Sudden infant death syndrome (SIDS), substance misuse, and smoking in pregnancy Kamal Ali, Na’eem Ahmed, Anne GreenoughDivision of Asthma, Allergy, and Lung Biology, Medical Research Council and Asthma UK Center in Allergic Mechanisms of Asthma, King’s College Hospital, London, United KingdomAbstract: In the developed world, sudden infant death syndrome (SIDS) remains the leading cause of death in the post neonatal period. This review highlights the association between maternal substance misuse and SIDS, and discusses whether the increased risk is explained by abnormalities of respiratory control. Substance misuse during pregnancy is common, and although the incidence of smoking has declined in recent years among pregnant women, an increasing proportion of mothers of infants who have died of SIDS' smoke. The risk of SIDS is increased in women who take opiates, but not cocaine or marijuana, although infants exposed to either of these drugs suffer morbidity, including reduced birth weight. Nicotine exposure increases the risk of SIDS, particularly if both parents smoke, and there is a dose-dependent effect. A variety of respiratory abnormalities have been described in the infants of substance abuse mothers, which may increase their risk of SIDS. These abnormalities include a reduced ability to recover from prolonged apnea and a blunted response to hypoxia and hypercarbia. These results are consistent with postmortem brainstem abnormalities reported among SIDS victims.Keywords: sudden infant death syndrome, nicotine, opiates

Sudden infant death syndrome (SIDS) continues to be one of the top causes of infant death in the U.S. Despite significant public health initiatives focused on high-risk populations to enhance sleep environments and techniques. The SIDS rate has remained stable in recent years. Risk factors and newer risk reduction strategies for SIDS are the focus of this review article. We conducted a comprehensive literature search on Medline, Cochrane, Embase, and Google Scholar until July 2022. The following search strings and Medical Subject Heading (MeSH) terms were used: "SIDS," "Sudden Infant Death" and "SUID". We explored the literature on SIDS for its epidemiology, pathophysiology, the role of various etiologies and their influence, associated complications leading to SIDS, and preventive and treatment modalities. Despite a more than 50% drop-in rates since the start of the "Back to Sleep" campaign in 1994, sudden infant death syndrome (SIDS) continues to be the top cause of post-neonatal mortality in the United States, despite continued educational initiatives that support safe sleep and other risk reduction strategies. The new American Academy of Pediatrics guidelines for lowering the risk of SIDS include a lot of emphasis on sleeping habits, bedding, and environment but also include elements that are frequently ignored (i.e., prenatal care, smoking, alcohol and drug use, and childhood vaccinations). This study highlights these less-frequently discussed aspects and identifies treatments that have produced beneficial behavioral shifts that benefit newborns as well as their mothers' health and wellbeing.

Sudden infant death syndrome (SIDS) is a type of death that occurs suddenly and without any apparent explanation, affecting infants between 28 days of life and up to a year. Recognition of this entity includes performing an autopsy to determine if there is another explanation for the event and performing both an external and internal examination of the different tissues to search for possible histopathological findings. Despite the relative success of awareness campaigns and the implementation of prevention measures, SIDS still represents one of the leading causes of death among infants worldwide. In addition, although the development of different techniques has made it possible to make significant progress in the characterization of the etiopathogenic mechanisms underlying SIDS, there are still many unknowns to be resolved in this regard and the integrative consideration of this syndrome represents an enormous challenge to face both from a point of view scientific and medical view as humanitarian. For all these reasons, this paper aims to summarize the most relevant current knowledge of SIDS, exploring from the base the characterization and recognition of this condition, its forensic findings, its risk factors, and the main prevention measures to be implemented. Likewise, an attempt will be made to analyze the causes and pathological mechanisms associated with SIDS, as well as potential approaches and future paths that must be followed to reduce the impact of this condition.

Background: Pacifier use decreases the risk of sudden infant death syndrome (SIDS). An emergency department (ED) visit may provide an opportunistic ‘teachable moment’ for parents. Objectives: To test the hypotheses (1) that caregivers were less familiar with the role of pacifiers in sudden infant death (SIDS) prevention than other recommendations, and (2) that an ED educational intervention would increase pacifier use in infants younger than six months, and (3) that otitis media would not occur more frequently in pacifier users. Methods: An intervention-group-only longitudinal study in a county hospital ED. We measured pacifier use infants and baseline knowledge of SIDs prevention recommendations in caregivers. We followed up three months later to determine pacifier use, and 12 months later to determine episodes of otitis media. Results: We analyzed data for 780 infants. Parents knew of advice against co-sleeping in 469/780 (60%), smoking in 660/776 (85%), and prone sleeping in 613/780 (79%). Only 268/777 (35%) knew the recommendation to offer a pacifier at bedtime. At enrollment 449/780 (58%) did not use a pacifier. Of 210/338 infants aged less than 6 months followed up 41/112 (37%) non-users had started using a pacifier at bedtime (NNT 3). Over the same period, 37/98 (38%) users had discontinued their pacifier. Otitis media did not differ between users and non-users at 12 months. Conclusion: Caregiver knowledge of the role of pacifiers in SIDS prevention was less than for other recommendations. Our educational intervention appeared to increase pacifier use. Pacifier use was not associated with increased otitis media.

Commentary on: Vennemann MM, Hense HW, Bajanowski T, et al. Bed sharing and the risk of sudden infant death syndrome: can we resolve the debate? J Pediatr 2012;160:44–8.e2.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Sudden infant death syndrome (SIDS) remains the leading cause of infant mortality in USA and most developed countries. After studies in the late 1980s and early 1990s which identified the prone sleep position as a main risk for SIDS, campaigns to promote back sleeping were initiated, and the number of SIDS declined significantly.1 However, … [1]: {openurl}?query=rft.jtitle%253DThe%2BJournal%2Bof%2Bpediatrics%26rft.stitle%253DJ%2BPediatr%26rft.aulast%253DVennemann%26rft.auinit1%253DM.%2BM.%26rft.volume%253D160%26rft.issue%253D1%26rft.spage%253D44%26rft.epage%253D8.e2%26rft.atitle%253DBed%2Bsharing%2Band%2Bthe%2Brisk%2Bof%2Bsudden%2Binfant%2Bdeath%2Bsyndrome%253A%2Bcan%2Bwe%2Bresolve%2Bthe%2Bdebate%253F%26rft_id%253Dinfo%253Adoi%252F10.1016%252Fj.jpeds.2011.06.052%26rft_id%253Dinfo%253Apmid%252F21868032%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/j.jpeds.2011.06.052&link_type=DOI [3]: /lookup/external-ref?access_num=21868032&link_type=MED&atom=%2Febnurs%2F15%2F4%2F115.atom [4]: /lookup/external-ref?access_num=000298143000014&link_type=ISI

Sudden infant death syndrome (SIDS) has been most recently defined as the sudden unexpected death of an infant less than one year of age, with onset of the fatal episode apparently occurring during sleep, that remains unexplained after a thorough investigation, including the performance of a complete autopsy and a review of the circumstances of death and clinical history. Despite the success of several prevention campaigns, SIDS remains a leading cause of infant mortality. In 1994, a 'triple risk model' for SIDS was proposed that described SIDS as an event that results from the intersection of three factors: a vulnerable infant; a critical development period in homeostatic control (age related); and an exogenous stressor. The association between pacifier (dummy) use and reduced incidence of SIDS has been shown in epidemiological studies since the early 1990s. Pacifier use, given its low cost, might be a cost-effective intervention for SIDS prevention if it is confirmed effective in randomised controlled trials. To determine whether the use of pacifiers during sleep versus no pacifier during sleep reduces the risk of SIDS. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 2), MEDLINE via PubMed, Embase, and CINAHL to 16 March 2016. We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Published and unpublished controlled trials using random and quasi-random allocations of infants born at term and at preterm (less than 37 weeks' gestation) or with low birth weight (< 2500 g). Infants must have been randomised by one month' postmenstrual age. We planned to include studies reported only by abstracts, and cluster and cross-over randomised trials. Two review authors independently reviewed studies from searches. We found no eligible studies. We identified no randomised controlled trials examining infant pacifiers for reduction in risk of SIDS. We found no randomised control trial evidence on which to support or refute the use of pacifiers for the prevention of SIDS.

Recommendations for Sudden Infant Death Syndrome (SIDS) are available, although it is uncertain the degree of adherence to these measures. The aim of the study is to assess the adherence to recommendations to reduce the risk of SIDS, seeking factors associated to the noncompliance with these recommendations. 468 infants were enrolled in two maternity hospitals, one public and one private. Postpartum and 4-month assessments were performed. A questionnaire was used adapting a model validated by the International Child Care Practices Study. Adherence to obstetric recommendations was higher (75.4%) than to pediatric recommendations (53.3%). Regarding pediatric recommendations, a compliance decrease was detected after 4 months. Follow-ups showed decrease in breastfeeding (p < 0.001 84.9% vs 48.6%) and supine position (61.2% vs 21.2%, p < 0.001). The decreased adherence to recommendations for SIDS prevention was mainly observed in younger and less educated women, who were not in a relationship and living in poor housing quality and crowded environments.

Sudden infant death syndrome (SIDS) is a complex, multifactorial phenomenon with an etiology that has not been fully clarified to this day. Despite a noticeable decrease in the number of SIDS cases worldwide, sudden infant death syndrome remains one of the most common causes of death among children in infancy. Sudden infant death syndrome is still the subject of scientific research aimed to clearly determine and identify potential pathogenetic factors responsible for the occurrence of SIDS. Many years of efforts to clarify the etiology of the discussed issue have made it possible to characterize important factors that increase the risk of sudden infant death syndrome. In addition, research has made it possible to develop important approaches that make a significant contribution to reduce the risk of SIDS in an infant. Complete knowledge of the specific conditions that have a protective effect against SIDS will significantly reduce the risk of sudden infant death syndrome, so a very important aspect is not only their precise analysis, but also their propagation among the public.

We conducted a literature review on the effect of breastfeeding and dummy (pacifier) use on sudden infant death syndrome (SIDS). From 4343 abstracts, we identified 35 relevant studies on breastfeeding and SIDS, 27 on dummy use and SIDS and 59 on dummy use versus breastfeeding.ConclusionWe found ample evidence that both breastfeeding and dummy use reduce the risk of SIDS. There has been a general reluctance to endorse dummy use in case it has a detrimental effect of breastfeeding. However, recent evidence suggests that dummy use might not be as harmful to breastfeeding as previously believed.

Sudden Infant Death Syndrome (SIDS) is an unexpected non-violent death of an apparently healthy child in the first year of life, with no rational explanations for the death cause, anamnesis and pathomorphological studies. Risk factors of SIDS are divided into two main groups – modifiable and non-modifiable. Modifiable risk factors include: sleeping in the prone position, infant and adult sleeping together, tobacco smoke, soft bedding, and prematurity. Non-modifiable risk factors include: vulnerability due to morphofunctional dismaturity; critical period of lifespan development; exogenous stress factor. The cumulative impact of all non-modifiable risk factors was used to develop a «triple risk» model. Today, the majority of modern concepts of the sudden infant death syndrome pathogenesis are based on genetic mechanisms. The main hypotheses of thanatogenesis in SIDS are congenital metabolic defects, immunologic incompetence, serotonergic dysfunction, SIDS-critical diaphragmatic failure, cardiogenic mechanisms. The main success in reducing the SIDS rate has been achieved by controlling modifiable risk factors underlying the syndrome development.