SIDS & Accidental Suffocation

SIDS, an unexplained infant death resulting from an unknown medical abnormality or vulnerability is usually classified a natural death. Accidental suffocation, a death resulting from full or partial airway obstruction causing death from oxygen deprivation and increased carbon monoxide, is classified as accidental. In most cases of sleep-related infant death, it is impossible to make a definitive classification of SIDS vs. accidental suffocation. Autopsy findings are similar and death scenes often reveal possible asphyxiating conditions, such as prone sleep or co-bedding, without clear evidence of airway obstruction.

In the United States in the last 20 years there has been a decrease in deaths classified as SIDS and an increase in those classified as accidental suffocation. Sleep-related deaths have leveled off at about 4,000 each year.

One theory is that most sleep-related deaths are caused from a combination of infant vulnerability and asphyxiating conditions and can be seen as existing on a continuum of highly vulnerable infant/safe environment to normal infant/highly asphyxiating environment.

To reduce the risk of a sleep-related death there are generally 4 theoretical approaches

  1. Decrease infant’s medical vulnerability. This is only possible through increased medical research to understand such things as genetic abnormalities, brain abnormalities, prematurity and other pregnancy related medical risks.
  2. Keep the child’s airway free. Avoid prone (stomach) sleep, bed sharing and cluttered sleep surfaces.
  3. Don’t do anything to decrease the infant’s arousal. Avoid prone sleep, bed sharing, over-heating, and sedation. Avoid risks of infections.
  4. Don’t do anything to decrease the parent’s arousal. Avoid situations leading to exhaustion as well as alcohol & drug sedation.