THE SUDDEN INFANT DEATH SYNDROME

The finding of an apparently healthy infant dead in his crib is as big a shock to physicians as to the parents. Sudden infant death syndrome (SIDS) is a definite entity that cannot be predicted and, therefore, cannot be prevented. Commonly known as "crib death" or "cot death," SIDS causes approximately 10,000 infant deaths each year in the United States. It is responsible for approximately three deaths of every 1,000 births. After the first week of life, SIDS is the most important single cause of death of infants under 1 year of age; it ranks second only to accidents as the greatest cause of death in children less than 15 years of age. It is more frequent in winter months, has a higher incidence in males and among lower socioeconomic groups, and has a peak incidence at 3 months of age. SIDS can he confirmed, but not explained, at autopsy by changes in the tissues of the respiratory system and the absence of other lethal lesions. This statement was prepared to provide guidelines for the pediatrician for his contact with the family and the agencies in the community when SIDS occurs. Because guilt feelings are usually associated with SIDS, the parents will need counsel and support to help alleviate these feelings, especially when they begin to wonder what they did wrong. The family should be encouraged to talk freely about their feelings, and they can be told about the usual reactions to losing a child. The counseling given initially may not be effective because of the emotional shock immediately following the infant9s death; therefore, the pediatrician should again meet with the family a day or two after the death.