Sudden Infant Death Syndrome - Diagnosis

Did you lose an infant due to SIDS? Please share your experience, including the diagnosis.

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How is SIDS diagnosed?

Sudden infant death remains an unpredictable, unpreventable, and largely inexplicable tragedy. The baby is seemingly healthy without any sign of distress or significant illness prior to the incident.

  • Death occurs rapidly while the infant is sleeping.
  • Typically, it is a silent event. The baby does not cry.
  • The infant usually appears to be well developed, well nourished, and is generally felt to be in good health prior to death. Minor upper respiratory or gastrointestinal symptoms due to viruses like respiratory syncytial virus (RSV) are not uncommon in the last two weeks preceding SIDS.

Sudden, unexpected infant death (SUID) is a general term used for the circumstance of an infant death which occurs suddenly and in an unexpected manner. SIDS is a diagnosis of exclusion, meaning that other causes of death must be ruled out. The cause of an infant's death can be determined only through a process of collecting information and conducting, at times, complex forensic tests and procedures. All other recognizable causes of death are investigated prior to making the diagnosis of SIDS.

Four major avenues of investigation aid in the determination of a SIDS death: postmortem lab tests, autopsy, death-scene investigation, and the review of victim and family case history.

  • Postmortem laboratory tests are done to rule out other causes of death (for example, electrolytes are checked to rule out dehydration and electrolyte imbalance; bacterial and viral cultures are obtained to evaluate whether an infection was present). In SIDS, these laboratory tests are generally not revealing.
  • An autopsy provides clues as to the cause of death. In 15%-25% of sudden, unexpected infant deaths specific abnormalities of the brain or central nervous system, the heart or lungs, or infection may be identified as the cause of death. The autopsy findings in SIDS victims are typically subtle and yield only supportive, rather than conclusive, findings to explain SIDS.
  • A thorough investigation of the death scene consists of interviewing the parents, other caregivers, and family members, collecting items from the death scene, and evaluating that information. A detailed scene investigation may reveal a recognizable and possibly preventable cause of death. Death scene investigations have helped to identify factors in the infant sleep environment that are potentially unsafe. These include soft, padded, or plushy objects that may obstruct an infant's airway, posing a suffocation hazard.
    • A parent or caregiver may be asked these questions:
      • Where was the baby discovered?
      • What position was the baby in?
      • Were there any objects within the sleep location that could have interfered with normal infant breathing?
      • When was the baby last checked? Last fed?
      • How was the baby sleeping?
      • Where there any recent signs of illness?
      • Was the infant taking any medication, either prescription or over the counter?
  • You should let your doctor know about any family or infant medical history. Family history to note would include any previous history of unexplained infant death, sudden cardiac death, and metabolic or genetic disorders, for example.
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