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Sudden infant death syndrome

Last reviewed: 10 Nov 2024
Last updated: 19 May 2023

Summary

Definition

History and exam

Key diagnostic factors

  • prone, side, or inclined position at last sleep
  • bed-sharing
  • soft sleeping environment
  • maternal cigarette smoking
  • premature birth
  • formula feeding
  • non-use of pacifier
  • maternal alcohol or drug use
Full details

Other diagnostic factors

  • absence of metabolic disease
  • absence of irritability, lethargy
  • absence of fever, cough, or nasal congestion
  • absence of trauma
Full details

Risk factors

  • side, prone, or inclined position at last sleep
  • bed-sharing/co-sleeping
  • soft sleeping surface/environment
  • maternal cigarette smoking
  • increasing number of smokers in house
  • smoking in same room as child
  • formula feeding
  • non-use of a pacifier
  • premature birth
  • maternal substance use/abuse
  • single parent
  • lower maternal age
  • low level of prenatal care
  • low level of maternal education
  • low socioeconomic status
  • lack of immunization
Full details

Diagnostic tests

Tests to consider

  • blood culture
  • cerebrospinal fluid culture
  • urine culture
  • serum chemistry
  • urine chemistry
  • photographic record
  • skeletal survey
  • anatomic pathology
  • vitreous chemistry
  • muscle biopsy
Full details

Treatment algorithm

ACUTE

caregivers and family

Contributors

Authors

Rachel Y. Moon, MD, FAAP

Professor of Pediatrics

University of Virginia School of Medicine

Charlottesville

VA

Disclosures

RYM receives research grants from the National Institutes of Health and the American SIDS Institute on SIDS-related topics. RM is an unpaid board member of the International Society for the Prevention of Infant Death. RM lectures at various hospitals, public health departments, and universities about SIDS-related topics (usual honorarium $1000). RM has two published books about SIDS and receives royalties (<$200/year).

Acknowledgements

Dr Rachel Y. Moon would like to gratefully acknowledge Dr John W. Berkenbosch, a previous contributor to this topic.

Disclosures

JWB declares that he has no competing interests.

Peer reviewers

Peter Fleming, MB ChB, PhD

Professor of Infant Health & Developmental Physiology

FSID Research Unit

Institute of Child Life and Health

St Michaels Hospital

Bristol

UK

Disclosures

PF is an author of a number of references cited in this topic.

Thomas Hegyi, MD

Professor and Vice-Chair

Department of Pediatrics

UMDNJ-Robert Wood Johnson Medical School

New Brunswick

NJ

Disclosures

TH declares that he has no competing interests.

  • Differentials

    • Accidental suffocation or asphyxia
    • Nonaccidental trauma or abusive injury, including Munchausen syndrome by proxy
    • Respiratory syncytial virus
    More Differentials
  • Guidelines

    • Sleep-related infant deaths: updated 2022 recommendations for reducing infant deaths in the sleep environment
    • Evidence base for 2022 updated recommendations for a safe infant sleeping environment to reduce the risk of sleep-related infant deaths
    More Guidelines
  • Patient information

    Sudden infant death syndrome: how can I reduce the risk?

    More Patient information
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