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Crib Death - Sudden Infant Death Syndrome


Overview, Causes, & Risk Factors

Sudden infant death syndrome, also known as SIDS, is the sudden and unexplained death of an infant under one year of age. No cause for the death can be found. Because many SIDS babies die in their cribs, this syndrome is often called crib death. But cribs are not the cause of SIDS.

What is going on in the body?

SIDS is the leading cause of death for babies between the ages of one month to one year. Most SIDS deaths occur between age 2 and 4 months. Most SIDS infants die silently, apparently in their sleep.

The good news is that, less than ten years ago, nearly twice as many babies were dying of SIDS in the US as are today. This decrease in SIDS is directly related to the campaign to educate parents to place infants on their backs - instead of sides or stomachs - to sleep.

Current research is focused on the "triple-risk model." This theory says that three things must happen at once for SIDS to occur:

  • The infant must have an underlying weakness in homeostatic control. Homeostasis involves the vital functions. This includes blood pressure, heart rate, respiration, chemoreception, upper airway reflexes, and body temperature control. The baby's brainstem and nervous system seem to be the key factors in homeostatic control.
  • The infant must be in a critical development period for homeostatic control. This critical period is thought to be within the first six months of life, when the baby's body and its systems are still maturing.
  • An external stressor increases how vulnerable the infant is to the homeostatic control issues. The most common external stressor appears to be the stomach sleeping position. Other factors may include soft bedding, infection, and fever.
  • This theory is still being tested, but evidence so far seems to strongly support it. Many studies are going on today, and experts hope to have more answers soon about what causes SIDS and who is at risk for it.

    What are the causes and risks of the condition?

    While there are known risk factors for SIDS, none of these factors clearly points to a distinct cause for SIDS. Many of these factors are also risk factors for the sudden death of infants from other, known causes. Risk factors linked with a higher rate of SIDS include:

  • Age of the child. Most cases occur in infants between one and four months of age. Ninety-five percent of cases occur in infants six months of age or younger.
  • Being part of a multiple birth. Twins or triplets are at greater risk for SIDS.
  • Being wrapped in blankets during sleep or sleeping on too soft a surface.
  • Exposure to tobacco smoke in the baby's environment.
  • Having a recent viral illness, such as an upper respiratory infection or gastroenteritis.
  • Low Apgar score at birth. The Apgar score is a measure of how well an infant adapts to life outside the womb in the first five minutes after birth.
  • Male gender. Boys die of SIDS slightly more often than girls.
  • Prematurity. Being born early and having a low birth weight are both risk factors for SIDS.
  • Sleeping on the stomach.
  • Sharing a crib or bed with another child.
  • Sharing a bed with a parent, when parents smoke or have recently consumed alcohol or used drugs.
  • Being African American, American Indian, or Alaskan Native. All of these ethnic groups have at least twice the risk for SIDS.
  • In addition, research has found risk factors in the mother that may lead to an increased incidence of SIDS. These factors include the following:

  • being unmarried, young, or poor
  • having had a large number of pregnancies
  • having pregnancies less than 12 months apart
  • lack of prenatal care
  • smoking during pregnancy
  • use of illicit drugs, especially cocaine, during pregnancy
  • binge drinking of alcohol during pregnancy

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