Sudden Unexpected Infant Death Syndrome (SIDS) and ALTE

INTRODUCTION

Preventive advice

After baby is born:

• Place to sleep on their back with no pillow (unless special reasons for placing on stomach)

• Ensure the head and face is uncovered

• Breastfeeding

• Ensure babies are not exposed to cigarette smoking (before and after birth)

• Ensure that babies do not get overheated (the sign of sweating around the head and neck indicates the baby is too hot)

• Bed coverings no more than adults require

• Nothing else in cot (e.g. soft toys, blankets) and preferably sleep alone

• Sleep baby in a safe cot in parents’ room

If baby is unwell, seek medical advice.

Management of SIDS

• Allow parents to see or hold baby

• Give explanations incl. reasons for coroner’s involvement

• Provide bereavement counselling

• Provide early contact and continuing support

• Contact the SIDS support group

• Revisit home

• Provide hypnotics (limited)

• Offer advice on lactation suppression

• Remember siblings can also experience grief reactions

• The police and coroner must be notified

APPARENT LIFE-THREATENING EPISODE (ALTE)

ALTE or ‘near-miss SIDS’ is defined as a ‘frightening’ encounter of apnoea, colour change or choking. At least 10% will have another episode. Management includes admission to hospital for investigation and monitoring.

Guidelines for home apnoea monitoring (doubtful value):

• ALTE

• subsequent siblings of SIDS victims

• twins of SIDS victims

• extremely premature infants