What is the cause of Sudden Infant Death Syndrome (SIDS)?

From the Guidelines

The exact cause of Sudden Infant Death Syndrome (SIDS) remains unknown, but it is believed to be related to a combination of factors, including sleep environment, prenatal and postnatal exposure to substances, and underlying health conditions, as suggested by the American Academy of Pediatrics in their 2016 recommendations for a safe infant sleeping environment 1. The current understanding of SIDS is that it is a multifactorial disorder, and while the exact cause is still unknown, there are several known risk factors that can be addressed to reduce the risk of SIDS. Some of the key risk factors for SIDS include:

• Sleep environment: sleeping on the stomach or side, sleeping on a soft surface, and sleeping with soft bedding or pillows
• Prenatal and postnatal exposure to substances: exposure to smoke, alcohol, and illicit drugs during pregnancy and after birth
• Underlying health conditions: premature birth, low birth weight, and certain congenital anomalies To reduce the risk of SIDS, the American Academy of Pediatrics recommends:
• Placing babies on their backs to sleep on a firm, flat surface with no soft bedding, pillows, or toys
• Using a crib or bassinet that meets current safety standards with a tight-fitting sheet
• Keeping the baby's sleep area in the same room as the parents for at least the first six months, but avoiding bed-sharing
• Maintaining a comfortable room temperature and dressing the baby appropriately without overheating
• Breastfeeding when possible, offering a pacifier at naptime and bedtime after breastfeeding is established, and ensuring regular prenatal care
• Avoiding smoke exposure during pregnancy and after birth, as well as avoiding alcohol and illicit drug use during pregnancy and after birth 1. It is essential to note that while these recommendations can help reduce the risk of SIDS, they do not guarantee that SIDS will not occur. The peak risk period for SIDS is between 2-4 months of age, and most cases occur between midnight and 9 a.m. By following these recommendations and being aware of the known risk factors, parents and caregivers can help reduce the risk of SIDS and create a safe sleep environment for their babies.

From the Research

Causes of Sudden Infant Death Syndrome (SIDS)

The exact cause of SIDS is still not fully understood, but several risk factors have been identified:

• Intrinsic vulnerability, such as impaired arousal, cardiorespiratory, and/or autonomic responses 2
• Exogenous trigger events, such as exposure to an unsafe sleeping environment 2
• Critical developmental period 2

Risk Factors for SIDS

Several risk factors have been identified, including:

• Prone and side sleeping positions, which are significantly more dangerous than the supine position 3, 4
• Bed sharing with a parent, especially in infants younger than 12 weeks 4
• Exposure to tobacco smoke 3, 4
• Soft bedding and overheating 3, 5, 4
• Maternal smoking, alcohol and drug use, and lack of prenatal care 6

Safe Sleep Environment

A safe sleep environment can reduce the risk of SIDS, and includes:

• Supine positioning 3, 5, 2, 4
• Use of a firm sleep surface 5, 2, 4
• Room-sharing without bed-sharing 5, 2, 4
• Avoidance of soft bedding and overheating 3, 5, 2, 4
• Breastfeeding and use of a pacifier during sleep once breastfeeding is established 5, 4