Causes
SIDS is believed to be caused by various combinations of child and environment-related factors.
There are indications that some of the victims show immaturity in the brain functions that control the heart and breathing rhythm and that keep the airways clear.
Various situations are closely associated with SIDS but it would be wrong to regard these factors as causes of cot death, as every average Flemish family would then belong to the risk group.
Identifying risk groups
Even now, cot deaths are not always avoidable. The polysomnographic examination, an examination that monitors many of the baby's functions while a baby is sleeping, such as the heart and respiratory rhythm, is not infallible at detecting children who are at risk. This examination worries some parents unnecessarily while giving others a false sense of security. Even if no abnormalities are detected during the examination, this does not guarantee that cot death can be excluded.
Polysomnographic examination is useful for the following risk groups:
- babies born very prematurely
- babies born with an extremely low birth weight
- the brothers, sisters and close family members (e.g. cousins) of a SIDS victim
- babies who have abnormally long pauses while breathing or an abnormal breathing pattern when they lie in their cot
- babies who snore loudly, with short, complete pauses in breathing
- babies who appear very pale, limp or ‘shocked’ in their cot. A ‘shocked’ infant has cold hands and feet. Their face, nose and limbs are also cold to the touch.
Breathing in babies
Breathing interruptions of less than 6 seconds are a common occurrence among babies.
It is also normal for children to regularly take deep sighs while sleeping, followed by a pause for breath. The regular alternation of pauses and breaths, however, must be followed carefully. This kind of periodic breathing is an immature breathing pattern that is sometimes accompanied by longer pauses in breathing.
If a child belongs to a risk group, a thorough physical and polysomnographic examination will be conducted before any decision is made to set up an at-home heart and respiratory monitor. For the remaining infants who are not in these groups, it is more sensible to be mindful and avoid the known risk factors as much as possible.