For a tiny percentage of infants, the rhythm of sleep is interrupted by a deadly affliction: sudden infant death syndrome. Sudden infant death syndrome (SIDS) is a disorder in which seemingly healthy infants die in their sleep. Put to bed for a nap or for the night, an infant simply never wakes up.

SIDS strikes about 1 in 2,500 infants in the United States each year. Although it seems to occur when the normal patterns of breathing during sleep are interrupted, scientists have been unable to discover why that might happen. It is clear that infants don’t smother or choke; they die a peaceful death, simply ceasing to breathe.

While no reliable means for preventing the syndrome has been found, the American Academy of Pediatrics now suggests that babies sleep on their backs rather than on their sides or stomachs—called the back-to-sleep guideline. In addition, they suggest that parents consider giving their babies a pacifier during naps and bedtime (Task Force on Sudden Infant Death Syndrome, 2005; Senter et al., 2011; Ball & Volpe, 2013)

The number of deaths from SIDS has decreased significantly since these guidelines were developed (see Figure 5-7). Still, SIDS is the leading cause of death in children under the age of 1 year (Eastman, 2003; Daley, 2004; Blair et al., 2006).

Figure 5-7

Declining Rates of SIDS

Some infants are more at risk for SIDS than are others. For instance, boys and African Americans are at greater risk. In addition, low birth weight and low Apgar scores found at birth are associated with SIDS, as is having a mother who smokes during pregnancy. Some evidence also suggests that a brain defect that affects breathing may produce SIDS. In a small number of cases, child abuse may be the actual cause. Still, there is no clear-cut factor that explains why some infants die from the syndrome. SIDS is found in children of every race and socioeconomic group and in children who have had no apparent health problems (Howard, Kirkwood, & Latinovic, 2007; Richardson, Walker, & Horne, 2009; Behm et al., 2012).

Many hypotheses have been suggested to explain why infants die from SIDS. These include such problems as undiagnosed sleep disorders, suffocation, nutritional deficiencies, problems with reflexes, and undiagnosed illness. However, the actual cause of SIDS remains elusive (Lipsitt, 2003; Machaalani & Waters, 2008; Kinney & Thach, 2009; Mitchell, 2009).

Because parents are unprepared for the death of an infant from SIDS, the event is particularly devastating. Parents often feel guilt, fearing that they were neglectful or somehow contributed to their child’s death. Such guilt is unwarranted, because nothing has been identified so far that can invariably prevent SIDS (Krueger, 2006).