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About sudden infant death syndrome (SIDS)

Last update date November 8, 2019

What is sudden infant death syndrome (SIDS)?

When the cause of death does not still become clear even if we perform dissection to investigate medical history before resulting in death from the situation and the past in the death, and to establish the cause of death when baby/infant under 1 dies suddenly, and the cause of death does not become clear, we are with SIDS (sudden infant death syndrome) in the United States. In Japan, we call SIDS "sudden infant death syndrome", but, unlike the United States, in the case of infant 1 year or older, include in "sudden infant death syndrome". According to the Japanese vital statistics, 196 people die by sudden infant death syndrome in 2005 (Heisei 17). 174 people (88.8%) of those were swaddling bands under 1. It becomes the third place (0.164 per birth 1000, 5.9% of baby/infant death) along with 174 "unexpected accidents" next to "congenital anomaly, transformation and 1,025 chromosome aberration" (0.965 per birth 1000, 34.7% of baby/infant death), "breathing disorder that is specific for the perinatal period and cardiovascular disorder" 414 (0.390 per birth 1000, 14.0% of baby/infant death) as the infant cause of death. In addition, the fifth place was "hemorrhagic disorder of fetus and newborn baby and 159 blood disorders" (0.150 per birth 1000, 5.4% of baby/infant death). On the other hand, according to the American vital statistics, baby/infant of 2,522 people dies of SIDS in 2000. It becomes the third place (0.621 per birth 1000, 9.0% of baby/infant death) next to "congenital anomaly, transformation and 5,756 chromosome aberration" (1.418 per birth 1000, 20.6% of baby/infant death), "abnormality in conjunction with premature birth that is not classified elsewhere, the low birth weight" 4,401 (1.084 per birth 1000, 15.7% of baby/infant death) as the infant cause of death. SIDS is the first place of the cause of death in the United States and between one month after birth and six months. Most SIDS is seen by six months after birth. Baby/infant of premature birth and the low birth weight is at increased risk for becoming SIDS, and there is more outbreak in boys than girl. Death visits sleeping baby/infant that a lot of outbreak appears healthy in the case of most in cold season from autumn to the early spring suddenly. We carry out the chief spread of points enlightenment activity to lower the onset rate that Ministry of Health, Labour and Welfare sets November with measures reinforcement month of sudden infant death syndrome (SIDS) every year from 1999 and rouses social interest in SIDS.

In addition, according to the Japanese vital statistics, 148 people die by sudden infant death syndrome in 2011 (Heisei 23). 132 people (89.2%) of those were swaddling bands under 1. It becomes the fourth place (0.126 per birth 1000, 5.4% of baby/infant death) next to "congenital anomaly, transformation and 862 chromosome aberration" (0.820 per birth 1000, 35.0% of baby/infant death), "breathing disorder that is specific for the perinatal period and cardiovascular disorder" 322 (0.306 per birth 1000, 13.1% of baby/infant death), "unexpected accident" 199 (0.189 per birth 1000, 8.1% of baby/infant death) as the infant cause of death. In addition, the fifth place was "hemorrhagic disorder of fetus and newborn baby and 85 blood disorders" (0.081 per birth 1000, 3.5% of baby/infant death). On the other hand, according to the American vital statistics, baby/infant of 2,063 people dies of SIDS in 2010. It becomes the third place (0.516 per birth 1000, 8.4% of baby/infant death) next to "congenital anomaly, transformation and 5,107 chromosome aberration" (1.277 per birth 1000, 20.8% of baby/infant death), "abnormality in conjunction with premature birth that is not classified elsewhere, the low birth weight" 4,148 (1.037 per birth 1000, 16.9% of baby/infant death) as the infant cause of death.
In addition, according to the Japanese vital statistics, 77 people die by sudden infant death syndrome in 2017 (Heisei 29). 69 people (89.6%) of those were swaddling bands of under 1 year old (0 years old), and boy 45 people, girl were 24 people. It becomes the fourth place (7.3 per 100,000 birth, 3.9% of baby/infant death) next to "congenital anomaly, transformation and 653 chromosome aberration" (67.1 per 100,000 birth, 36.1% of baby/infant death), "breathing disorder that is specific for the perinatal period and cardiovascular disorder" 236 (24.9 per 100,000 birth, 13.4% of baby/infant death), "unexpected accident" 77 (8.1 per 100,000 birth, 4.4% of baby/infant death) as the infant cause of death. In addition, the fifth place was "hemorrhagic disorder of fetus and newborn baby and 64 blood disorders" (6.8 per 100,000 birth, 3.6% of baby/infant death). On the other hand, according to the American vital statistics, baby/infant of 1,500 people dies of SIDS in 2016. It becomes the third place (38.0 per 100,000 birth, 6.5% of baby/infant death) next to "congenital anomaly, transformation and 4,816 chromosome aberration" (122.1 per 100,000 birth, 20.8% of baby/infant death), "abnormality in conjunction with premature birth that is not classified elsewhere, the low birth weight" 3,927 (99.5 per 100,000 birth, 17.0% of baby/infant death) as the infant cause of death. In late years, about sudden infant death syndrome (SIDS), trend toward decreases has the number of the annual outbreak in both Japan and the United States.

Figure 1 the number of the sudden infant death syndrome occurrence in Japan (people).

In the United States, difference by race is seen in incidence. According to the MacDorman and others (documents 1), it was 0.8 in people of 0.8, Asia and Pacific Islands in 1.1, Hispanic in 2.2, whites of non-Hispanic in 3.0, blacks of non-Hispanic in American Indians per birth 1000 in the United States of 1,990-1,991 years. In addition, smoking rate of pregnant mother was high in American Indians with 20.5%, and it was low with 4.7% in people of 5.9%, Asia and Pacific Islands in Hispanic. It is at low incidence of Asian system, but Davies (documents 2) has high population density as reason that is at low incidence in Hong Kong, and custom to lay baby/infant by facing upward with environment where there are many family, relatives watching baby/infant says that it is thought. According to the Lee and others (documents 3), SIDS of 21 people occurred in Hong Kong between December 1, 1986 and November 30, 1987 and seemed to be the incidence of 0.29 per birth 1000. In addition, according to the Lee and others (documents 3), lying face-down was 2 of 32 (6%) about posture when we let baby/infant sleep in Hong Kong in the same way in 7 of 16 (44), control group in SIDS group. On the other hand, about posture when we let baby/infant sleep in the United States, lying face-down was 14% in 17%, 2000 in 70%, 1998 in 1992 (documents 4, 5). During this time, in the United States, as for the outbreak of SIDS, it decreases with 0.62 in 0.72, 2000 in 1998 in 1992 to have been 1.2 per birth 1000. In addition, in American African-Americans, lying face-down was 32% in 82%, 1998 in 1992 (documents 4). As there is a lot of lying face-down of thing which decreased than before in African-Americans, outbreak of SIDS is 1.4 per birth 1000, and it is 0.6 per birth 1000 in whites (documents 4).
With decrease in outbreak of SIDS, ratios of death by accident or abuse among the death (SUIDs: sudden, unexplained infant deaths) of baby/infant that the cause of death does not become clear in the death may relatively increase (documents 6, 7). When SUIDs is seen, we perform detailed investigation including dissection and pursue cause to reduce SUIDs, and it is necessary to reduce the death by not only SIDS but also accident or abuse.

To reduce the risk to become nyuyojizenshishokogun; ...

When healthy baby/infant sleeps to reduce the risk to become sudden infant death syndrome, it ups back, and it is known to firm bed that it is effective lying supine peels off, and to lay. But let's talk about posture when we let there are case of baby/infant which is in a state to be easy to wake up confinement of the respiratory tract by laying by facing upward or congenital obstacle and is easy to vomit, and baby/infant sleep in cases of baby/infant having problem with of respiratory organs and heart with pediatrician well. In addition, it is said that the development of exercise side may be slightly late for baby/infant of facing upward shin in comparison with baby/infant of lying face-down first, but we gradually catch up with, and it is said that the difference is not seen at 1 year, 6 months old. In addition, it is recommended that we arrange time for some lying on one's stomach while baby/infant is taking place in preventing occipital flatness from the development of exercise side. We change direction of face every one week to prevent form of head from becoming distorted when we sleep, and let's sometimes turn for baby/infant changing position and direction of Bet to direction (e.g., direction of entrance of room) indicating interest. Even if form of head becomes distorted, form of head is not gradually distorted when mostly baby/infant comes to sit down with temporary thing.
Possibility of suffocation increases by lying face-down with it is soft bed where form turns into to form of head of baby/infant. Thing that cover just fitted hard bed is good.
In late years by reducing to let baby/infant sleep by nationwide campaign on the stomach, outbreak of sudden infant death syndrome decreases in United States and Japan, Australia. In the United States, as for the SIDS, it becomes outbreak of 0.38 in 0.52, 2016 in 0.56, 2010 in 0.62, 2001 in 2000 in 1990 to have been outbreak of 1.30 per birth 1000. According to the Japanese vital statistics, annual outbreak of sudden infant death syndrome becomes 77 people in 148 people, 2017 (Heisei 29) in 196 people, 2011 (Heisei 23) in 579 people, 2005 (Heisei 17) in 1995 (Heisei 7). In Australia, it is 40 people in 49 people, 2015 in 61 people, 2014 in 58 people, 2013 in 134 people (including nine people 1 year or older), 2012 in 485 people (including 11 people 1 year or older), 2000 in 1990.
In example of sudden infant death syndrome, we up stomach, and face, nose, mouth may be discovered in state covered with soft bedclothing such as pillow, kilt, feather bed, fur of sheep on the stomach. It will prevent baby/infant from sleeping with tender bedclothing which can disturb breathing. Similarly, it will prevent baby/infant from sleeping with tender toy which can disturb breathing. As it increases, three months after birth later, it will warn the risk of the death (SUIDs: sudden, unexplained infant deaths) of baby/infant that the cause of death does not become clear in the death around baby/infant to get into tender bedclothing by roll-over. As string-shape things such as string for opening and shutting of curtain or electric cord strangle, and they may cause suffocation, it is dangerous.
In addition, example of sudden infant death syndrome may be discovered in state that head was covered with tender bedclothing such as blanket, feather bed though we up back and are sleeping by facing upward. During sleep of baby/infant, it will prevent head of baby/infant from being covered with bedclothing or hat.
As baby/infant is revealed by smoke of cigarettes in environment, not only it becomes at great risk of sudden infant death syndrome, but also becomes easy to become bronchitis and pneumonia. As for the baby/infant revealed in home by smoke of cigarettes in environment, the risk of sudden infant death syndrome is double than baby/infant which is not revealed. In addition, the risk of sudden infant death syndrome is triple than baby/infant born from mother who is pregnant as for the baby/infant born from mother who smoked during the pregnancy, and did not smoke. It is thought that it may affect quantity of oxygen which fetus receives by smoking of pregnant mother decreases, and to put away. Mother will give up smoking during the pregnancy as well as after giving birth. Person who is in room with baby/infant will refrain from smoking. Let's be going to have non-smoking zone (smoke-free zone) around baby/infant. Our Yokohama City Inst. of Health web page, please refer to "about passive smoking of child" for the risk of passive smoking (please click underline part). In addition, it becomes at great risk of sudden infant death syndrome of baby/infant when smoker does not breathe in bed when smoker of adult is sleeping with baby/infant.
Let's bring up baby/infant with mother's milk as much as possible. It is thought that nutrition with mother's milk is helpful to prevent infectious disease triggering sudden infant death syndrome.
It will prevent it from lying in bed where is same as baby/infant. It raises not only the risk of sudden infant death syndrome but also the risk of death from suffocation to lie in bed where is same as baby/infant. There is the risk that person who lied in bed where is same as baby/infant is piled up on the baby/infant and wakes up death from suffocation of baby/infant. In the case of person who took person who drank and drug controlling consciousness including sleeping drug, it is easy to have in particular such an accident. In addition, parent often sleeps during the nursing. Let's be careful not to sleep in particular when we nurse in bed. Near the bed of parent is desirable for place of bed of baby/infant in bedroom and the same room of parent.
It is good doze and to give teething ring during sleep. We do not understand the mechanism well, but it is reported that use of teething ring controls outbreak of sudden infant death syndrome. When baby/infant sleeps, we give teething ring, but it is not necessary to return to entrance even if teething ring falls from mouth. In addition, it is not necessary to force teething ring if baby/infant hates. When teething ring has string and belonging, it may cause suffocation. We do not know whether finger sucking of baby/infant controls outbreak of sudden infant death syndrome.
In the case of baby/infant of lying face-down in particular, it is revealed that the risk of sudden infant death syndrome increases when baby/infant warms too much. When body of baby/infant is covered with kimono or blanket thick, the head particularly face becomes passage running away of internal heat, but when downward face and head are covered with bedclothing by lying face-down, heat becomes hard to run away, and heat will stay in the body (documents 9). Not to make any baby/infant being too much full of heat, it will prevent you from putting kimono and blanket too much. Room temperature will prevent it from being too hot, too. It is said that setting of room temperature by heating of the winter season has good warmth as adult of light dress is comfortable. Warmth marisugiga beginning and Suiko of baby/infant are thought about with one cause that is easy to have sudden infant death syndrome in the winter season with the winter season having many respiratory infectious diseases for heating, wearing thick clothes, thick blanket in the winter season.

About guidelines (March, 2005: Ministry of Health, Labour and Welfare study group) about sudden infant death syndrome (SIDS)

Well, about guidelines about sudden infant death syndrome (SIDS), report was performed in public welfare labor science study (child home synthesis study business) "study on guidelines making for diagnosis of sudden infant death syndrome (SIDS) and prevention and onset rate reduction" (chief researcher: Masamichi Sakanoue Kitasato University Emeritus Professor) in March, 2005.
In the guidelines about this sudden infant death syndrome (SIDS), we are doing "syndrome that cannot predict the death from previous health condition and anamnesis and brought sudden death to, as a general rule, children that the cause is not identified by the death situation investigation and dissection inspection either under 1" with sudden infant death syndrome (SIDS).
In addition, notice matters on the occasion of diagnosis of sudden infant death syndrome (SIDS) include four following matters.

  1. We consider study conducted in foreign countries, and, as a general rule, as for the diagnosis of sudden infant death syndrome (SIDS), it is said with under 1 year old including the newborn baby period, but does with sudden infant death syndrome (SIDS) only when we meet definition except age when we exceed 1 year old.
  2. When dissection is not accomplished and when make diagnosis of sudden infant death syndrome (SIDS) based on autopsy, and the death situation investigation is not carried out, classification of the cause of death is impossible, therefore of death certificate (postmortem certificate) say, "12 is unknown" categorically.
  3. Sudden infant death syndrome (SIDS) is one disease unit not exclusion diagnosis, and, for the diagnosis, differential diagnosis with exogenous death such as disease to bring infants except sudden infant death syndrome (SIDS) sudden death and suffocation or abuse is necessary.
  4. We need the situation of the death spot and forensic evidence for diagnosis of exogenous death. The physical situation at the time of sleep that can explain the cause of death directly that we are put between gap and fence of bed, and it is if restriction is in a state, and the head cannot evade is necessary and, regardless of the physique, is not diagnosed only in views to merely lie on their face with bedclothing normally using so that death from suffocation is diagnosed in exogenous death. In addition, intentional death from suffocation by abuse or murder may have difficulty in differentiation with sudden infant death syndrome (SIDS), and it is necessary to be diagnosed carefully.

About sudden infant death syndrome (SIDS) diagnosis guidelines (the second edition)

In public welfare labor science study (next-generation upbringing base study business such as growth disease conquest) "integrated study by plural domain specialists for the condition of a patient elucidation and prophylaxis development in sudden infant death syndrome (SIDS) and infants burst-related emergency situation" (ALTE) (study representative: President Hajime Togari Nagoya City Univ.) of 2012, we made "sudden infant death syndrome (SIDS) diagnosis guidelines" (the second edition) and announced in October, 2012. For the purpose of diagnosis of SIDS being made more appropriately, addition of inspection item which was necessary for exclusion diagnosis of SIDS and item which was necessary when we performed detailed analyses such as the situation of roll-over was performed in interview, check list with the second edition, and the entry point of interview, check list was made. For more details, please refer to web page of following Ministry of Health, Labour and Welfare (please click underline part).

Ministry of Health, Labour and Welfare web page "sudden infant death syndrome (SIDS) diagnosis guidelines (the second edition)" (the outside site)

References

  1. Marian F. MacDorman, Sven Cnattingius, Howard J. Hoffman, et al. ; Sudden Infant Death Syndrome and Smoking in the United States and Sweden. ; American Journal of Epidemiology. Vol. 146, No. 3, August 1, 1997, p.249-257.
  2. D. P. Davies, Cot death in Hong Kong: Is it a rare problem? THE LANCET, December 14, 1985, No. 8468, Vol.2, p.1346-1349.
  3. M. Lee, D. P. Davies, and Y. F. Chan, Is it Prone or supine for preterm babies? THE LANCET, June 11, 1988, No. 8598, Vol. 1, p.1332.
  4. National Institute of Child Health and Human Development (NICHD), National Institutes of Health, U.S. Department of Health and Human Services. ; Targeting Sudden Infant Death Syndrome (SIDS): A Strategic Plan, It is p.1-39. June 2001
  5. National Institute of Child Health and Human Development (NICHD), National Institutes of Health, U.S. Department of Health and Human Services. ; Infant Sleep Position and SIDS: Questions and Answers for Health Care Providers, Nov. 2003.p.1-12.
  6. AMERICAN ACADEMY OF PEDIATRICS, Committee on Child Abuse and Neglect. ; Distinguishing Sudden Infant Death Syndrome From Child Abuse Fatalities. ; PEDIATRICS Vol. 107 No. 2 February 2001, p. 437-441.
  7. Centers for Disease Control and Prevention. Guidelines for death scene investigation of sudden, unexplained infant deaths: recommendations of the Interagency Panel on Sudden Infant Death Syndrome. MMWR June 21, 1996, 45 (No. RR-10): p.1-22.
  8. AMERICAN ACADEMY OF PEDIATRICS, Task Force on Infant Sleep Position and Sudden Infant Death Syndrome. ; Changing Concepts of Sudden Infant Death Syndrome: Implications for Infant Sleeping Environment and Sleep Position. ; PEDIATRICS Vol. 105 No. 3 March 2000, p. 650-656.
  9. E. A. S. Nelson, B. J. Taylor, and I. L. Weatherall, Sleeping position and infant bedding may predispose to hyperthermia and the Sudden Infant Death Syndrome. ; THE LANCET, January 28, 1989, No. 8631, Vol. 1, p.199-201
  10. National Institute of Child Health and Human Development (NICHD), National Institutes of Health, U.S. Department of Health and Human Services. ; Safe Sleep for Your Baby: Reduce the Risk of Sudden Infant Death Syndrome. ; August 2003.
  11. Mathews TJ, Menacker F, MacDorman MF. Infant mortality statistics from the 2000 period linked birth/infant death data set. National vital statistics reports; vol 50 no 12. Hyattsville, Maryland: National Center for Health Statistics. 2002.
  12. Ministry of Health, Labour and Welfare SIDS study group, Sudden infant death syndrome (SIDS) diagnosis guidelines (the second edition) (the outside site); October, 2012 (Heisei 24).
  13. Donna L. Hoyert, Ph.D. and Jiaquan Xu, M.D.; Deaths: Preliminary Data for 2011, National Vital Statistics Reports (the outside site), Vol. 61, No. 6, October 10, 2012, p. 1-64.
  14. Jiaquan Xu, M.D., and Sherry L. Murphy, B.S., Kenneth D. Kochanek, M.A., et al. ; Deaths: Final Data for 2016, National Vital Statistics Reports (the outside site), Vol. 67, No. 5, July 26, 2018, p. 1-76.
  15. AMERICAN ACADEMY OF PEDIATRICS, Task Force on Sudden Infant Death Syndrome (the outside site). SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment. ; PEDIATRICS Vol. 138 No. 5 November 2016, e20162938. (DOI: 10.1542/peds.2016-2938)

November 24, 2004 first publication
The April 25, 2005 enlargement
The December 1, 2006 enlargement
The November 7, 2012 enlargement
The October 31, 2018 enlargement

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