Cot death – causes, symptoms, risk factors. How to prevent cot death?

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Cot death concerns infants who have not been diagnosed with diseases or congenital abnormalities. It is the most common cause of death in children under 1 year of age. Unfortunately, despite advanced diagnostic techniques, the specific causes of cot death are still unknown.

Cot Death – What is it?

Cot death, sometimes also called sudden infant death syndrome, is the colloquial name of the medical entity – sudden infant death syndrome (SIDS). The term denotes a sudden death that affects an apparently perfectly healthy child. Although the name is suggestive, cot death does not always occur in bed or even at night. Usually, however, it occurs while the infant is asleep (95% of cases), less often during wakefulness. In general, a visual inspection and an autopsy of the body do not indicate the child’s suffering. Cot death is considered the leading cause of death in infants from 1 month to 1 year of age.

What is cot death? During sleep, the baby goes into apnea. This may be related to a neurotransmission error (the brain does not control breathing, forgets about it). The child’s heart rate stops under the influence of hypoxia. Cot death occurs. It is usually adjudicated when the infant has never been diagnosed with any medical problems, including birth defects.

The highest risk of cot death for an infant is at 12 weeks of age. It most often affects babies from 2 to 4 months. Nevertheless, the risk group is wider. It is assumed that the problem may occur already in the 5th week of life. Until what age is cot death a threat to a child? It turns out that even up to 6 months of age. Later, the risk drops dramatically.

How common is cot death?

Statistical data on cot death, despite the passage of years and the development of medical diagnostics, are still imprecise. Data from the United States shows much more about the percentage of cot death than from Poland. The American SIDS Institute reported that the number of sudden infant deaths has been steadily declining since the 80s. How many children die of cot death? It is assumed that in 1980 cot death affected 153/1000 children born, and already in 2010 it was 51,6 / 1000 children born.

The method of recognizing sudden infant death is to blame for imprecise results. The diagnosis of cot death is made only after all other possible direct causes have been ruled out. In determining them, an autopsy of the child’s body is used, as well as a thorough analysis of the room where his death took place.

See also: “Mourning and loss and psychotherapy – how to come to terms with death?”

Symptoms before cot death

Before the infant suddenly dies, there are symptoms that should arouse alertness. Unfortunately, it also happens that the moment of cot death goes unnoticed. Please note:

1. a sudden drop or increase in the child’s body temperature (measured in the anus), values ​​higher than 38 degrees C and lower than 36 degrees C,
2. baby skin pale,
3. the child’s grunting when awake or asleep
4. lack of appetite, vomiting after a meal,
5. mood swings, ranging from agitation to dementia,
6. general difficulties in breathing, noisy inhalation or exhalation.

Cot death – causes

Despite the progress of medicine in the world, scientists and doctors still find it difficult to pinpoint a clear cause of cot death. There are many hypotheses that are constantly being tested. However, there are several situations that are seen in the sudden death of infants. These are speculations rather than confirmed causes of cot death. Some of them will never lead to cot death, and the death itself may occur despite the lack of such premises. Belong to them:

1. birth defects in a child, especially a heart defect,
2. arterial pressure control disorders – it is natural that the pulse and blood pressure drop during sleep, but it happens that infants have problems with controlling these fluctuations,
3. compression of the vertebral artery when the baby raises its head while lying on its stomach,
4. central nervous system immaturity and resulting apnea, which may last longer than 20 seconds
5. bacterial infection (e.g. with E. Coli bacteria),
6. damage to the structure of the brain stem, where the centers controlling basic life functions are located – in the event of abnormalities, the brainstem may not recognize the lack of oxygen and, consequently, cause cot death,
7. low levels of serotonin – the deficiency of this neurotransmitter leads to a disturbance of the proper transmission of nerve impulses to the brain, and thus to the stopping of the breathing reflex,
8. genetic background – the more likely it is if the parents’ families have experienced cot death of their children (the highest risk concerns the situation when it has affected the infant’s siblings),
9. premature birth – prematurity (born before the 37th week of pregnancy) is one of the most serious factors increasing the risk of sudden infant death,
10. low birth weight of a newborn – the limit value is 2,5 kg.

Recently, scientists from University Collage London presented a new theory regarding cot death as a result of mutations in the SCN4A gene acting directly on the sodium channel. This mutation affects the functioning of the respiratory muscles.

Read more: “Some children die in their sleep. We know what could be the cause “

Cot death – risk factors

There are also several factors that increase the risk of cot death in infants. Some of them are not obvious, while others are generally considered harmful to the fetus and then to the newborn. It is about:

1. poor prenatal care,
2. alcohol abuse by the mother during pregnancy and after childbirth,
3. smoking by a pregnant woman and constant exposure of a newborn to cigarette smoke floating in the room,
4. mother’s age – interestingly, in this case we are talking not about late, but early age, and more precisely under the age of 20,
5. overheating the child – dressing inadequately to the prevailing temperature, and maintaining too high temperature in the rooms,
6. not ventilating rooms, keeping “used”, dry air in the house.

How to prevent cot death?

As it is difficult to identify a specific risk group for cot death in infants, it is worth being vigilant and observing the child. How can I protect my baby from cot death?

1. Don’t let your baby overheat. The baby should be dressed like yourself – the parents’ temperature sensations are the same as the baby’s. Therefore, it is worth avoiding adding extra layers of clothes to your child. To find out if your baby is too hot or too cold, touch their tummy or nape. Overheating can also result in too high a temperature in the room. The optimal one is in the range from 18 to 22 degrees C.
2. Cigarette smoke is an enemy of a baby. There is an opinion that the more often a toddler is exposed to cigarette smoke, the greater the risk of cot death. The mother should avoid smoking and also not allow anyone else to smoke in the company of the baby. Cigarette smoke rising in the room where the child is sleeping or will be sleeping should be ventilated as soon as possible.
3. Cot Death and Sleeping on the Belly. It is suspected that putting the baby to sleep on its stomach may increase the risk of death. It is better to put them on their backs and make sure that the legs are close to the base of the crib. This will reduce the likelihood of your baby getting buried in the bedding.
4. Safe crib. In addition to the position on the back, it is also important to eliminate items that could cover the child during sleep, e.g. tetrapods. In addition, it would be best if the mattress was soft, brand new (not previously used by another child). Cot death can also be avoided by eliminating the pillow or using a flat and soft pillow. The rungs in the crib should also be suitably small.
5. Sleeping alone. It is recommended that a child up to the age of 6 months sleeps alone. The cot, of course, should be near the parents’ bed, especially if mom is still breastfeeding.
6. Caring for yourself and the pregnant baby. It is worth reducing any potential stressful situations, giving up stimulants and taking care of healthy eating. It will also help to carry out the physical activities allowed during pregnancy to oxygenate the body.
7. Immediate reaction in the event of any disturbing symptoms in the infant. Be sure to contact your doctor.

Cot death in adults

Although cot death affects infants, death in sleep can also occur in adults. It is primarily about the obstructive pulmonary apnea syndrome. It is a condition whose first symptom is completely normal and unexpected snoring. It is accompanied by a period of complete apnea. Breaks in breathing may last from several to several dozen seconds. At the same time, the patient’s chest is still moving.

Pthe equation of cot death with obstructive pulmonary apnea syndrome points to one similarity – death in sleep. All other features differ between these two units. First of all, these are the unequivocal causes that cause sleep apnea. Belong to them:

1. oversized turbinate,
2. retracted mandible,
3. curve septum,
4. polyps in the nasal cavity,
5. flaccidity of the palatine muscles,
6. elongated or drooping tab,
7. hypertrophy of the pharyngeal or palatine tonsils,
8. short neck,
9. big language.

This “cot death” in adults primarily affects men aged 45 to 55 years. The most common symptoms of OBS are sudden sleepiness, fatigue upon waking up, decreased concentration, nervousness, headaches, and impotence.