Sudden Infant Death Syndrome: History, Risk Factors And Possible Interventions To Reduce The Prevalence (Research Paper Sample)

Sudden Infant Death Syndrome Name Institution Sudden Infant Death Syndrome Abstract Sudden infant death Syndrome (SIDS) is one of the principal causes of death of infants in many western countries. In the period of the 1990s, The United Kingdom and other nations embarked on back to sleep campaigns in a bid to reduce the prevalence of post-neonatal deaths among infants. As a result, there has been significant progress from the use of the campaigns. Notably, deaths in SIDS decreased by 83% in Australia between 1985-2005. This paper attempts to evaluate the existing comprehension of the epidemiology and etiology of sudden unforeseen deaths of infants and the general postulations on the pathophysiology of the causes of death. It will also look at the current interventions that have been implemented, with a focus on the degree of success in attempts undertaken to decrease the records of deaths and new advances that present the likelihood of prevention of future SIDS. Definition Sudden infant death syndrome has been understood by scholars to be the abrupt demise of infants of less than one year of age. A number of these fatal incidences occur during sleep, and the causes remain unknown even after thorough examination including performing an elaborate autopsy, and evaluation of circumstances surrounding the death and medical history (Adams, Ward & Garcia, 2015). SIDS remains one of the leading causes of postnatal deaths. Several interventions taken by medical practitioners and governments to reduce the prevalence have achieved significant success but still more remains to be done (Fleming, Blair & Pease, 2015). A triple risk model was proposed in 1994 suggesting that SIDS is a combination of a vulnerable infant, a vulnerable developmental phase of the infant and an ultimate causative factor that triggers the death. History SIDS is a phenomenon that has always existed. The first documented instance of death in SIDS is in the old testament of the bible. King Solomon’s wisdom is tested in a case pitting two women. A child of one woman had died while in sleep (Adams, Ward & Garcia, 2015). In the case, the cause of the death was the woman lying on her infant while asleep. Advances in the medical field in mid 20th century led to instances of death in SIDS reducing. Several proposals attempt to explain the cause of SIDS. Among them is the sleeping position of infants (Psaila et al., 2014). Researchers have observed that putting a child to sleep with the back facing down reduces the possibility of death in SIDS. Swaddling the infant as opposed to putting them also increases the likelihood of unexpected death. Several studies have been carried out on co-sleeping, use of pacifiers, smoking, and breastfeeding. Three-factor risk model Kenney and Filiano in 1994 listed physiological vulnerability, risky developmental phase and environmental factors as a fatal combination that increases the chances of SIDS (Haynes et al., 2017). The medical field has widely acknowledged this hypothesis as an essential tool for assessing specific categories of infants who are prone to dying at particular ages when exposed to possible stressors. Infants between two and four months with low birth weight, metabolical abnormalities and are exposed to tobacco smoke pose a high risk to SIDS. Male infants are more predisposed to SIDS at this stage than females (Fleming, Blair & Pease, 2015). The combination of these factors makes infants vulnerable to environmental factors and infections such as thermal factors, and sleeping position. Further, a combination of respiratory abnormalities, brain neurophysiology, and growth physiology pose risks to infants. Respiratory abnormalities often affect the number of sighs that occur while a child is sleeping. Sighs balance the cell oxygen level deficit in an infant. During periods of moderate hypoxemia, increased occurrence of gasps is attributed to cerebral arousal. On the other hand, progressive hypoxemia results to eupnoea, which progresses to apnoea (Haynes et al., 2017). Usually, gasps are a result of interactions between several networks of neurons and are often less prone to failure. During hypoxemia, the interactions occur but are less complicated but are more prone to failing. The less connected network is dependent on serotonin neurons which are likely to result in resuscitation failure. (Haynes et al., 2017). An abnormality causes inability to resuscitate in brain neurophysiology automatically. Infants with a lower frequency of sighs signify defects in respiratory control and are more predisposed to SIDS. Environmental factors such as increased temperature can result in decreased air circulation thus diminishing uptake of oxygen. Low oxygen intake is fatal considering the infant has fewer gasps compared to those of healthy infants. Toxic bacteria as a result of exposure to tobacco smoke and recreational drugs, on the other hand, can significantly contribute to death (Psaila et al., 2014). Several polymorphisms have been seen to increase Susceptibility of infants to SIDS. Whereas the contribution of these polymorphisms such as Aquaporin 4 in infants cannot be precisely established in death in SIDS, they pose significant effects on the brains neurophysiology (Haynes et al., 2017). Also, there have been cardiac genetic disorders such as cardiac channelopathies discovered when postmortems were performed on the bodies of infants. Bed sharing with infants causes some unexpected deaths. Research suggests that co-sleeping of infants with adults poses risks and can lead to SIDS. Co-sleeping has led to some countries banning co-sleeping (Pease et al., 2016). With the back to sleep campaign, there was a significant decrease in deaths when infants slept on cots. Interventions to reduce SIDS Sleeping Position Studies have shown that sleeping on the back is the safest position for infants. Side-sleeping provides a higher risk for infants. The risk increases when an infant is saddled (Pease et al., 2016). If a baby rolls over when sleeping in a side position, they might be prone to suffocating. The American Academy of Pediatrics (AAP) released additional guiding principles in 2011, highlighting the need for a safe sleeping setting alongside its previous suggestions. SIDS maintains the leading cause of death for infants under the age of 12 months and is thus a primary concern. The AAP recommends education of nurses and mothers on correct positioning. The association also provides role modelling for infant care for nurses and caretakers. Several likely models have been advanced where the horizontal sleeping position may lead to amplified risks of SIDS; it includes the likelihood of breathing used gases where carbon II oxide rises, and oxygen levels fall (Pease et al., 2016). Also, thermal stress due to warmth from the adult may increase nasal temperature thus providing a conducive environment for bacteria to thrive. Increased environmental temperature can result in diminished oxygen saturation in the body hence hypoxemia. Smoking Tobacco Research has proved that preterm and post-term smoking of tobacco increases the risk of mortality for infants. During pregnancy, mothers should avoid nicotine gums. Infants exposed to tobacco smoke exhibit lower levels of arousing the neurological system. The risk increases if the mother and the baby co-share a bed after birth. Tobacco and nicotine affect the automatic nervous control of cardiac function and blood pressure (Adams, ward & Garcia, 2015). The smoke has a detrimental effect on the homeostasis of the infant. Sleeping On Cots Scientists argue that the safest place for infants under the age of three months is in cots. Sleeping on cots is also recommended for breastfeeding infants even when the mother is a non-smoker. Psaila et al. (2014) concluded that there was a significant increase in the risk of SIDS even where the infant's caregiver did not use recreational drugs and maintained a safe and clean environment. The adul...