Sudden infant death syndrome (SIDS) refers to the sudden and often unexplained death of any baby under 1 year old. Doctors don't fully understand all the causes of SIDS, but findings from a 2022 study suggest that a biochemical marker may actually be the key to unlocking what causes SIDS. The study found that babies who lacked a specific brain enzyme had higher rates of SIDS.
“They [researchers] found the activity of the enzyme butyrylcholinesterase (BChE) was significantly lower in babies who died of SIDS compared to living infants and other non-SIDS infant deaths,” explains an article for BioSpace. “BChE plays a major role in the brain's arousal pathway, explaining why SIDS typically occurs during sleep.”
Of course, this news is groundbreaking—but the study did have its limitations and the findings are still only one piece of the puzzle. Parents should still make following safe sleep rules like placing babies on their backs when they sleep and keeping toys and blankets out of their cribs a priority. But this research could potentially help to identify which infants are more at risk for SIDS and help to prevent it.
Here's everything you need to know about SIDS, from what it is to what the latest research shows.
12 Ways To Reduce Your Baby's Risk of SIDS
What Is SIDS?
Sudden infant death syndrome (SIDS) refers to any infant death before age 1 that has no clear cause or explanation. SIDS is a subcategory of sudden, unexpected infant death syndrome (SUIDS), which the American Academy of Pediatrics (AAP) explains is any "sudden and unexpected death, whether explained or unexplained, occurring during infancy."
How Common Is SIDS?
According to the Centers for Disease Control and Prevention (CDC), there are about 3,400 sudden unexpected infant deaths in the US each year. However, that number includes deaths that are not due to SIDS, such as accidental strangulation and suffocation or trauma. In 2020, the CDC reported that there were 1,389 infant deaths due to SIDS, 1,062 deaths due to unknown causes, and 905 from accidental strangulation and suffocation in bed.
After an infant dies suddenly and unexpectedly, there will be a thorough case investigation, including a scene investigation, autopsy, and review of the clinical history to try to determine the cause of death. When none of those avenues lead to answers, the death is labeled as SIDS, says the AAP.
Possible Causes of SIDS
Doctors aren't completely sure what causes SIDS, but they theorize that brain defects, biological factors, and/or environmental components could all play a role. The 2022 study also points to a specific arousal response that some babies may lack, placing them at a higher risk for SIDS.
“Babies have a very powerful mechanism to let us know when they are not happy,” lead researcher Dr. Carmel Harrington told The Sydney Children's Hospitals Network. “Usually, if a baby is confronted with a life-threatening situation, such as difficulty breathing during sleep because they are on their tummies, they will arouse and cry out. What this research shows is that some babies don't have this same robust arousal response.”
Without the appropriate "wake" response, experts theorize that some babies will fail to wake when presented with a life-threatening situation, such as a lack of oxygen, and breathing will stop.
Symptoms of SIDS
“Unfortunately, there are no preceding symptoms of SIDS,” says William Mudd, DO, a pediatrician at Cleveland Clinic Children's. Melissa Manrique, MD, a pediatric hospitalist at Lurie Children's at Northwestern Medicine Central DuPage Hospital, adds that the majority of infants with SIDS are less than 6 months of age and are found unresponsive, cool, or with dusky gray and blue color changes after being put to sleep.
Following unsafe sleep practices, such as co-sleeping, putting your baby down to sleep on their stomach, or having blankets, loose bedding, stuffed animals, or any other people or pets in the bed, can also increase a baby's risk of SIDS, notes the National Institute for Health.
A Parent's Guide to Safe Sleep for Babies
SIDS Prevention
While there is not currently a known cause of SIDS and as a result no foolproof way to prevent it, the CDC recommends that parents and caregivers take the following steps to help reduce their baby's risk of SIDS:
Always place your baby on their back to sleep (even for naps) on a firm, flat surface covered with a fitted sheet.Never co-sleep or let your baby share a sleep surface with anyone or a pet.Do not use any blankets, pillows, bumpers, or toys in your baby's crib or bassinet.Do not use weighted swaddles, sleepers, or blankets.Keep your baby's crib or bassinet in the same room where you sleep until they are at least 6 months old and ideally until they are 1 year old.Do not cover your baby's head or allow them to get too hot while sleeping (you can check for sweat or feel their chest).Never let your baby sleep in a swing, bouncer, or car seat.
You'll also want to use new baby equipment whenever possible, as some previously-sold items have been deemed unsafe for baby sleep. For instance, the Safe Sleep for Babies Act of 2021 prohibited the manufacturing and sale of crib bumpers or inclined sleepers for infants. Buying new whenever possible helps ensure your baby's equipment adheres to the latest safety regulations.
Research about SIDS is ongoing, and hopefully, there will be a cure and more concrete ways to prevent the tragedy of infant deaths in the future. Until then, parents and caregivers can stay up-to-date on the latest research and follow recommendations for safe sleep practices to reduce their baby's risk of SIDS.
"Now that we know that BChE is involved we can begin to change the outcome for these babies and make SIDS a thing of the past," added Dr. Harrington. "This finding represents the possibility for the identification of infants at risk for SIDS infants prior to death and opens new avenues for future research into specific interventions."
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