Greegor
November 26th 06, 02:58 AM
> many SIDS infants have abnormalities in the "arcuate nucleus,"
> a portion of the brain that is involved in control of breathing and waking during sleep.
> Babies born with defects in other portions of the brain or body may also be
> more prone to a sudden death.
> These abnormalities may stem from prenatal exposure to a toxic
> substance, or lack of a vital compound in the prenatal environment,
> such as sufficient oxygen.
> SIDS is the leading cause of death in infants between
> one to 12 months old.
DAN! LEADING CAUSE OF DEATH!
That makes it more likely than homicide!
So an infant death is not "probable cause".
> Most SIDS deaths occur when a baby is between 2 and 4 months of age.
Is there an upper age range?
If it's possible but less likely for a THREE YEAR OLD, do
you think a CPS caseworkers would EVEN CONSIDER IT?
Dan Sullivan wrote:
> http://www.sidsalliance.org/expectantparents/exp_reduce_qa.html
>
> QUESTIONS AND ANSWERS ON SUDDEN
> INFANT DEATH SYNDROME (SIDS)
> **Revised February, 2006
> Q: What is Sudden Infant Death Syndrome (SIDS)?
> A: SIDS is the diagnosis given for the sudden death of an infant under
> one year of
> age that remains unexplained after a complete investigation, which
> includes
> an autopsy, examination of the death scene (Center for Disease Control
> and
> Prevention guidelines), and review of the symptoms or illnesses the
> infant had
> prior to dying and any other pertinent medical and family history.
> Because
> most babies sleep in cribs, and therefore, most cases of SIDS occur
> when a
> baby is in a crib sleeping, SIDS is sometimes called "crib death."
> Cribs do not
> cause SIDS. However, other aspects of an infant's sleep environment
> have
> been associated with increasing the risks for SIDS.
> Q: What causes SIDS?
> A: There is mounting evidence that suggests some SIDS babies are born
> with
> brain abnormalities that make them vulnerable to sudden death during
> infancy. Studies of SIDS victims reveal that many SIDS infants have
> abnormalities in the "arcuate nucleus," a portion of the brain that is
> involved in
> control of breathing and waking during sleep. Babies born with defects
> in
> other portions of the brain or body may also be more prone to a sudden
> death. These abnormalities may stem from prenatal exposure to a toxic
> substance, or lack of a vital compound in the prenatal environment,
> such as
> sufficient oxygen.
> Q: When is SIDS most likely to occur?
> A: SIDS is the leading cause of death in infants between one to 12
> months old.
> Most SIDS deaths occur when a baby is between 2 and 4 months of age.
> Ninety percent of SIDS victims die before 6 months. The risk of SIDS
> diminishes
> during the first year of life. The diagnosis of SIDS is not commonly
> used after 1
> year of age.
> Q: Is there anything we can do to prevent SIDS?
> A: There currently is no way of predicting which newborns will succumb
> to SIDS.
> However, there are a few measures parents can take to lower the risk of
> their
> child dying from SIDS in order to give their infant the best possible
> chance to
> thrive.
> Back Sleeping. Placing babies on their backs to sleep is the single
> most
> important step that parents and other caregivers can take to reduce the
> risk
> of SIDS. Infants who fall asleep on their stomachs should be gently
> turned
> onto their backs. Studies have shown that countries where caregivers
> have
> switched from placing babies on their stomachs to sleep to placing
> babies on
> their backs to sleep have reduced their total SIDS deaths by more than
> 50
> percent. 3,500 fewer infants die of SIDS in the U.S. each year due to
> this simple
> 2
> measure. It is important to note that the side sleeping position is not
> a safe
> alternative. Babies that roll from their side to their tummy are 18
> times more
> likely to die of SIDS.
> Bedding. Parents should make sure their baby sleeps on a firm, flat
> mattress in
> a crib that meets current safety standards. Caregivers should also
> avoid
> using soft, fluffy or loose bedding or other objects in the crib, and
> should not
> use pillows, sheepskins or comforters under the baby. Bumpers are not
> necessary, and soft or pillow-like bumpers should be avoided. Consider
> using
> a sleeper or other sleep clothing as an alternative to blankets, with
> no other
> covering. If using a blanket, put baby with feet at the foot of the
> crib. Tuck a
> large, thin blanket around the crib mattress, reaching only as far as
> the baby's
> chest to lessen the likelihood of having the infant crawl under the
> bedclothes
> or pull-up over his face. Infants under 1 year of age should not be
> placed to
> sleep on an adult bed, waterbed, sofa or with stuffed toys or pillows.
> Head Covering. Make sure your baby's head remains uncovered during
> sleep. Babies are at an increased risk for SIDS if their head becomes
> covered
> during sleep. Avoid using a blanket or other covering over your
> baby's face
> as a sun or weather screen, or to block out distractions or sounds
> while your
> baby is sleeping. Bedding that bunches up or contours around your
> baby's
> face can obstruct the mouth and nose, causing potentially dangerous
> rebreathing
> of stale air.
> Bed Sharing/Sofa Sharing. Do not share a sleep surface with your baby.
> Bring
> baby into bed to feed and cuddle, put place them in a separate, safe
> sleep
> area alongside your bed when its time to go to sleep. In addition to
> the
> recognized hazards presented by pillows and comforters in the family
> bed,
> there are risks associated with infants who sleep with parents whose
> instincts
> are impaired by exhaustion, drug or alcohol abuse, or who are smokers.
> There
> are also dangers connected with infants sharing a bed with brothers,
> sisters, or
> relatives other than the baby's mother. Sofas and chairs are
> particularly
> dangerous environments for shared sleep. Bed sharing has not been found
> to
> be protective against SIDS, though studies suggest that room sharing
> may be
> protective. Keeping the baby next to the adult bed in her own separate
> sleep space for at least the first six months provides greater safety
> for the
> infant and proximity for parents seeking to facilitate breastfeeding
> and share
> closeness with their baby.
> Pacifiers. Recent research has shown that pacifiers can significantly
> reduce a
> baby's risk for SIDS. Experts recommend providing your baby with a
> pacifier
> EVERY time they are placed down to sleep. While the exact safety
> mechanism is not yet know, there are many possibilities for this
> finding. It has
> been suggested that the presence of a pacifier in the mouth may
> discourage
> babies from turning over onto their faces during sleep. Moving or
> turning may
> dislodge the pacifier, which may have the effect of encouraging babies
> to
> stay on their backs. Another theory suggests that pacifier use might
> help to
> 3
> keep the tongue positioned forward, keeping the airways open. It has
> also
> been hypothesized that pacifier use may quiet a restless infant, who
> might
> otherwise move more aggressively around the crib. On the other hand,
> pacifiers may stimulate the upper airway muscles and saliva production,
> possibly triggering brain activity and ability to arouse from sleep.
> Increased
> arousability is seen in infants who usually sleep with a pacifier, even
> if the
> pacifier is not being used.
> Smoking. Mothers who smoke during pregnancy are three times more likely
> to
> have a SIDS baby, and exposure to passive smoke from smoking by
> mothers,
> fathers, and others around the baby after its born doubles their risk
> of SIDS.
> Parents should be sure to keep their babies in a smoke-free
> environment.
> Studies have found that the risk of SIDS rises with each additional
> smoker in the
> home, the numbers of cigarettes smoked a day, and the length of the
> infant's
> exposure to cigarette smoke. Components of smoke are believed to
> interfere
> with an infant's developing lungs and nervous system, and to disrupt
> a baby's
> ability to wake from sleep.
> Room Temperature. Babies should be kept warm, but they should not be
> allowed to get too warm. An overheated baby is more likely to go into a
> deep sleep from which it is difficult to arouse. Keep the temperature
> in the
> baby's room at a level that feels comfortable to an adult (68 -
> 72ºF)and avoid
> overdressing the baby.
> Prenatal Care. Good prenatal care - including proper nutrition,
> abstinence
> from alcohol, drugs, and smoking, and frequent medical checkups
> beginning
> early in pregnancy - might help prevent a baby from developing an
> abnormality that could put him or her at risk for sudden death.
> Breastfeeding. Breastfeeding has been shown to be good for babies by
> building their immunity against illness and infections, in addition to
> other
> benefits. Mothers should be encouraged to breastfeed exclusively for at
> least
> the first six months if at all possible.
> Data analyzed by scientists at the National Institute of Environmental
> Health
> Sciences suggest that breastfeeding can reduce the risk of death for
> infants in
> their first year of life. Looking at infants between 28 days and one
> year of age,
> researchers concluded that promoting breastfeeding could potentially
> prevent up to 720 post-neonatal deaths in the U.S. each year.
> Researchers
> compared CDC records of 1,204 children who died between 28 days and
> one year of causes other than congenital anomalies or cancer with those
> of
> 7,740 children still alive at one year.
> Regular Health Care. Parents should take their babies to their health
> care
> provider for regular well baby checkups, and should make sure that
> their
> babies receive their immunizations on schedule.
> 4
> Child Care. Babies who routinely sleep on their backs and are
> unaccustomed
> to sleeping on their stomachs are at a significantly increased risk of
> SIDS when
> placed prone by a well intentioned but ill-informed relative or
> caregiver. Be
> sure to communicate Back to Sleep information to baby sitters, daycare
> providers, grandparents and everyone else who cares for your infant.
> Parents
> cannot assume that everyone knows about Back to Sleep and other ways to
> reduce SIDS risk.
> Q: What is the Back to Sleep campaign?
> A: Back to Sleep is aptly named for its main recommendation to place
> healthy
> infants on their backs to sleep to reduce the risk of SIDS. The
> National Institute
> of Child Health and Human Development (NICHD) leads the campaign, along
> with the Maternal and Child Health Bureau and other Federal agencies
> such
> as the Centers for Disease Control and the Census Bureau. The American
> Academy of Pediatrics (AAP) is the major private sponsor, along with
> First
> Candle/SIDS Alliance and the Association of SIDS and Infant Mortality
> Programs. Based on a recommendation made by the AAP in 1992, the
> campaign was launched in 1994 with an effort to reach every newborn
> nursery in the country. A toll-free number was established for ordering
> Back To
> Sleep pamphlets, posters, and videos.
> Q: Is the campaign successful?
> A: This campaign has been increasingly successful in reaching parents
> and other
> caretakers of infants. We have seen a change from 70 percent of babies
> placed on their stomachs to sleep in 1992 to 15 percent in 2005. The
> death
> rate of Sudden Infant Death Syndrome (SIDS) declined by more than 50%
> between 1994 and 2002, signifying the first significant decrease in
> SIDS deaths
> in the U.S.
> Q: Are there any infants that are more at risk for SIDS?
> A: Yes, infants in the following categories are at a higher risk for
> SIDS:
> · Infants born to mothers who are less than 20 years old at the time
> of
> their first pregnancy
> · Babies born to mothers who had no or late prenatal care
> · Infants born to mothers with too short an interval between
> pregnancies
> · Premature or low birth weight babies and multiples
> · Babies born to mothers who smoke during or after pregnancy
> · Infants who are placed to sleep on their stomach or side
> Q: Are any ethnic groups more prone to SIDS?
> A: African American infants are nearly two-and-a-half times more likely
> to die of
> SIDS than white infants, and Native American babies are approximately
> three
> times as likely to die from SIDS. The Back to Sleep campaign is being
> stepped
> up, with a special effort to get the message out to these two
> populations with
> the help of community, civic and religious groups.
> 5
> Q: Is SIDS inherited?
> A: There may be something that genetically predisposes an infant to
> higher SIDS
> risk. Metabolic disorders, which can be inherited, have, at times, been
> mistaken for SIDS. One such disorder, medium chain acylCoA
> dehydrogenase deficiency, prevents the infant from properly processing
> fatty
> acids. A build up of these acid metabolites could eventually lead to a
> rapid
> and fatal disruption in breathing and heart functioning. If there is a
> family
> history of this disorder or childhood death of unknown cause
> (especially more
> than one case within a family), genetic screening of parents by a blood
> test
> can determine if they are carriers of this disorder. If one or both
> parents are
> found to be a carrier, the baby can be tested soon after birth at
> little cost.
> This is another reason why the autopsy is so important. Tests can be
> done on
> the tissues of an infant to identify known metabolic disorders.
> Q: I have heard that the side sleep position is effective against SIDS.
> A: In 1992, the American Academy of Pediatrics (AAP) recommended both
> the
> side and the back sleeping position to reduce the risk of SIDS. In
> 1996,
> however, after reviewing data from various new studies, they revised
> their
> recommendation to back sleeping as the safest position for infants.
> These
> reports indicated that the risk for SIDS is greater for babies placed
> on their
> sides versus those placed on their backs, perhaps because babies placed
> on
> their sides have a higher likelihood of spontaneously turning onto
> their
> tummies. Most recently (2005) the AAP has recommended against side
> sleep
> position for babies.
> Q: Won't my baby choke on spit-up or vomit during sleep if placed on
> its back?
> A: Many parents place babies on their stomachs to sleep because they
> think it
> prevents them from choking on spit-up or vomit during sleep. But
> studies in
> countries where there has been a switch from babies sleeping
> predominantly
> on their stomachs to sleeping mainly on their backs have not found any
> evidence of increased incidence of aspiration, pneumonia, choking, or
> other
> problems. In addition, the AAP has reviewed all the scientific
> literature and
> found that there is no additional risk of choking on vomit when babies
> sleep
> on their backs. Experts actually feel that babies are at a higher risk
> for choking
> or aspirating when placed on their tummies than they are when placed on
> their back.
> Q: Which babies should not be placed on their backs to sleep?
> A: In some instances, doctors may recommend that babies be placed on
> their
> stomachs to sleep if they have disorders such as gastroesophageal
> reflux or
> certain upper airway disorders that predispose them to choking or
> breathing
> problems while lying on their backs. If parents are unsure about the
> best
> sleep position for their baby, it is always a good idea to talk to the
> baby's
> doctor or other health care provider.
> 6
> Q: Doesn't back sleeping cause flat heads?
> A: There is some suggestion that the incidence of babies developing
> flat spots
> may have increased with back sleeping. This is almost always a benign
> condition, which will disappear within several months after the baby
> has
> begun to sit up. Flat spots can be avoided by altering the back
> sleeping
> head position, such as turning the head to one side for a week or so
> and then
> changing to the other. Reversing the head-to-toe axis in the crib so
> the
> baby's head can continually face outside activity (e.g., the door to
> the room)
> helps maintain this position. Parents should be sure to alternate arms
> when
> feeding and provide lots of supervised tummy-time while awake (see
> below).
> Be sure that your baby does not spend too much time in car seats and
> carriers
> to further minimize the potential for a flat head.
> Q: Should infants ever be placed on their tummies?
> A: As much "tummy time" as possible while the infant is awake and being
> observed is recommended for motor development of the upper body
> muscles. In addition, tummy time may also help prevent flat spots from
> developing on the back of the baby's head. Never leave your baby
> unattended during tummy-time. If the baby tires or is sleepy, place
> them on
> their back in a safe sleep area.
> Q: What if my baby cries and cries and won't sleep in the back
> position?
> A: Positional preference appears to be a learned behavior among infants
> from
> birth to 4 to 6 months of age. If placed on their back from day one,
> most
> infants become accustomed to the back sleeping position.
> Q: Should sleeping "wedges" be used for infants?
> A: The American Academy of Pediatrics has stated that devices designed
> to
> maintain sleep position are not recommended since they have not been
> sufficiently tested for their safety and none have been shown to be
> effective
> at reducing the risk of SIDS.
> Q: Are there any advantages or disadvantages to "shared sleeping"
> arrangements?
> A: Scientific studies have demonstrated that bed sharing, between baby
> and
> mother, can alter sleep patterns of mother and baby. These studies have
> led
> to a speculation in the lay press that bed sharing or "co-sleeping"
> may also
> reduce the risk of SIDS. While bed sharing may have certain benefits
> (such as
> encouraging breast feeding), there are no scientific studies
> demonstrating
> that bed sharing reduces SIDS. Conversely, there are studies suggesting
> that
> bed sharing, under certain conditions, may actually increase the risk
> of SIDS.
> There is no basis at this time for encouraging bed sharing as a
> strategy to
> reduce SIDS risk. However, room-sharing - keeping the baby alongside
> the
> adult bed in his own crib or bassinet - can be protective against
> SIDS.
> 7
> Q: Is enough research being conducted to determine the cause of SIDS?
> A: Scientists are exploring the development and function of the nervous
> system,
> the brain, the heart, breathing and sleeping patterns, body chemical
> balances, autopsy findings and environmental factors. SIDS, like other
> medical disorders, may eventually have more than one explanation -
> and
> more than one means of prevention. This may explain why the
> characteristics
> of SIDS babies seem so varied. SIDS has been a high priority for
> research for
> the National Institute of Child Health and Human Development (NICHD) at
> the
> National Institutes of Health (NIH). Although SIDS deaths are
> decreasing, it is
> important that NICHD continue to support research aimed at uncovering
> what causes SIDS, who is at risk for the disorder, and ways to lower
> the risk of
> sudden infant death. In addition to its grassroots advocacy program
> that
> helps ensure Congressional allocation of adequate funding for
> NICHDsponsored
> SIDS research, First Candle/SIDS Alliance maintains its own national
> research program.
> The importance of understanding the causes of SIDS is only underscored
> by its
> consistent place in the headlines. The more we learn about SIDS, the
> more
> easily we will be able to distinguish SIDS from other infant deaths,
> and perhaps
> even one day be able to predict more accurately which babies are at
> highest risk.
> Q: Is there any research on home monitors?
> A: Among the many avenues of research initiated by the NICHD, infant
> monitoring was thoroughly investigated by NICHD-funded researchers. In
> the
> 1970's and early 1980's, it was thought that monitoring had promise in
> identifying infants at risk for SIDS and signaling caregivers when
> infants have
> life-threatening events that may proceed to SIDS. In September of 1986,
> the
> NICHD held a consensus conference titled, "Infantile Apnea and Home
> Monitoring." After examining all available research, the consensus
> panel
> determined that cardiorespiratory monitoring is effective only in some
> cases to
> manage apnea. For the normal newborn, the risks, disadvantages, and
> costs
> of monitoring outweigh the potential of identifying infants at risk for
> SIDS.
> Today, NICHD funds the Collaborative Home Infant Monitoring Evaluation
> (CHIME), a multi-center study initiated in 1991 that employs a
> specifically
> commissioned monitor with multiple innovative capabilities, including
> substantially increased memory, detection of obstructive as well as
> central
> apnea, continuous measurement of blood oxygen saturation, and
> assessment
> of sleep position. The CHIME project will create an extensive database
> (which
> will be made available to the scientific community) on the development
> of
> cardiorespiratory physiology in normal and in at risk infants. In this
> context, the
> study should yield important new insights regarding the frequency and
> nature
> of clinically significant events as related to breathing pattern, heart
> rate, and
> oxygen saturation.
> 8
> Q: Then, NICHD does not recommend the use of monitors to prevent SIDS?
> A: Although some electronic home monitors detect and sound an alarm
> when a
> baby stops breathing, there is no evidence that such monitors prevent
> SIDS.
> The monitors also pose several disadvantages, including frequent false
> alarms,
> restricted mobility of both infant and parents, and the risk of
> electrical injury to
> young children.
> A panel of experts convened by the National Institutes of Health
> recommended that home monitors not be used for babies who do not have
> an increased risk of sudden unexpected death. However, the monitors may
> be recommended in some cases including for infants who have experienced
> one or more severe episodes during which they stopped breathing and
> required resuscitation or stimulation, if the baby is premature and has
> symptomatic apnea, or if the baby has a medical condition such as
> central
> hypoventilation. If an incident has occurred or if an infant is on a
> monitor,
> parents need to know how to properly use and maintain the device as
> well as
> how to resuscitate their baby if the alarm sounds.
> Q: Haven't there been stories of misdiagnoses in the news lately?
> A: Research has indicated that a small percentage of cases originally
> believed
> to be SIDS were actually caused by a metabolic disorder. Other recent
> reports indicate that some SIDS deaths may not actually be SIDS, but
> might be
> attributed to hemorrhaging in the lungs (pulmonary hemosiderosis).
> Q: Do you have any estimates on how often SIDS is a misdiagnosis?
> A: Estimates from a few studies have shown that misdiagnoses account
> for a
> very small percentage of SIDS deaths. In a 2005 policy statement, the
> American Academy of Pediatrics (AAP) estimated that cases of sudden
> infant
> death thought to be SIDS were correct 95-98% of the time.
> Q: There have been recent stories in the news suggesting that some
> cases of SIDS
> have been misdiagnosed and may be hidden cases of abuse and
> infanticide.
> A: While cases of abuse misdiagnosed as SIDS grab the media spotlight,
> it is
> actually far more common for the families or caregivers of SIDS victims
> to be
> unjustly accused or suspected of wrongdoing. By medical definition, the
> term
> SIDS is a postmortem diagnosis affixed when no known or possible cause
> for
> an infant's death can be found following a thorough autopsy, death
> scene
> investigation and review of the medical history. Many of the cases
> reported
> by the media are decades old, prior to the implementation of proper
> autopsy
> and death scene investigation protocol. Although there have been
> instances
> of cases that have fallen through the cracks of the medical examiner
> system,
> the overwhelming number of SIDS cases are bonafide medical disorders,
> and
> remain a medical mystery after all known and possible causes, including
> child
> abuse, have been ruled out.
> These unusual cases only reiterate the need to fully investigate, on a
> case by
> 9
> case basis, each instance of a sudden infant death and to consider the
> many
> possible causes of death, including but not limited to SIDS, congenital
> anomalies, metabolic disorders, unintentional injuries, child abuse,
> and
> infections.
> Q: Are there state or national guidelines for investigating the sudden
> death of
> infants?
> A: In 1993, the Interagency Panel on SIDS held a meeting to develop
> guidelines
> for death scene investigation of sudden unexplained infant deaths. A
> death
> scene investigation is an integral part of a SIDS diagnosis to rule out
> accidental, environmental, and unnatural causes and to provide
> information
> to researchers on risk factors for SIDS. In June 1996, the Panel
> published
> guidelines for death scene investigation that include model protocol
> and
> data form for collection of information by medical examiners, coroners,
> death
> team investigators, and police officers. Although state and local
> ordinances
> define which deaths must be investigated and the extent of the
> investigation,
> these guidelines set the stage for uniform death scene investigation
> around
> the country.
> In 2004 the CDC launched an initiative to improve the investigation and
> reporting of SUID, in collaboration with other federal agencies and
> organizations representing medical examiners, coroners, death scene
> investigators, emergency medical personnel, law enforcement officials,
> SIDS
> researchers, infant death review experts, and SIDS parents. As part of
> this
> effort, on March 1, 2006, CDC will release the Sudden, Unexplained
> Infant
> Death Investigation (SUIDI) Reporting Form for state and local use in
> infant
> death scene investigations. The SUIDI Reporting Form replaces the
> Investigation Report Form that accompanied the 1996 Guidelines for the
> Death Scene Investigation of Sudden, Unexplained Infant Death.
> Currently, approximately half of the states have mandatory autopsy
> legislation for the sudden death of an infant that, in many cases,
> includes
> support for the administration of compassionate services for SIDS
> families.
> Other states are in the process of establishing similar legislation.
> SIDS families,
> at the guidance of First Candle/SIDS Alliance, have been at the
> forefront of
> efforts urging the funding of research, adoption of mandatory autopsy
> legislation, and thorough, but compassionate death scene
> investigations.
> Broader, standardized implementation of autopsy and death scene
> mandates is crucial to efforts to differentiate cases of SIDS from
> cases of child
> abuse, and to expand our medical knowledge about SIDS.
> Q: How does a SIDS death affect the family?
> A: A SIDS death is a tragedy that prompts intense emotional reactions
> among
> surviving family members. After the initial disbelief, denial, or
> numbness begins
> to wear off, parents often fall into a prolonged depression. This
> depression can affect their sleeping, eating, ability to concentrate,
> and
> 10
> general energy level. Crying, weeping, incessant talking, and strong
> feelings
> of guilt or anger are all normal reactions.
> Many parents experience unreasonable fears that they, or someone in
> their
> family, is in danger. Over protection of surviving children and fears
> for future
> children are common reactions. As the finality of the child's death
> becomes a
> reality for the parents, recovery occurs. Parents begin to take a more
> active
> part in their own lives, which begin to have meaning once again. The
> pain of
> their child's death becomes less intense but not forgotten. Birthdays,
> holidays,
> and the anniversary of the child's death trigger periods of intense
> pain and
> suffering.
> Children will also be affected by the baby's death. They may fear that
> other
> members of the family, including themselves, will also suddenly die.
> Children
> often also feel guilty about the death of a sibling and may feel that
> they had
> something to do with the death. Children may not show their feelings in
> obvious ways. Although they may deny being upset and seem unconcerned,
> signs that they are disturbed include intensified clinging to parents,
> misbehaving, bedwetting, difficulties in school, and nightmares. It is
> important
> to talk to children about the death and explain to them that the baby
> died
> because of a medical problem that only occurs in infants and in rare
> instances.
> Q: Are there any support groups available for families who have lost a
> baby to
> SIDS?
> A: Families are encouraged to seek counseling and support. First
> Candle/SIDS
> Alliance can provide bilingual crisis intervention counseling and
> access to
> extensive grief resources by calling 800.221.7437, or visiting
> www.firstcandle.org.
> Excerpted and edited by First Candle SIDS Alliance -- February, 2006
> from materials
> developed by the National Institute of Child Health and Human
> Development (NICHD)
> a portion of the brain that is involved in control of breathing and waking during sleep.
> Babies born with defects in other portions of the brain or body may also be
> more prone to a sudden death.
> These abnormalities may stem from prenatal exposure to a toxic
> substance, or lack of a vital compound in the prenatal environment,
> such as sufficient oxygen.
> SIDS is the leading cause of death in infants between
> one to 12 months old.
DAN! LEADING CAUSE OF DEATH!
That makes it more likely than homicide!
So an infant death is not "probable cause".
> Most SIDS deaths occur when a baby is between 2 and 4 months of age.
Is there an upper age range?
If it's possible but less likely for a THREE YEAR OLD, do
you think a CPS caseworkers would EVEN CONSIDER IT?
Dan Sullivan wrote:
> http://www.sidsalliance.org/expectantparents/exp_reduce_qa.html
>
> QUESTIONS AND ANSWERS ON SUDDEN
> INFANT DEATH SYNDROME (SIDS)
> **Revised February, 2006
> Q: What is Sudden Infant Death Syndrome (SIDS)?
> A: SIDS is the diagnosis given for the sudden death of an infant under
> one year of
> age that remains unexplained after a complete investigation, which
> includes
> an autopsy, examination of the death scene (Center for Disease Control
> and
> Prevention guidelines), and review of the symptoms or illnesses the
> infant had
> prior to dying and any other pertinent medical and family history.
> Because
> most babies sleep in cribs, and therefore, most cases of SIDS occur
> when a
> baby is in a crib sleeping, SIDS is sometimes called "crib death."
> Cribs do not
> cause SIDS. However, other aspects of an infant's sleep environment
> have
> been associated with increasing the risks for SIDS.
> Q: What causes SIDS?
> A: There is mounting evidence that suggests some SIDS babies are born
> with
> brain abnormalities that make them vulnerable to sudden death during
> infancy. Studies of SIDS victims reveal that many SIDS infants have
> abnormalities in the "arcuate nucleus," a portion of the brain that is
> involved in
> control of breathing and waking during sleep. Babies born with defects
> in
> other portions of the brain or body may also be more prone to a sudden
> death. These abnormalities may stem from prenatal exposure to a toxic
> substance, or lack of a vital compound in the prenatal environment,
> such as
> sufficient oxygen.
> Q: When is SIDS most likely to occur?
> A: SIDS is the leading cause of death in infants between one to 12
> months old.
> Most SIDS deaths occur when a baby is between 2 and 4 months of age.
> Ninety percent of SIDS victims die before 6 months. The risk of SIDS
> diminishes
> during the first year of life. The diagnosis of SIDS is not commonly
> used after 1
> year of age.
> Q: Is there anything we can do to prevent SIDS?
> A: There currently is no way of predicting which newborns will succumb
> to SIDS.
> However, there are a few measures parents can take to lower the risk of
> their
> child dying from SIDS in order to give their infant the best possible
> chance to
> thrive.
> Back Sleeping. Placing babies on their backs to sleep is the single
> most
> important step that parents and other caregivers can take to reduce the
> risk
> of SIDS. Infants who fall asleep on their stomachs should be gently
> turned
> onto their backs. Studies have shown that countries where caregivers
> have
> switched from placing babies on their stomachs to sleep to placing
> babies on
> their backs to sleep have reduced their total SIDS deaths by more than
> 50
> percent. 3,500 fewer infants die of SIDS in the U.S. each year due to
> this simple
> 2
> measure. It is important to note that the side sleeping position is not
> a safe
> alternative. Babies that roll from their side to their tummy are 18
> times more
> likely to die of SIDS.
> Bedding. Parents should make sure their baby sleeps on a firm, flat
> mattress in
> a crib that meets current safety standards. Caregivers should also
> avoid
> using soft, fluffy or loose bedding or other objects in the crib, and
> should not
> use pillows, sheepskins or comforters under the baby. Bumpers are not
> necessary, and soft or pillow-like bumpers should be avoided. Consider
> using
> a sleeper or other sleep clothing as an alternative to blankets, with
> no other
> covering. If using a blanket, put baby with feet at the foot of the
> crib. Tuck a
> large, thin blanket around the crib mattress, reaching only as far as
> the baby's
> chest to lessen the likelihood of having the infant crawl under the
> bedclothes
> or pull-up over his face. Infants under 1 year of age should not be
> placed to
> sleep on an adult bed, waterbed, sofa or with stuffed toys or pillows.
> Head Covering. Make sure your baby's head remains uncovered during
> sleep. Babies are at an increased risk for SIDS if their head becomes
> covered
> during sleep. Avoid using a blanket or other covering over your
> baby's face
> as a sun or weather screen, or to block out distractions or sounds
> while your
> baby is sleeping. Bedding that bunches up or contours around your
> baby's
> face can obstruct the mouth and nose, causing potentially dangerous
> rebreathing
> of stale air.
> Bed Sharing/Sofa Sharing. Do not share a sleep surface with your baby.
> Bring
> baby into bed to feed and cuddle, put place them in a separate, safe
> sleep
> area alongside your bed when its time to go to sleep. In addition to
> the
> recognized hazards presented by pillows and comforters in the family
> bed,
> there are risks associated with infants who sleep with parents whose
> instincts
> are impaired by exhaustion, drug or alcohol abuse, or who are smokers.
> There
> are also dangers connected with infants sharing a bed with brothers,
> sisters, or
> relatives other than the baby's mother. Sofas and chairs are
> particularly
> dangerous environments for shared sleep. Bed sharing has not been found
> to
> be protective against SIDS, though studies suggest that room sharing
> may be
> protective. Keeping the baby next to the adult bed in her own separate
> sleep space for at least the first six months provides greater safety
> for the
> infant and proximity for parents seeking to facilitate breastfeeding
> and share
> closeness with their baby.
> Pacifiers. Recent research has shown that pacifiers can significantly
> reduce a
> baby's risk for SIDS. Experts recommend providing your baby with a
> pacifier
> EVERY time they are placed down to sleep. While the exact safety
> mechanism is not yet know, there are many possibilities for this
> finding. It has
> been suggested that the presence of a pacifier in the mouth may
> discourage
> babies from turning over onto their faces during sleep. Moving or
> turning may
> dislodge the pacifier, which may have the effect of encouraging babies
> to
> stay on their backs. Another theory suggests that pacifier use might
> help to
> 3
> keep the tongue positioned forward, keeping the airways open. It has
> also
> been hypothesized that pacifier use may quiet a restless infant, who
> might
> otherwise move more aggressively around the crib. On the other hand,
> pacifiers may stimulate the upper airway muscles and saliva production,
> possibly triggering brain activity and ability to arouse from sleep.
> Increased
> arousability is seen in infants who usually sleep with a pacifier, even
> if the
> pacifier is not being used.
> Smoking. Mothers who smoke during pregnancy are three times more likely
> to
> have a SIDS baby, and exposure to passive smoke from smoking by
> mothers,
> fathers, and others around the baby after its born doubles their risk
> of SIDS.
> Parents should be sure to keep their babies in a smoke-free
> environment.
> Studies have found that the risk of SIDS rises with each additional
> smoker in the
> home, the numbers of cigarettes smoked a day, and the length of the
> infant's
> exposure to cigarette smoke. Components of smoke are believed to
> interfere
> with an infant's developing lungs and nervous system, and to disrupt
> a baby's
> ability to wake from sleep.
> Room Temperature. Babies should be kept warm, but they should not be
> allowed to get too warm. An overheated baby is more likely to go into a
> deep sleep from which it is difficult to arouse. Keep the temperature
> in the
> baby's room at a level that feels comfortable to an adult (68 -
> 72ºF)and avoid
> overdressing the baby.
> Prenatal Care. Good prenatal care - including proper nutrition,
> abstinence
> from alcohol, drugs, and smoking, and frequent medical checkups
> beginning
> early in pregnancy - might help prevent a baby from developing an
> abnormality that could put him or her at risk for sudden death.
> Breastfeeding. Breastfeeding has been shown to be good for babies by
> building their immunity against illness and infections, in addition to
> other
> benefits. Mothers should be encouraged to breastfeed exclusively for at
> least
> the first six months if at all possible.
> Data analyzed by scientists at the National Institute of Environmental
> Health
> Sciences suggest that breastfeeding can reduce the risk of death for
> infants in
> their first year of life. Looking at infants between 28 days and one
> year of age,
> researchers concluded that promoting breastfeeding could potentially
> prevent up to 720 post-neonatal deaths in the U.S. each year.
> Researchers
> compared CDC records of 1,204 children who died between 28 days and
> one year of causes other than congenital anomalies or cancer with those
> of
> 7,740 children still alive at one year.
> Regular Health Care. Parents should take their babies to their health
> care
> provider for regular well baby checkups, and should make sure that
> their
> babies receive their immunizations on schedule.
> 4
> Child Care. Babies who routinely sleep on their backs and are
> unaccustomed
> to sleeping on their stomachs are at a significantly increased risk of
> SIDS when
> placed prone by a well intentioned but ill-informed relative or
> caregiver. Be
> sure to communicate Back to Sleep information to baby sitters, daycare
> providers, grandparents and everyone else who cares for your infant.
> Parents
> cannot assume that everyone knows about Back to Sleep and other ways to
> reduce SIDS risk.
> Q: What is the Back to Sleep campaign?
> A: Back to Sleep is aptly named for its main recommendation to place
> healthy
> infants on their backs to sleep to reduce the risk of SIDS. The
> National Institute
> of Child Health and Human Development (NICHD) leads the campaign, along
> with the Maternal and Child Health Bureau and other Federal agencies
> such
> as the Centers for Disease Control and the Census Bureau. The American
> Academy of Pediatrics (AAP) is the major private sponsor, along with
> First
> Candle/SIDS Alliance and the Association of SIDS and Infant Mortality
> Programs. Based on a recommendation made by the AAP in 1992, the
> campaign was launched in 1994 with an effort to reach every newborn
> nursery in the country. A toll-free number was established for ordering
> Back To
> Sleep pamphlets, posters, and videos.
> Q: Is the campaign successful?
> A: This campaign has been increasingly successful in reaching parents
> and other
> caretakers of infants. We have seen a change from 70 percent of babies
> placed on their stomachs to sleep in 1992 to 15 percent in 2005. The
> death
> rate of Sudden Infant Death Syndrome (SIDS) declined by more than 50%
> between 1994 and 2002, signifying the first significant decrease in
> SIDS deaths
> in the U.S.
> Q: Are there any infants that are more at risk for SIDS?
> A: Yes, infants in the following categories are at a higher risk for
> SIDS:
> · Infants born to mothers who are less than 20 years old at the time
> of
> their first pregnancy
> · Babies born to mothers who had no or late prenatal care
> · Infants born to mothers with too short an interval between
> pregnancies
> · Premature or low birth weight babies and multiples
> · Babies born to mothers who smoke during or after pregnancy
> · Infants who are placed to sleep on their stomach or side
> Q: Are any ethnic groups more prone to SIDS?
> A: African American infants are nearly two-and-a-half times more likely
> to die of
> SIDS than white infants, and Native American babies are approximately
> three
> times as likely to die from SIDS. The Back to Sleep campaign is being
> stepped
> up, with a special effort to get the message out to these two
> populations with
> the help of community, civic and religious groups.
> 5
> Q: Is SIDS inherited?
> A: There may be something that genetically predisposes an infant to
> higher SIDS
> risk. Metabolic disorders, which can be inherited, have, at times, been
> mistaken for SIDS. One such disorder, medium chain acylCoA
> dehydrogenase deficiency, prevents the infant from properly processing
> fatty
> acids. A build up of these acid metabolites could eventually lead to a
> rapid
> and fatal disruption in breathing and heart functioning. If there is a
> family
> history of this disorder or childhood death of unknown cause
> (especially more
> than one case within a family), genetic screening of parents by a blood
> test
> can determine if they are carriers of this disorder. If one or both
> parents are
> found to be a carrier, the baby can be tested soon after birth at
> little cost.
> This is another reason why the autopsy is so important. Tests can be
> done on
> the tissues of an infant to identify known metabolic disorders.
> Q: I have heard that the side sleep position is effective against SIDS.
> A: In 1992, the American Academy of Pediatrics (AAP) recommended both
> the
> side and the back sleeping position to reduce the risk of SIDS. In
> 1996,
> however, after reviewing data from various new studies, they revised
> their
> recommendation to back sleeping as the safest position for infants.
> These
> reports indicated that the risk for SIDS is greater for babies placed
> on their
> sides versus those placed on their backs, perhaps because babies placed
> on
> their sides have a higher likelihood of spontaneously turning onto
> their
> tummies. Most recently (2005) the AAP has recommended against side
> sleep
> position for babies.
> Q: Won't my baby choke on spit-up or vomit during sleep if placed on
> its back?
> A: Many parents place babies on their stomachs to sleep because they
> think it
> prevents them from choking on spit-up or vomit during sleep. But
> studies in
> countries where there has been a switch from babies sleeping
> predominantly
> on their stomachs to sleeping mainly on their backs have not found any
> evidence of increased incidence of aspiration, pneumonia, choking, or
> other
> problems. In addition, the AAP has reviewed all the scientific
> literature and
> found that there is no additional risk of choking on vomit when babies
> sleep
> on their backs. Experts actually feel that babies are at a higher risk
> for choking
> or aspirating when placed on their tummies than they are when placed on
> their back.
> Q: Which babies should not be placed on their backs to sleep?
> A: In some instances, doctors may recommend that babies be placed on
> their
> stomachs to sleep if they have disorders such as gastroesophageal
> reflux or
> certain upper airway disorders that predispose them to choking or
> breathing
> problems while lying on their backs. If parents are unsure about the
> best
> sleep position for their baby, it is always a good idea to talk to the
> baby's
> doctor or other health care provider.
> 6
> Q: Doesn't back sleeping cause flat heads?
> A: There is some suggestion that the incidence of babies developing
> flat spots
> may have increased with back sleeping. This is almost always a benign
> condition, which will disappear within several months after the baby
> has
> begun to sit up. Flat spots can be avoided by altering the back
> sleeping
> head position, such as turning the head to one side for a week or so
> and then
> changing to the other. Reversing the head-to-toe axis in the crib so
> the
> baby's head can continually face outside activity (e.g., the door to
> the room)
> helps maintain this position. Parents should be sure to alternate arms
> when
> feeding and provide lots of supervised tummy-time while awake (see
> below).
> Be sure that your baby does not spend too much time in car seats and
> carriers
> to further minimize the potential for a flat head.
> Q: Should infants ever be placed on their tummies?
> A: As much "tummy time" as possible while the infant is awake and being
> observed is recommended for motor development of the upper body
> muscles. In addition, tummy time may also help prevent flat spots from
> developing on the back of the baby's head. Never leave your baby
> unattended during tummy-time. If the baby tires or is sleepy, place
> them on
> their back in a safe sleep area.
> Q: What if my baby cries and cries and won't sleep in the back
> position?
> A: Positional preference appears to be a learned behavior among infants
> from
> birth to 4 to 6 months of age. If placed on their back from day one,
> most
> infants become accustomed to the back sleeping position.
> Q: Should sleeping "wedges" be used for infants?
> A: The American Academy of Pediatrics has stated that devices designed
> to
> maintain sleep position are not recommended since they have not been
> sufficiently tested for their safety and none have been shown to be
> effective
> at reducing the risk of SIDS.
> Q: Are there any advantages or disadvantages to "shared sleeping"
> arrangements?
> A: Scientific studies have demonstrated that bed sharing, between baby
> and
> mother, can alter sleep patterns of mother and baby. These studies have
> led
> to a speculation in the lay press that bed sharing or "co-sleeping"
> may also
> reduce the risk of SIDS. While bed sharing may have certain benefits
> (such as
> encouraging breast feeding), there are no scientific studies
> demonstrating
> that bed sharing reduces SIDS. Conversely, there are studies suggesting
> that
> bed sharing, under certain conditions, may actually increase the risk
> of SIDS.
> There is no basis at this time for encouraging bed sharing as a
> strategy to
> reduce SIDS risk. However, room-sharing - keeping the baby alongside
> the
> adult bed in his own crib or bassinet - can be protective against
> SIDS.
> 7
> Q: Is enough research being conducted to determine the cause of SIDS?
> A: Scientists are exploring the development and function of the nervous
> system,
> the brain, the heart, breathing and sleeping patterns, body chemical
> balances, autopsy findings and environmental factors. SIDS, like other
> medical disorders, may eventually have more than one explanation -
> and
> more than one means of prevention. This may explain why the
> characteristics
> of SIDS babies seem so varied. SIDS has been a high priority for
> research for
> the National Institute of Child Health and Human Development (NICHD) at
> the
> National Institutes of Health (NIH). Although SIDS deaths are
> decreasing, it is
> important that NICHD continue to support research aimed at uncovering
> what causes SIDS, who is at risk for the disorder, and ways to lower
> the risk of
> sudden infant death. In addition to its grassroots advocacy program
> that
> helps ensure Congressional allocation of adequate funding for
> NICHDsponsored
> SIDS research, First Candle/SIDS Alliance maintains its own national
> research program.
> The importance of understanding the causes of SIDS is only underscored
> by its
> consistent place in the headlines. The more we learn about SIDS, the
> more
> easily we will be able to distinguish SIDS from other infant deaths,
> and perhaps
> even one day be able to predict more accurately which babies are at
> highest risk.
> Q: Is there any research on home monitors?
> A: Among the many avenues of research initiated by the NICHD, infant
> monitoring was thoroughly investigated by NICHD-funded researchers. In
> the
> 1970's and early 1980's, it was thought that monitoring had promise in
> identifying infants at risk for SIDS and signaling caregivers when
> infants have
> life-threatening events that may proceed to SIDS. In September of 1986,
> the
> NICHD held a consensus conference titled, "Infantile Apnea and Home
> Monitoring." After examining all available research, the consensus
> panel
> determined that cardiorespiratory monitoring is effective only in some
> cases to
> manage apnea. For the normal newborn, the risks, disadvantages, and
> costs
> of monitoring outweigh the potential of identifying infants at risk for
> SIDS.
> Today, NICHD funds the Collaborative Home Infant Monitoring Evaluation
> (CHIME), a multi-center study initiated in 1991 that employs a
> specifically
> commissioned monitor with multiple innovative capabilities, including
> substantially increased memory, detection of obstructive as well as
> central
> apnea, continuous measurement of blood oxygen saturation, and
> assessment
> of sleep position. The CHIME project will create an extensive database
> (which
> will be made available to the scientific community) on the development
> of
> cardiorespiratory physiology in normal and in at risk infants. In this
> context, the
> study should yield important new insights regarding the frequency and
> nature
> of clinically significant events as related to breathing pattern, heart
> rate, and
> oxygen saturation.
> 8
> Q: Then, NICHD does not recommend the use of monitors to prevent SIDS?
> A: Although some electronic home monitors detect and sound an alarm
> when a
> baby stops breathing, there is no evidence that such monitors prevent
> SIDS.
> The monitors also pose several disadvantages, including frequent false
> alarms,
> restricted mobility of both infant and parents, and the risk of
> electrical injury to
> young children.
> A panel of experts convened by the National Institutes of Health
> recommended that home monitors not be used for babies who do not have
> an increased risk of sudden unexpected death. However, the monitors may
> be recommended in some cases including for infants who have experienced
> one or more severe episodes during which they stopped breathing and
> required resuscitation or stimulation, if the baby is premature and has
> symptomatic apnea, or if the baby has a medical condition such as
> central
> hypoventilation. If an incident has occurred or if an infant is on a
> monitor,
> parents need to know how to properly use and maintain the device as
> well as
> how to resuscitate their baby if the alarm sounds.
> Q: Haven't there been stories of misdiagnoses in the news lately?
> A: Research has indicated that a small percentage of cases originally
> believed
> to be SIDS were actually caused by a metabolic disorder. Other recent
> reports indicate that some SIDS deaths may not actually be SIDS, but
> might be
> attributed to hemorrhaging in the lungs (pulmonary hemosiderosis).
> Q: Do you have any estimates on how often SIDS is a misdiagnosis?
> A: Estimates from a few studies have shown that misdiagnoses account
> for a
> very small percentage of SIDS deaths. In a 2005 policy statement, the
> American Academy of Pediatrics (AAP) estimated that cases of sudden
> infant
> death thought to be SIDS were correct 95-98% of the time.
> Q: There have been recent stories in the news suggesting that some
> cases of SIDS
> have been misdiagnosed and may be hidden cases of abuse and
> infanticide.
> A: While cases of abuse misdiagnosed as SIDS grab the media spotlight,
> it is
> actually far more common for the families or caregivers of SIDS victims
> to be
> unjustly accused or suspected of wrongdoing. By medical definition, the
> term
> SIDS is a postmortem diagnosis affixed when no known or possible cause
> for
> an infant's death can be found following a thorough autopsy, death
> scene
> investigation and review of the medical history. Many of the cases
> reported
> by the media are decades old, prior to the implementation of proper
> autopsy
> and death scene investigation protocol. Although there have been
> instances
> of cases that have fallen through the cracks of the medical examiner
> system,
> the overwhelming number of SIDS cases are bonafide medical disorders,
> and
> remain a medical mystery after all known and possible causes, including
> child
> abuse, have been ruled out.
> These unusual cases only reiterate the need to fully investigate, on a
> case by
> 9
> case basis, each instance of a sudden infant death and to consider the
> many
> possible causes of death, including but not limited to SIDS, congenital
> anomalies, metabolic disorders, unintentional injuries, child abuse,
> and
> infections.
> Q: Are there state or national guidelines for investigating the sudden
> death of
> infants?
> A: In 1993, the Interagency Panel on SIDS held a meeting to develop
> guidelines
> for death scene investigation of sudden unexplained infant deaths. A
> death
> scene investigation is an integral part of a SIDS diagnosis to rule out
> accidental, environmental, and unnatural causes and to provide
> information
> to researchers on risk factors for SIDS. In June 1996, the Panel
> published
> guidelines for death scene investigation that include model protocol
> and
> data form for collection of information by medical examiners, coroners,
> death
> team investigators, and police officers. Although state and local
> ordinances
> define which deaths must be investigated and the extent of the
> investigation,
> these guidelines set the stage for uniform death scene investigation
> around
> the country.
> In 2004 the CDC launched an initiative to improve the investigation and
> reporting of SUID, in collaboration with other federal agencies and
> organizations representing medical examiners, coroners, death scene
> investigators, emergency medical personnel, law enforcement officials,
> SIDS
> researchers, infant death review experts, and SIDS parents. As part of
> this
> effort, on March 1, 2006, CDC will release the Sudden, Unexplained
> Infant
> Death Investigation (SUIDI) Reporting Form for state and local use in
> infant
> death scene investigations. The SUIDI Reporting Form replaces the
> Investigation Report Form that accompanied the 1996 Guidelines for the
> Death Scene Investigation of Sudden, Unexplained Infant Death.
> Currently, approximately half of the states have mandatory autopsy
> legislation for the sudden death of an infant that, in many cases,
> includes
> support for the administration of compassionate services for SIDS
> families.
> Other states are in the process of establishing similar legislation.
> SIDS families,
> at the guidance of First Candle/SIDS Alliance, have been at the
> forefront of
> efforts urging the funding of research, adoption of mandatory autopsy
> legislation, and thorough, but compassionate death scene
> investigations.
> Broader, standardized implementation of autopsy and death scene
> mandates is crucial to efforts to differentiate cases of SIDS from
> cases of child
> abuse, and to expand our medical knowledge about SIDS.
> Q: How does a SIDS death affect the family?
> A: A SIDS death is a tragedy that prompts intense emotional reactions
> among
> surviving family members. After the initial disbelief, denial, or
> numbness begins
> to wear off, parents often fall into a prolonged depression. This
> depression can affect their sleeping, eating, ability to concentrate,
> and
> 10
> general energy level. Crying, weeping, incessant talking, and strong
> feelings
> of guilt or anger are all normal reactions.
> Many parents experience unreasonable fears that they, or someone in
> their
> family, is in danger. Over protection of surviving children and fears
> for future
> children are common reactions. As the finality of the child's death
> becomes a
> reality for the parents, recovery occurs. Parents begin to take a more
> active
> part in their own lives, which begin to have meaning once again. The
> pain of
> their child's death becomes less intense but not forgotten. Birthdays,
> holidays,
> and the anniversary of the child's death trigger periods of intense
> pain and
> suffering.
> Children will also be affected by the baby's death. They may fear that
> other
> members of the family, including themselves, will also suddenly die.
> Children
> often also feel guilty about the death of a sibling and may feel that
> they had
> something to do with the death. Children may not show their feelings in
> obvious ways. Although they may deny being upset and seem unconcerned,
> signs that they are disturbed include intensified clinging to parents,
> misbehaving, bedwetting, difficulties in school, and nightmares. It is
> important
> to talk to children about the death and explain to them that the baby
> died
> because of a medical problem that only occurs in infants and in rare
> instances.
> Q: Are there any support groups available for families who have lost a
> baby to
> SIDS?
> A: Families are encouraged to seek counseling and support. First
> Candle/SIDS
> Alliance can provide bilingual crisis intervention counseling and
> access to
> extensive grief resources by calling 800.221.7437, or visiting
> www.firstcandle.org.
> Excerpted and edited by First Candle SIDS Alliance -- February, 2006
> from materials
> developed by the National Institute of Child Health and Human
> Development (NICHD)