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What should the nurse teach the parents about preventing sudden infant death syndrome (sids)?

Sudden infant death is the most common cause of death in the first year of life. The triggers have not yet been researched – here is how parents can prevent.

After dinner, the parents wrap their child, move it and put it to bed. Then he falls asleep peacefully – and never wakes up again. It's a horrible idea, but for some families it's a bitter reality. In 2014 for example, 119 children in Germany died of sudden infant death, also known as Sudden Infant Death Syndrome (SIDS), according to the Federal Health Report. Three quarters of all cases occur between the second and fourth months of life – and despite intensive research, medicine still does not know the exact cause of sudden death for no apparent reason.

Sudden infant death: prevention is successful

Pubmed, the world's most important medical bibliographic database, lists almost 100 studies from Germany alone in which more than 30,000 deaths were analysed for suspected risk factors. The results allow statements to be made about the strength of correlations – and enable effective prevention: “In 1991 the number of cases was still 1285. The decline is clearly linked to the prevention work of recent years,” says Professor Ekkehart Paditz. He is chairman of the “Babyhilfe Deutschland Association” and has organised large information campaigns in the past. He explains the most influential measures according to the study situation:

Sleeping bag instead of blanket

“You can't give a better gift for birth than a sleeping bag,” says Ekkehart Paditz. According to studies, children who sleep under a blanket before their first birthday have a 35-fold increased risk of SIDS. “Many children who died were covered,” says Paditz. In many cases, the lack of oxygen probably caused overheating.

The expert advises not to put an extra blanket over the sleeping bag, to keep the room temperature at 16 to 19 degrees (°C) if possible, and to make sure that the sleeping bag fits the season. The size should also be right: “If the child slips in, the best model is useless.”

Resting in your own bed

Children who sleep in their parents' bed for the first three months have a 20-fold increased risk of SIDS. From about the 13th week of life, the risk is only 2.6 times higher, provided that no other factors are added. “Parents did not drink alcohol, the flat is smoke-free, the child does not get between mattresses, pillows, blankets and so on,” explains Paditz. Further recommendation: Let the little ones sleep in their parents' room at least until their first birthday. They seem to slide more rarely thereby into too long deep sleep phases. “The risk is demonstrably reduced by sleeping in the parents' room,” says Paditz. Additional Baby Cribs are also an option.


On your back

“Babies always sleep on their backs,” advises Ekkehart Paditz. Otherwise, the risk is six times higher. He expressly recommends that the child also lie on his stomach when awake: “The children perceive more, train their motor skills as well as their neck, neck and shoulder muscles. The latter seems important for the time when the little ones start to rotate – even at night. Paditz: “Babies who have been able to train their muscles probably have an advantage, because they can lift or turn their head”.

Do not smoke

Cigarette smoke is never good for babies, whether before or after birth. “But the time in late pregnancy seems to be particularly serious, i.e. from the 30th week onwards,” explains Paditz. “From then on, the brain spurts its growth. It is suspected that tobacco smoke disturbs the formation of structures that are important for breathing regulation or for the wake-up reflex. If the mother smokes actively or passively during this phase, the risk of SIDS increases at least 3.4 times. “There is a clear dose-response relationship: the more smoking, the higher the risk,” says the expert.

Better without pillows

“In the first year of life, pillows in the baby cot should be avoided,” says Ekkehart Paditz. Studies indicate a 3.4-fold increase in the risk of SIDS when the child sleeps on a pillow. One possible reason cited by Paditz is temperature regulation, which in children runs strongly over the skin of the head and face. Therefore, he also advises against babies wearing caps in the flat: “The danger of heat build-up simply seems too great”.

Breastfeeding the child

If babies are breastfed for only two weeks or less, the risk increases 1.7-fold. “Breastfeeding seems to reduce the risk of SIDS,” says Paditz. Possible reason: breastfed children wake up easier and more often at night and often have a better immune system. In its guideline, the German Society for Sleep Medicine therefore advises breastfeeding children as long as it is possible for the mother.

Pacifiers protects

“Meta-studies show that regular pacifier use reduces the risk by 30 percent,” says Paditz. He advises offering the child a pacifier as soon as breastfeeding works. Several studies have shown that the pacifier does not stand in the way of successful breastfeeding, as some parents fear.

Sources: – prevention of sudden infant death – The Sudden Infant Death Syndrome – Sudden Infant Death Syndrome and the time of death: factors associated with night-time and day-time deaths

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