After reading a post from my neighbor about white noise and newborns yesterday, I began looking into when and how to use white noise, and if there were any research papers on the subject. I considered sharing about this today, but instead, I found an update from the American Academy of Pediatrics (AAP) on recommended sleep environments to reduce SIDS, based on their June 2022 standards. For more details on this resource, you can refer to the linked below.
Sudden Infant Death Syndrome (SIDS)
Firstly, by definition, SIDS refers to the sudden death of an infant under one year of age. 90% of these deaths occur before the age of 6 months, peaking between 1-4 months, and rarely occurring after 8 months. The leading cause often pointed out for SIDS is the sleep position. Notably, since the "Back-to-Sleep" campaign began in 1994, instances of SIDS have decreased.
SIDS usually happens due to a combination of factors. External stressors, such as sleeping face-down or on their side, obstructions in the airway, combined with periods when SIDS is common (within the first 6 months), and functional underdevelopment in infants, are all contributing factors.
Typically, when a baby has low oxygen levels during sleep, the brain's nerve cells get activated, prompting the baby to wake up and adjust their position to breathe more effectively. But some infants with immature systems might fail to respond to this signal and can even die if they breathe in expelled carbon dioxide, leading to an accumulation in their blood.
Many research papers have highlighted various causes of SIDS, such as preterm birth, exposure to nicotine, cardiorespiratory control and arousal, and genetic factors. Some recommended practices based on this research include:
Risk Factors for SIDS
- Putting the baby to sleep on their side or stomach
- Being a preterm or low-birth-weight baby
- Elevated body temperature during sleep
- Sleeping on soft blankets or pads
- Family history
- External factors:
- Being younger than 20 at childbirth (indicating social instability)
- Not receiving proper prenatal care
- Smoking during pregnancy
Prevention for SIDS
Sleep position and environment: Lay the baby down on their back, looking upwards. If they fall asleep in a car seat or stroller, move them to a flat, firm surface as soon as possible. Keep plush toys or blankets away from their sleep space. If you swaddle, ensure the baby is on their back, and stop swaddling when they start rolling over. Also, the sleeping position of the baby matters; it's best to keep the baby in the same room, but not in the same bed, for at least the first six months. Avoid overheating the baby while they sleep.
Use of a pacifier: Using a pacifier during sleep can help maintain breathing and keep the airway clear. However, don’t force a baby who resists the pacifier, and if it falls out during sleep, there’s no need to put it back in.
Others: Smoking increases the risk of SIDS by more than double. Mothers are advised to breastfeed for at least 6 months, up to a year, and be careful not to doze off on a soft surface with the baby.
In the U.S., there are established programs, like the Young Parents Program (YPP) and the Children’s Hospital Primary Care Center (CHPCC), that support teenagers and low-income families by providing quality medical care, health, and education.
However, in our country, such support is relatively limited. There was a recommendation in July 2022 for a six-month trial of a support scheme for teen parents, but the amount was insufficient, and there is no legal basis for sustained efforts.
As a father, I am always looking for information to ensure the well-being of my daughter, Nayul, and I can't help but feel the need for more government support. Given that there isn't a clear and definitive cause for SIDS, I wish the government would offer more support, especially for teen parents and the economically challenged.
Study notes from May 13, 2023