According to the National Center on Health
Statistics (NCHS) 2,523 infants died of SIDS in the United States in
2000. Sudden Infant Death Syndrome (SIDS) is the sudden death of an
infant under one year of age which remains unexplained after completion
of a complete autopsy, examination of the death scene and review of the
baby’s health history. If any of these three steps are not conducted, a
SIDS diagnosis should not be made. The SIDS diagnosis reflects the
clear admission by medical examiners that an infant’s death remains
completely unexplained.
One model that guides our understanding of SIDS is the triple risk
hypothesis. An infant is believed to be at the highest risk for SIDS
when three risk variables converge for him or her: 1) a physiological
defect; 2) the critical development period (SIDS risk peaks between two
and four months of age); and 3) environmental stressors such as
sleeping face down, exposure to second-hand smoke or overheating while
wrapped in heavy blankets.
Studies throughout the world have found that infants that sleep on
their backs are much less likely to die of SIDS. Although the reasons
for this are still not fully explained, the U.S launched the Back to
Sleep education campaign in 1994. Since then, the rate of SIDS deaths
has been reduced by more than half. Between 1983 and 1992, more than
5,000 babies died each year due to SIDS in the U.S. By 1999, this
number had dropped to 2,648.
Despite major improvements, SIDS remains the leading cause of death for
infants between one month and one year of age. Racial and ethnic
disparities are still evident in SIDS rates nationwide. Blacks and
American Indians still have rates two to three times higher than the
national average. Many believe one major reason for this is that the
Back to Sleep message is not effectively reaching these populations of
parents and caregivers. 
Major Risk
Factors
- Infants sleeping on their stomachs.
- Soft infant sleep surfaces and loose bedding.
- Maternal smoking during pregnancy.
- Second-hand smoke exposure.
- Overheating.
- Prematurity and/or low birth weight.
- Infants that share a bed with others.
- Place and position where child was sleeping or
playing.
- Type of bedding, blankets and other objects
near child.
- Faulty design of cribs or beds.
- Number of and ages of persons sleeping with
child.
- Obesity, fatigue, or drug or alcohol use by
persons supervising or sleeping with child.
- Quality of supervision at time of death.
- Family’s ability to provide safe sleep or play
environment for child.
Records Needed
for Case Review
- Autopsy reports
- Scene investigation reports and photos
- Prenatal, birth and health records
- Interviews with family members
- Day Care Licensing investigative reports
- EMS run reports
- Emergency Department reports
- Prior CPS history on child, caregivers and
person supervising child at time of death
- Criminal background checks on person
supervising the child at time of death
- Reports of home visits from public health or
other services
- Any information on prior deaths of children in
family
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