribute.

00:57 So what causes SIDS? Well, we don't really know.

01:00 The etiology is unknown.

01:01 It's a combination of physical and sleep environmental factors that can make an infant more vulnerable to SIDS.

01:07 These factors can vary from child to child.

01:10 Here are the physical factors.

01:12 We know that babies who have brain defects, are born at a low birth weight, and have current respiratory infections are more likely to suffer from SIDS.

01:21 Combine that with some sleep environmental factors, such as babies who sleep on their stomach or side, babies who sleep on a soft surface, babies who share a bed or co-sleep, or babies who get too warm and overheat while they sleep.

01:33 You can combine these genetic risk factors and the maternal risk factors, and this gives you a vulnerable infant.

01:40 These babies have impaired autonomic regulation and this is what controls the breathing rate and the heart rate.

01:46 If the baby's also at an at-risk age group, remember 2 month-4 month olds, and you add in some environmental risk factors, such as their sleep position, co-sleeping, increased heat, and head covering, this puts the baby more likely to suffer from SIDS.

02:02 So what's happening during SIDS? Well, the baby becomes apneic.

02:06 They go into respiratory failure.

02:08 They completely stop breathing and then this causes cardiovascular failure.

02:13 And when these babies are found, there's a bit of a paradox.

02:16 The baby is observed to be clean and well-cared for, and they look like they're in an excellent state of health, development, nutrition, and hydration.

02:25 Externally, on the post-mortem exam, you may note moderate amounts of cyanosis.

02:30 This is blue discoloration of the skin.

02:32 The baby may have a mucoid fluid in their mouth and nostrils.

02:35 This is seen in about 50% of the cases.

02:38 And usually, the babies are found with a soiled diaper.

02:41 Internal findings.

02:43 The baby may have intrathoracic petechiae, and these are those small, pinpoint hemorrhages.

02:47 And those are observed more consistently in SIDS cases than in any other cases at this age.

02:53 The baby may have pulmonary congestion and edema, and inflammation of the upper respiratory tract because, remember, upper respiratory infections increase the risk.

03:02 So, how do we diagnose SIDS? Well, SIDS is the diagnosis of exclusion, that means we've ruled out other things.

03:08 And this combines information from the post-mortem exam, assessment of the scene, and interviews with the parents and caregivers.

03:16 So how do we prevent SIDS? This is all about prevention.

03:20 It's key that the baby sleeps alone.

03:23 We don't want babies exposed to secondhand smoke, and the baby should not have any pillows, stuffed animals, toys, or a bumper pad in their surrounding environment.

03:32 If the baby has a blanket, it should be tucked in and only as high as the baby's chest.

03:38 The blankets should not be heavy and they should not be loose.

03:41 The crib sheet should be pulled tightly over the mattress and, the mattress should be firm.

03:47 The baby should be in a safe infant bed, not too hot, and always put to sleep on their back.

03:54 The foot of the baby should be to the foot of the bed.