Sudden unexpected infant death (SUID) describes any unexpected and sudden death of an infant in which the cause is not obvious before an investigation is done. SUID includes sudden infant death syndrome (SIDS), deaths of undetermined cause, and accidental suffocation and strangulation in bed (ASSB) in infants less than 1 year of age.
The exact cause of sudden infant death syndrome (SIDS) is not known.
Putting infants to sleep on their back; removing pillows, bumper guards, and toys from the crib; protecting infants from overheating; feeding human milk; and preventing exposure to tobacco during pregnancy and in infancy helps prevent SIDS.
Parents who have lost a child to SUID or SIDS should seek counseling and support groups.
There is more than one term used to describe a sudden infant death. Sudden unexpected infant death (SUID) is used broadly to describe any unexpected and sudden death in a child less than 1 year of age in which the cause is not obvious before a complete autopsy and postmortem investigation are done. SUID includes sudden unexpected deaths for which a cause is eventually found, such as accidental suffocation and strangulation in bed (ASSB). SUID also includes sudden, unexpected deaths for which no cause is identified even after an evaluation or investigation is done, such as deaths of undetermined cause, and sudden infant death syndrome (SIDS).
In 2022, SUID occurred in about 1 out of 1,000 infants in the United States. There are racial, social, and economic inequalities with SUID. For example, rates of SUID in non-Hispanic Black infants are about 3 times higher than in non-Hispanic White infants. Infants who live in poverty are also at greater risk of SUID.
SIDS (also called crib death) is the most common type of SUID. It is the leading cause of death in infants in the United States from about 1 month of age until the first birthday. It most often affects infants between 1 and 4 months of age. The syndrome occurs worldwide. There are many risk factors.
Did You Know...
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Causes of SIDS
The cause of SIDS is unknown. If a cause is diagnosed, it is no longer unknown and is not considered SIDS. SIDS may be caused by problems in the area of an infant's brain that controls breathing and waking up from sleep.
Genes that cause heart rhythm disturbances or seizures have been identified in some infants who die of SIDS.
That siblings of infants who have died of SIDS are at greater risk of SIDS suggests an inherited cause, at least in some cases.
Risk factors for SIDS
Children who have or who are exposed to any of the following major risk factors are at increased risk of SIDS.
Sleep-related risk factors:
Sleeping on the stomach (most important risk factor)
Soft bedding and soft sleep surfaces (especially couches and armchairs)
Overheating (caused by blankets or a hot room)
Major non-sleep–related risk factors:
Tobacco smoking by the mother (during pregnancy or after the infant is born)
No or incomplete vaccinations
Not feeding with any human milk (by breastfeeding [chestfeeding] or by bottle)
A brother or sister who died of SIDS
These risk factors have been studied mostly as risk factors for SIDS, but they apply to the broader category of SUID as well.
Diagnosis of SIDS
Autopsy
Doctors cannot make the diagnosis of SIDS without doing an autopsy (an inspection and examination of a body after death) to rule out other causes of sudden death (such as suffocation, abuse, intracranial hemorrhage, meningitis, or myocarditis or other illness), investigating the death scene, or without reviewing the infant's medical and family history.
Prevention of SIDS
Putting infants to sleep on their back
Despite the known risk factors for SIDS, there is no certain way to prevent it. However, certain measures seem to reduce the risk, particularly putting infants to sleep on their back on a firm, flat sleep surface. The number of deaths resulting from SIDS has decreased dramatically as more parents have put their infants to sleep on their back for every sleep (see the Safe to Sleep campaign).
Regular prenatal care during pregnancy has been shown to lower the risk of SIDS.
Breastfeeding and preventing infants from breathing second-hand smoke may help and clearly have other health benefits. Infants born to mothers who smoke during pregnancy have a greater risk of SIDS with each additional cigarette that is smoked.
There is no evidence that at-home breathing monitors reduce the risk of SIDS. There is also no evidence to recommend swaddling for prevention of SIDS.
Safe to Sleep: Reducing the Risk of Sudden Infant Death Syndrome (SIDS)
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Adapted from The National Institute of Child Health and Human Development's Ways to Reduce Baby’s Risk. |
Resources for Parents Who Have Lost an Infant to SUID or SIDS
Counseling
Support groups
Most parents who have lost an infant to SIDS are grief-stricken and unprepared for the tragedy. They often feel guilty. The experience of the investigations conducted by police, social workers, or others may cause additional distress.
Counseling and support from specially trained doctors, nurses, therapists, social workers, and other parents who have lost an infant to SUID or SIDS are critical to helping parents cope with the tragedy. Specialists can recommend reading materials, web sites (such as the American SIDS Institute), and support groups to assist parents.
More Information
The following English-language resources may be useful. Please note that The Manual is not responsible for the content of these resources.
National Institute of Child Health and Human Development (NICHD): Safe to Sleep
NICHD: Ways to Reduce Baby’s Risk
