Sudden death of an infant. Sudden death of an infant

Fetal death can occur: before birth (in antenatal period), during childbirth and after it (in the postnatal period), It can be both non-violent and violent.

Nonviolent fetal death and can be caused either by underdevelopment (non-viability) or by the presence of developmental defects incompatible with life (anencephaly, eventration internal organs and so on.). In addition, non-violent death of the fetus and newborn can be caused by various pathological processes or birth trauma.

In more than half of all cases, the cause of death is intrauterine asphyxia(which may be based on changes in both the fetus and the mother) from circulatory disorders, placenta previa and placenta infarction, true nodes umbilical cord, etc. In other cases, non-violent death can be caused by acute infectious diseases, some chronic diseases (for example, syphilis, etc.).

A common cause of death of a child during childbirth is birth trauma, which occurs more easily in immature fetuses, in the mother, in large fruit and during prolonged labor. can be expressed in bone fractures, intracranial hemorrhage in the membranes and substance of the brain, in damage to skeletal bones: collarbones, cervical vertebrae; in damage to internal organs (subcapsular hematomas of the liver, apoplexy of the kidneys and adrenal glands, hemorrhages into the lung tissue, etc.).

Violent Death of newborns during childbirth is rare.

It should be noted here that injuries that occur during self-help during childbirth, which occur outside the maternity facility and without outside help. Trying to help herself, without experience, a woman in labor damages the presenting part of the fetus, most often the head, with her hands. In this case, abrasions, bruises, wounds, dislocations of the lower part, and bone fractures may occur.

After childbirth, violent deaths of newborns can result from infanticide, homicide, and accidents.

As already indicated, infanticide can be passive (when a newborn is left without care and assistance) and active.

In active infanticide (and murder of a newborn), death most often occurs from various types of mechanical asphyxia.

There are cases when a newborn is thrown into bodies of water, cesspools. In these cases, death occurs from hypothermia, etc. There are cases of death from closing the respiratory openings with hands or soft objects. It should be borne in mind that during childbirth outside a hospital facility, when the woman in labor is alone and cannot provide necessary assistance a newborn may bury his face in a soft object and suffocate.

As a method of infanticide, strangulation with a noose can be used, which can be rags, twine, and sometimes parts of the mother’s linen or clothing.

It should be borne in mind that sometimes a loop of the umbilical cord is found around the baby’s neck. The umbilical cord may become wrapped around the neck during childbirth. However, the possibility of killing a newborn by strangulation with the umbilical cord cannot be ruled out.

Mechanical damage as a method of infanticide is less common. Damage to vital organs from blunt or sharp objects may occur. Injuries caused by blunt objects must be distinguished from birth trauma and injuries that occur during so-called rapid labor.

Control questions
1. Which baby is considered a newborn?
2. Define the concept of “infanticide”.
3. How to determine whether it is full-term and mature?
4. How to set a deadline intrauterine life newborn?
5. What is the difference between the concepts of “fetus” and “newborn baby”?
6. How can you determine whether a baby was born alive or dead?
7. How is the viability of a newborn baby confirmed?
8. How to determine the duration of extrauterine life?
9. Name the most common causes of infant death:
a) before childbirth;
b) during childbirth;
c) after childbirth.

Syndrome sudden death in children (SIDS) is the death of a child in the first year of life who has virtually no health problems. Moreover, even a pathologist cannot determine the reason for this during an autopsy. Quite often the syndrome is referred to as “death in the crib” or “death without a cause.” However, reasons and risk factors for the occurrence of this practically unstudied phenomenon still exist. By excluding them, parents can minimize the risk of SIDS.

Description

Sudden death syndrome is not a disease. This diagnosis is made posthumously if the analysis of the child’s medical history and the results of the autopsy do not allow determining the cause of death. If it is possible to discover that a pathology that was not previously identified led to death, the diagnosis of SIDS is not made.

Since ancient times, information has been received about cases of sudden death of babies, but an explanation for this phenomenon has not yet been found, despite the fact that scientists around the world are trying to solve this problem. It is noteworthy that SIDS is not typical for children of the Asian race, and is twice as common in the white race as in Indians and African Americans.

Most often, sudden death syndrome occurs when the child is sleeping, and no symptoms appear the day before. Currently, up to 6 cases of this phenomenon are registered for every thousand of their peers.

Until what age can sudden infant death occur?

The study of the phenomenon made it possible to identify some patterns of this mysterious phenomenon:

Factors that increase the risk of SIDS

Scientists, by studying cases of sudden death in infants, were able to identify a number of factors that contribute to its development:

1. Development of postpartum depression in the mother.
2. Birth of a baby by a single mother.
3. Poor social and economic family conditions (parents lack knowledge of how to properly care for a child, parents do not have jobs, family members smoke, there is no regular ventilation of the apartment, there is overcrowding in the apartment).
4. During pregnancy, the mother took drugs or smoked.
5. The mother gave birth when her age was less than 17 years.
6. The child has recently suffered from some illness.
7. Hypoxia and anemia of the fetus were noted during gestation.
8. Medical observation of pregnancy was started at later or was absent altogether.
9. Known history of stillbirth or SIDS in these parents.
10. The mother had many pregnancies, and the intervals between them were short.
11. Multiple pregnancy.
12. At birth the baby was underweight.
13. Prematurity of the baby. Moreover, the lower the child’s gestational age, the higher the risk of developing SIDS.
14. Overheating of the child's body. This factor includes both excessive heating in the room and the use of too warm blankets when covering the child.
15. Too soft for a child bed dress- blankets, mattress, pillows.
16. Baby sleeps in a prone position.

The causes of sudden infant death are not fully understood. Of particular note is the increase risk of SIDS when parents smoke. Research shows that SIDS cases would be reduced by 40% if mothers did not smoke during pregnancy. Moreover, the danger lies in both active and passive smoking. Even smoking in an adjacent room, in which the window is open and the ventilation is turned on, can cause harm.

Probable causes of sudden death

SIDS has not been fully studied by scientists. However, some of its mechanisms have been described. Currently, there are several theories that can explain the mechanism of development of this phenomenon.

Normal sleep is often accompanied by breathing disturbances, in which breathing may stop for a short time. The result of such a stop is the development of hypoxemia. Normally, hypoxemia provokes awakening and subsequent recovery respiratory function. If breathing is not restored, sudden death occurs. The reasons for this are given below.

The child’s regulatory mechanisms are in an immature state, and therefore apnea in infancy- a common occurrence. If such breath holdings occur more than once an hour, and their duration reaches 15 seconds, it is important to immediately contact your pediatrician.

A separate group of scientists believe that the leading factor in SIDS is heart rhythm disturbances, not apnea. Among them are frequently changing heart rate, bradycardia (accompanied by a decrease in the number of heart contractions to 70 or less beats per minute), disorders such as blockades and extrasystoles.

This theory is confirmed by the discovery in some cases of SIDS of a gene mutation that is responsible for the structure of sodium channels located in the heart. Changes in these structures provoke heart rhythm disturbances.

Even healthy children may experience disturbances in heart rhythm, even to the point of short-term cardiac arrest. If such phenomena are observed in infancy, it is important to immediately contact a pediatrician and examine the baby.

What else can cause sudden death syndrome? Changes in the structures of the brain stem. The medulla oblongata contains the vasomotor center and the respiratory center, which are responsible for cardiac activity. Studies of some cases of SIDS have revealed a violation of enzyme synthesis, the formation of acetylcholine receptors in the brain stem due to the influence of components of tobacco smoke. It is assumed that such changes may contribute to the development of SIDS.

In some infants after sudden infant death, structural changes and lesions of the cells that form the brain stem were identified, which arose at the stage intrauterine development as a result of hypoxia.

Ultrasound echography, which was carried out on children rescued after respiratory arrest, revealed that in 50% of cases there was pathology of the arteries that supply the brain stem with blood. This may indicate that the disorder cerebral circulation Can cause SIDS in some babies.

Blood circulation is disrupted if the artery is pinched due to the incorrect position of the baby's head. Due to underdeveloped muscles, the child is unable to turn his head independently. The child can reflexively turn his head to a safe position only after 4 months.

In addition, there is a circulatory disorder if the baby sleeps on its side. Blood flow is most severely disrupted when sleeping in a prone position. Studies confirm that in this position there is a sharp slowdown in breathing and a weakening of the pulse.

Totality large number Pathological changes found in all deceased children suggest that SIDS often develops against the background of severe stress to which the child’s body has been subjected. Such pathological changes are expressed in the form of small hemorrhages found in the thymus gland, the outer lining of the heart, lungs, traces of ulceration on the mucous membranes of the gastrointestinal tract, wrinkled lymphoid formations, and reduced blood viscosity. Such phenomena represent symptoms of nonspecific stress syndrome.

Clinically, this syndrome manifests itself in the form of a runny nose, discharge from the eyes, enlarged tonsils, spleen, liver, rash, and weight loss. Most often, such symptoms are observed in a child approximately 3 weeks before the development of SIDS in 90% of cases. However, many scientists believe that these symptoms are not sufficient to cause death. It is quite possible that a combination of any disturbances in the development of a child and stress can lead to dire consequences.

It was noted that the majority of children who died suddenly had symptoms of a viral infection within a week before the onset of SIDS. At the same time, the children were examined by a pediatrician, and some children were prescribed antibiotics.

Among supporters of this theory, there is an opinion that pathogens secrete cytokinins and toxins that can disrupt defense mechanisms the body, for example, the ability to awaken from sleep during apnea. Thus, the risk factors present are aggravated by infectious contamination. Toxins of pathogenic microorganisms (often found posthumously) Staphylococcus aureus) can provoke and intensify inflammation.

The data obtained allow us to judge that toxins affecting children, together with risk factors, can cause death.

Recent studies report the discovery of the SIDS gene in comparative analysis DNA of children who died from SIDS and healthy children. It is generally accepted that the likelihood of sudden infant death syndrome occurring is three times higher in those children who have a mutation in the gene responsible for the formation and subsequent development of immune system. However, scientists prefer to believe that the presence of a mutated gene in itself does not provoke SIDS, but only in combination with other factors.

Some studies indicate the likelihood of sudden death as a result of the presence of the Helicobacter pylori bacterium in the body. This conclusion is based on the fact that this bacterium is most often found in deceased children. These microbes provoke the synthesis of ammonium, which causes breathing problems, resulting in the sudden death of the baby. It is assumed that when a child burps, he may inhale a certain amount of microbes in the vomit. Thus, ammonium enters the blood and causes breathing problems until it stops.

Let's look at one more probable cause sudden infant death syndrome.

Swaddling a baby as a risk factor

Experts have differing opinions regarding the safety of swaddling. Some believe that swaddling reduces the risk of SIDS by preventing the baby from rolling over and being covered with the blanket over his head.

Others are of the opinion that when swaddling, physiological development baby. Tight swaddling restricts the baby's movements and does not allow him to accept comfortable position. As a result, thermoregulation is disrupted - in a straightened position of the body, its heat transfer increases.

In addition, breathing is limited, meaning the risk of developing pneumonia and SIDS increases significantly.

Pacifier as a way to prevent SIDS

Some researchers believe that using a pacifier during baby's nap and sleep periods can reduce the risk of SIDS. This effect is explained by the fact that the design of the nipple ensures the penetration of air into respiratory organs child in cases where he accidentally covers his head with a blanket.

You should start using a pacifier from 1 month, when breastfeeding has already been established. However, if the child refuses to take the pacifier, you should not be persistent. Weaning a child off a pacifier should begin at the age of 1 year.

Safety of co-sleeping between baby and mother

Various scientists have ambivalent interpretations of co-sleeping with a baby. Undoubtedly, co-sleeping helps prolong the period of breastfeeding. Relevant studies have revealed that when sleeping together mothers with a child, the risk of the latter developing SIDS is reduced by approximately 20%. This may be explained by the fact that the baby’s body is sensitive and is able to synchronize breathing and heartbeat with the breathing and heartbeat of the mother.

In addition, the mother, being nearby, is able to subconsciously control the child’s sleep. It is noted that the risk of sudden death increases if the baby first cries loudly and then falls asleep soundly. During such periods, the child should not be isolated; it will be safer if he is close to his mother, who is able to notice the cessation of breathing and provide assistance. timely assistance.

However, on the other hand, when sleeping together, the risk of sudden onset syndrome increases significantly. infant death if the baby's parents smoke. Even if smoking is not done in the presence of the baby, during sleep the smoker exhales air saturated with harmful components contained in tobacco. A similar situation arises if parents use alcohol or drugs. In addition, the likelihood that a soundly sleeping parent will accidentally crush the baby increases. When sleeping together with a child, it is also not recommended to overuse perfume.

Rules for choosing a bed for a baby

The best option for placing a crib is the mother's room. It should be placed away from the radiator, heater, or fireplace. This will prevent the baby from overheating. The mattress must be firm and even. You can lay an oilcloth on it, and a carefully straightened sheet on top. It's better to do without a pillow. The child's bed should be of such a degree of rigidity that there are no dents on it from the child's head.

During the cold period, the child's blanket should be made of wool, not cotton or down. The use of a thermal blanket is prohibited. The child should not be covered higher than up to the shoulders. This minimizes the likelihood that the child will accidentally cover his head. In this case, the child must be positioned in the crib so that his legs rest against the bottom side of the bed.

If used sleeping bag, then it must be selected in strict accordance with the size (to avoid the child moving to the bottom). The average temperature in the children's room should be no more than 20 degrees Celsius. Overheating of the baby causes deterioration in brain control over the activity of the respiratory center.

You can tell if your baby is cold by touching his tummy. Determination by arms and legs is considered incorrect, since they can be cold even if the child is hot. Upon returning from a walk, it is necessary to undress him, even if this may cause him to wake up.

When putting the baby to sleep, the baby should be placed in a supine position. To prevent regurgitation and further aspiration of vomit while sleeping on the back, the child should be kept in a vertical position about 15 minutes. This will allow the air swallowed along with the food to escape from the stomach.

Sleeping on your stomach increases your risk of sudden death for several reasons:

1. Weaker physiological control of the lungs, heart, and autonomic functions.
2. The balance between the sympathetic and parasympathetic parts of the nervous system may be disturbed.
3. Lung ventilation is impaired. This is doubly important for infants under 3 months of age, who have weakened ventilatory reflexes.
4. Stomach sleep is deeper due to the increased awakening threshold.

This sleeping position is most dangerous for those children who usually sleep on their backs and accidentally roll over onto their stomachs. Babies who prefer to sleep on their stomach should be turned onto their back once they fall asleep. The side position is also considered less safe than lying on your back. Putting Stuffed Toys should not go to bed.

After six months, the baby can already roll over in bed on his own, so you can allow him to take the most comfortable position for him. However, he should be put to sleep on his back.

Using a baby monitor

Currently, there are specialized devices that allow you to control the heartbeat and breathing in babies up to one year old. Such monitors have a special warning system that is triggered when the heart rhythm is disturbed or breathing suddenly stops.

Such devices are not capable of protecting a baby from SIDS, but they can promptly notify parents of existing problems. This will allow you to provide timely assistance to the child. The most appropriate use of such monitors is in children who are at risk of developing sudden infant death syndrome and who have breathing problems.

Risk groups by age

SIDS is atypical for babies under one month old. Most often the syndrome occurs from 2 to 4 months. According to statistics, the most critical is the 13th week of life. About 90% of all cases of SIDS occur before the age of six months. It is extremely rare that sudden death syndrome in children occurs after a year, although there are registered such cases even in adolescence.

Help a child

If a child has a sudden stop in breathing, you need to immediately pick him up and vigorously run your fingers several times along the spine, in the direction from bottom to top. Then you need to massage his earlobes, feet, hands, and stir him up. Most often, such actions lead to the restoration of breathing.

If breathing still does not return, you should immediately contact an ambulance service. While waiting for her arrival, the child should undergo cardiac massage and artificial respiration.

Thus, it is impossible to completely eliminate the risk of sudden death due to the fact that its causes are not fully understood. However, every parent can minimize risks by reducing development factors.

One can understand the despair of parents when, in the background full health, without any visible reasons they find their child dead in the cradle. Subsequent investigation into the circumstances of the death of the newborn, analysis of his developmental history (outpatient chart), as well as the results of the post-mortem examination do not answer the question of the cause of the child’s death. This condition, the fact of which is established by excluding any other pathology, is included in the International Classification of Diseases under the name Sudden Infant Death Syndrome (SIDS). According to studies conducted in various countries Europe, the incidence of SIDS ranges from 0.5 to 4 per 1000 infants. Unfortunately, in Russia there are no reliable statistics of this kind yet, since the awareness of medical workers regarding SIDS is low and often death of unknown etiology is classified as a result of complications of ARVI or other common diseases.

This syndrome is known to affect boys more often; The ratio of boys to girls is 1.5:1. The most dangerous age in terms of the risk of developing SIDS is considered to be 2-4 months. Most often, sudden death of infants occurs in autumn or winter months of the year

A large-scale study of this problem in the world began in the 60s of the last century. Since then, many attempts have been made to explain the occurrence of SIDS, and it can be argued that significant steps towards identifying risk factors and preventing SIDS have already been made. Unfortunately, due to the fact that in our country sudden infant death syndrome for a long time was not accepted by the medical community as a full-fledged diagnosis, time was lost that could have been used to develop preventive measures that have brought success in preventing the syndrome in developed countries of the world. But in the 80s, on the individual initiative of enthusiastic doctors, research was finally started, thanks to which the current state of domestic science has approached the global one.

Why?

This is the first question that arises for both grief-stricken parents and the attending physician. Science is not yet able to answer this question unambiguously, although there is great amount hypotheses. Many of them were consistently rejected: the possibility of “suffocation”, “crushing” of the child by the mother or pillow sleeping nearby; overheat; inhalation of vomit; psycho-emotional stress; infections; enlargement of the thymus gland. However, despite the inconsistency of these assumptions regarding SVSM, they have proven useful in the development of a number of hygiene requirements for caring for an infant. Thus, the mother is recommended to sleep separately from the baby and is not recommended to place the newborn on his tummy to sleep (it is preferable to place the baby to sleep on his back or on his side with a soft cushion at the neck that prevents him from turning face down). The child should not be dressed too warmly, and there should be no sharp sounds during sleep. During play, the child should not be shaken or tossed sharply.

Currently, the following theories of the occurrence of the syndrome predominate: "Heart"

This is one of the early hypotheses that has received serious confirmation today. Its essence boils down to the fact that the syndrome can be caused by the development of heart rhythm disturbances that are fatal for the child’s body, or arrhythmias. Normally, the human heart has the so-called automaticity, that is, the ability to independently, not subject to the influence of regulatory systems (nervous and endocrine), but in “cooperation” with them, generate impulses leading to its reduction. Therefore, the heart always beats in a certain rhythm, creating pauses for rest, alternating with contractions that push blood into the aorta to supply blood to organs and tissues. Thus, the heart rhythm is the key to adequate oxygen supply to the entire body. Arrhythmia is extraordinary, abnormal, often simply chaotic heartbeats. In this case, situations incompatible with life sometimes arise: cardiac arrest, ultra-frequent, erratic contractions, or fibrillation. As a rule, serious rhythm disturbances are manifested by a sudden sharp pallor of the child, lethargy, apathy, visible pulsation of the cervical vessels, and sometimes vomiting.

Arrhythmia can occur not only in children with heart disease. This is what makes diagnosis so difficult. It is possible to suspect and prevent a life-threatening arrhythmia only on the basis of a very qualified analysis of electrocardiograms, as well as all possible precursors of the arrhythmia.

The breathing function is vital. Located in the brain respiratory center, which controls this function. We don’t think about how to take a breath, it happens automatically. The respiratory center also regulates the breathing rate. As soon as the oxygen content in the blood decreases and, accordingly, the carbon dioxide content increases, breathing becomes more frequent. This happens, for example, when physical activity being in a stuffy room. On the contrary, pauses in breathing may occur that are protective in nature, for example, when liquid or food enters the upper respiratory tract. In addition, infants experience such phenomena as episodes of holding their breath during sleep, or apnea. Apnea can also occur in adults who snore. The norm for infant Holding your breath for no more than 20 seconds is considered. The reason for such delays is the immaturity of the respiratory regulation system. As the child grows, episodes of apnea become increasingly rare and by 3 months almost disappear. It has been proven that children with SIDS have more frequent periods of apnea. Death can occur from complete cessation of breathing during sleep. Therefore, if you notice signs of breath holding in a child, you should encourage the baby and rub his arms and legs. Unfortunately, episodes of apnea are usually recognized only retrospectively during a conversation with the parents of the deceased infant.

To summarize, it should be noted that the circumstances and all possible mechanisms of SIDS are caused by a violation of the adaptation of the central and autonomic nervous system. It is she, as noted above, who exercises control over breathing and cardiac activity. The immaturity of the newborn’s nervous system is the basis on which any life-threatening disorder is based. Therefore, the state of the newborn’s central nervous system should be given Special attention. Most scientists now believe that children who subsequently die from SIDS were born with much less protection from the internal and external stresses that occur in the life of any young child.

Risk factors for SIDS

Risk factors include environmental factors, age and gender characteristics, social and obstetric factors. We mentioned age and gender characteristics at the beginning of the article, when we talked about the greater prevalence of the syndrome in boys and children 2-4 months old. life. Environmental factors include the change of season (cold snap), since getting used to the cold requires a certain strain on the baby’s adaptive reserves. Social factors such as the age of the parents, their bad habits, and the child’s living conditions also play an important role. Various disorders during pregnancy and childbirth lead to increased susceptibility of children to the effects of unfavorable factors environment.

Avert trouble

Today, the main method of preventing SIDS is the timely identification of risk factors and adequate medical supervision for children who are at risk of developing this syndrome. In our country, since 1996, the Children's Scientific and Practical Center for Heart Rhythm Disorders of the Russian Ministry of Health has been operating. One of the main tasks of the Center is to develop risk criteria for sudden cardiac death and methods for early detection of life-threatening arrhythmias in children.

There are also indications for an extraordinary visit to a local pediatrician with a child in his first year of life:

• in case of difficulty waking up from sleep and/or an unusual half-asleep state of the child;
• in case of difficulty breathing, hoarseness or cough;
• if the child has an unusually long or intense cry;
• if the child has repeated refusal to eat, repeated vomiting, frequent loose stool;
• in case of a sharp increase or decrease in body temperature.

Of course, the cornerstone of SIDS prevention is to healthy image life of both the expectant mother and the newborn. All recommendations for child care, despite their apparent simplicity, have a serious theoretical, experimental and practical basis. Even at the stage of planning pregnancy, a woman should take care of her health, great importance has a waiver bad habits both before and during pregnancy, as well as after childbirth (for example, smoking in the room where the baby is located increases the risk of SIDS). Certainly, big role play social programs to improve living conditions, sanitary education, and medical examination of children. So it is within our power to reduce the likelihood of tragedy to a minimum.

SIDS (or SIDS - sudden infant death syndrome, or “death in the crib”, in foreign medicine - SIDS) is the unexpected causeless death of a child aged from a week to a year. The origin of the syndrome is not fully understood, but most doctors consider it to be the result of apnea (stopping breathing) and heart rhythm disturbances. The most susceptible to SIDS are boys (about 60%) under the age of seven months (“peak” occurs at 2-4 months). Most often, sudden death occurs at night or in the morning, during the cold season.

How common is SIDS?

According to statistics, the SIDS rate in developed countries ranges from 0.2 to 1.5 cases per 1000 newborns (for example, in 1999: in Germany - 0.78, USA - 0.77, Russia (data for St. Petersburg) - 0.43, Sweden - 0.45). Following an information campaign to reduce the risk of SIDS in England and Sweden, rates fell by 70% and 33% respectively.
According to World Organization healthcare, SIDS is one of the three leading causes of death in children in the first year of life (along with congenital anomalies and perinatal conditions) – to its share in different countries accounts for up to 30% in the structure of infant mortality.

In what cases is SIDS diagnosed?

Doctors speak about sudden infant death syndrome only after a thorough investigation of all the circumstances of the child’s death, during which any possible pathologies. When neither a post-mortem examination nor a thorough analysis of the child's developmental history explains the reasons for his sudden death, a diagnosis of SIDS is made. Special statistical studies of all circumstances accompanying SIDS are carried out, and risk factors are identified.

What are the main risk factors for SIDS?

According to statistics, the main risk factors include: overheating and poor ventilation of the room, smoking in the child’s room, excessively tight swaddling, sleeping on the stomach, too soft a pillow and mattress. According to some pediatricians, the reason for the increase in the number of cases of SIDS - in the tummy position - actually lies in soft pillow or a mattress. They simply “pinch” the child’s nose, blocking his breathing. Therefore, the crib should have a hard, smooth mattress, and it is better to abandon the pillow altogether. But, one way or another, statistics clearly indicate that sleeping on the stomach significantly increases the risk of SIDS: in countries where, traditionally, or as a result of an information campaign, children are placed to sleep on their backs, the lowest percentage of cases of sudden death of babies is recorded.
Risk factors also include: prematurity and low birth weight of the child; young age mothers (up to 17 years old); complicated, prolonged or premature; abortions; multiple births, especially with short time intervals.

What can cause SIDS?

Experts believe that most often this is the result of the immaturity of the infant’s neurohumoral system. During this period, children often experience apnea - temporary holding their breath; and if they occur more than once an hour and last longer than 10-15 seconds, you should immediately inform your pediatrician about it.

Another version of SIDS is a violation of the infant’s cardiac activity: various kinds arrhythmias, even short-term cardiac arrest; they can occur even in healthy children. In any such case, you should also immediately consult your pediatrician.

There is an increase in the number of sudden deaths of infants in the autumn-winter period. This may be due to an increase in the number of respiratory viral infections, or with a decrease in immunity and the need for increased stress on the adaptation reserves of the child’s body.

According to one hypothesis, the death of an infant may occur as a result of chronic psycho-emotional stress.
Does co-sleeping increase the risk of SIDS?
There is no clear opinion on this matter. Some doctors are inclined to believe that co-sleeping may increase the risk of SIDS - if it disrupts the baby's comfortable sleep. However, most pediatricians consider co-sleeping, on the contrary, a factor in the prevention of SIDS. After all, the child’s body is so sensitive that it synchronizes its own breathing and heartbeat with the breathing and heartbeat of the mother. In addition, the close proximity of the mother allows her to react as quickly as possible, for example, if the child stops breathing.

Is the risk of SIDS higher in dysfunctional families?

Since ill-being is primarily manifested in the lack of basic conditions for the life of a newborn, as well as in the mother’s addictions during pregnancy and lactation - smoking, alcoholism, drug addiction, this, of course, increases the risk of SIDS. In addition, in such families the level of education and awareness of parents is extremely low, there are no basic knowledge and nursing skills. Such parents, as a rule, are inattentive to the baby’s health and may not notice any alarming symptoms.

What does “genetic predisposition to SIDS” mean?

If the baby’s siblings or his parents experienced causeless cardiac or respiratory arrest in infancy, and even more so if there have been cases of causeless infant death in the family, then such a child should be classified as a high-risk group.
Can SIDS be prevented?
Unfortunately, it is impossible to completely exclude the syndrome, since the exact causes that cause it have not yet been established, but it is possible and necessary to reduce the risk of SIDS. Competent, careful observation of a child by a pediatrician from birth can reveal health problems in the baby and his predisposition to SIDS at the earliest stages.

To monitor the child’s condition, there are special devices: respiratory monitors (or breathing monitors) and cardiorespiratory monitors (additionally responding to heart rhythm disturbances). Respiratory monitors are used more in the home; they are installed under the mattress of the crib and are equipped with a warning system.

What to do if the child stops breathing?

If the baby suddenly stops breathing, you should vigorously move your fingers from bottom to top along the spinal column, pick him up, stir him, massage his arms, feet, and earlobes. As a rule, these measures are enough to restore the child’s breathing. If this does not happen, it is necessary to urgently call " Ambulance", and before the doctors arrive, resort to emergency measures: get a massage chest, artificial respiration.

It is necessary to know how to provide first aid in case of suffocation - after all, respiratory arrest can also occur due to the child entering the respiratory tract foreign objects.

Infants whose age ranges from 2 to 4 months are most susceptible to sudden death syndrome. By six months, this phenomenon is extremely rarely recorded, and only isolated cases of SIDS have been reported among 9-month-old infants and older children.

The conducted research helped scientists find out the most dangerous period of infant mortality, but until now the exact cause of the sudden death of infants has not been found out. There are several main predisposing SIDS factors. Pathological studies have proven some connection between underdevelopment individual parts brain and child mortality rates.

Concept of sudden infant death syndrome

Only at the end of the 60s did the medical community face an acute question regarding mortality in infancy. It was during this period that the term SIDS was coined. Of course, children have died before, but only at the end of the last century did pediatricians around the world begin to “sound the alarm”, conducting all sorts of campaigns to try to prevent the development of this syndrome.

Although infants are able to quickly adapt to new conditions, their mortality due to external or internal reasons still high. Usually seemingly healthy children die due to various pathologies development, due to previous infections and often as a result of previous injuries. Unsuspecting parents put their baby in a crib and then find him dead there.

A sleeping baby may experience breathing problems. As a rule, its short-term delay is considered normal for children. As the oxygen level in the blood drops, signals from the brain cause the baby to wake up and resume breathing.

Only in in rare cases apnea is fatal. If parents begin to notice that their baby holds his breath for 10-15 seconds during sleep, and several stops occur within an hour, then this serious reason to show the child to the doctor.

Typically, the cause of death is determined at autopsy by a pathologist, and only when this cannot be done is a diagnosis of SIDS made. According to statistics:

• African American children die from SIDS much less frequently;
• In approximately three children out of a thousand who die, the autopsy fails to identify the cause of death;
• more than half of the deaths are boys;
• in 90% of cases, 2-4 month old children die;
• the risks of SIDS increase most when the baby reaches 13 weeks of age;
• the death of a child in more than half of cases is associated with improper behavior of parents;
• 40% of infants had cold symptoms on the eve of death;
• Most often, the development of sudden child death syndrome is facilitated by a period of cold weather.

Parents whose children are at risk need to make every effort to create the most favorable living conditions for their child. They need to be more attentive to the baby’s whims and devote most of their free time to him.

Factors that can provoke this phenomenon

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So far, the phenomenon of SIDS has not been fully studied. Medical workers remain perplexed when caring parents suddenly dies healthy child. No one can answer with 100% certainty what caused sudden infant death syndrome. The most likely provoking factors are:

• stopping breathing during sleep;
• abnormal heart rhythm;
• pathology of the coronary vessels that supply oxygen to the brain;
• deterioration general condition child’s health against the background of psycho-emotional stress;
• infection;
• compression of the vertebral arteries.

It is also worth highlighting some factors that can negatively affect the child’s health and lead to sudden death at night:

• nicotine and drug addiction of the mother during pregnancy;
• intrauterine growth retardation;
• birth of a child prematurely;
• incorrect position of the baby in the crib during sleep (on the stomach);
• incorrectly selected bedding (large pillow, soft blanket, etc.);
• foreign objects in the crib (bottle, pacifier, toys, etc.);
• excessive air temperature in the children's room;
• parental smoking.

Many dead children could have been saved - most often children die due to the fault of their parents. If at the autopsy the doctor finds traces of violent death, then SIDS is classified as murder. There are often cases when the mother covered the baby with a pillow so as not to hear him cry anymore.

Parental care and attention are the main guarantee of a long and happy life baby

Sometimes parents may unintentionally harm their helpless child. Due to the fact that the neck muscles of the baby are weak, any careless movement or shaking of the baby leads to concussions or bruises of the brain (we recommend reading:).

Often, after a shake, the baby becomes quiet, he may lose consciousness and fall into a coma. Very often, children die in their sleep when their own mother, under the influence of sleeping pills or alcohol, leans her body on a nearby sleeping helpless baby.

At what height is there a risk of developing SIDS?

For newborns and infants up to 2 months syndrome sudden death not typical. The peak of deaths occurs at 13 weeks of age. If the child moves to the next age category, he is already more than 6 months old, in this case the risks of SIDS are reduced to 10%.

One-year-old children die in their sleep extremely rarely; only isolated cases are recorded. Teenagers and adults who were completely healthy can also die suddenly due to increased physical activity, and being at rest.

SIDS most often occurs in children from birth to 1 year. As soon as the baby learns to roll over, sit down and stand up, then the risks of sudden death syndrome approach zero. From this moment on, the child can independently change the position of his body in his sleep, taking the most comfortable position for himself.

Is the syndrome possible in an adult?

Unfortunately, sudden nocturnal death syndrome also occurs among the adult population, so no one can say exactly up to what age one should be afraid of this phenomenon. Year after year, deaths are recorded around the world when healthy people from 18 to 30 years old die for unknown reasons.

Although many studies have brought scientists closer to unraveling the causes of SIDS, such a phenomenon as sudden death in adults requires serious study. The scientific community insists on the need to introduce a new term SIDS (sudden adult death syndrome). In young people, cardiac activity stops or breathing stops during sleep. The autopsy did not note any pathological changes, which can cause death. On the contrary, in most cases the deceased was distinguished by good health.

Based on the available and very contradictory statistics, it can be assumed that on average 4 people die every week in the world for no apparent reason. More than 200 cases of SHS are recorded per year.

If you look at other data obtained by UK scientists, the mortality rate from SHS is simply amazing. In this country, 3,500 people die needlessly every year.

First aid for a child who suddenly stops breathing

Health workers in the maternity hospital and local pediatricians should conduct conversations with new parents so that they, in turn, can immediately provide emergency assistance to your child. Knowing the terrible symptoms of sudden infant death syndrome can help you avoid tragedy.

After breathing stops, a child can be saved if measures are taken in time. Symptoms of SIDS can last from 1 to 30 minutes. Typically, infants' breathing becomes weak. The child is not active and turns blue skin, muscle tone decreases.

As soon as parents suspect that heartbeat If the baby is disturbed or has breathing problems, you should immediately call an ambulance. You can’t waste a minute, you need to try to restore cardiac and respiratory activity without panicking and maintaining composure. To do this you need to do the following:

• run your fingers intensively along the spine several times;
• shake the baby slightly, trying to wake him up;
• massage your feet, hands and earlobes.

Thanks to such actions, the child can be brought to his senses. He wakes up, his breathing and heart rate are restored. However, if all the manipulations carried out did not give positive result, you don’t need to stop, you need to massage again and again until the ambulance arrives.

It is also necessary to give the baby a heart and chest massage. All actions must be carried out with extreme caution, since the baby’s bones are still too fragile, and you can injure him.

Is it possible to prevent the development of the syndrome?

Thanks to many years of research, doctors were able to prove the effectiveness preventive measures in the fight against SIDS. You can reduce the risk of sudden nocturnal infant death by:

• Stop smoking, as tobacco smoke is extremely toxic. Its constant impact on the child’s fragile body is unacceptable.
• There should be no foreign objects in the crib. Children under 1 year of age do not need a pillow; their mattress should be firm.
• You can't cover the baby warm blanket during sleep. The baby is not able to control his movements; he can easily pull the blanket over himself, thereby limiting access to fresh air.
• Many experts are of the opinion that it is better for a child to sleep with his mother. This way she can monitor the baby’s sleep. You need to understand that drinking alcohol or sleeping pills in this case is unacceptable.
• When placing a baby in a crib to sleep, you need to lay him on his back, and move his head to the side, or on his side, fixing the body on both sides with a positioner.

If during pregnancy a woman monitors her health, regularly attends antenatal clinics and follows doctors’ recommendations, then she has every chance of giving birth and raising a child. healthy child. It has also been noted that breastfed children have good health and better adapt to environment than babies on artificial nutrition.

Based on all of the above, we can draw a simple conclusion: parents need to lead a healthy lifestyle, pay more attention to their child and follow the basic rules of children's sleep hygiene.

If the baby is at risk of SIDS, parents should take care in advance to purchase equipment specially designed for such cases. This way, while your child is sleeping, you can monitor his heart rate, and if it is disturbed, an alarm will sound. A respiratory heart monitor is placed next to the crib and electrodes are attached to the baby's body.

SIDS statistics in Russia

Sudden infant death syndrome (SIDS) is not a disease. This is a diagnosis that is made only in cases where it is impossible to establish the true cause of death of the infant. At the autopsy there are no pathologies, there are no signs of violence, the death is diagnosed as a result of SIDS.

In the Russian Federation, statistics on sudden deaths among child population. According to the statistical data obtained, in Russia, per 1000 children born, the sudden mortality rate is 0.43.

Educational activities by the Foundation for the Study of Child Mortality Problems began in 1991. Since then, the number of sleep-related infant deaths has dropped significantly. Parents began to listen to the recommendations of specialists, tragic cases decreased by 75%, but SIDS continues to claim the lives of babies.