Risk Factors That Babies Face in the First Year

Introduction

Identification of factors that increase risk of, or are protective against, sudden baby death syndrome (SIDS) has largely been accomplished through epidemiological case-control studies. Risk factors include side and decumbent positioning, prenatal and postnatal tobacco smoke exposure, sleeping on soft or cushioned surfaces (particularly sofas, couches, and armchairs), bed sharing, soft bedding, head covering and overheating, and prematurity. Protective factors include breastfeeding, pacifier use, and room sharing. In this affiliate, nosotros will discuss the evidence for these chance and protective factors. We will also review the leading theories for SIDS causation including the Triple Hazard Hypothesis, rebreathing theory, and deficient arousal and autonomic regulation, and how these theories create a plausible explanation for the risk and protective factors for SIDS identified in case-control studies.

Risk Factors

Side and decumbent sleep position

The decumbent sleep position was noted in multiple case-control studies to exist associated with SIDS (1-6), beginning in 1965 in the Great britain (UK) (7). Even earlier this, in 1944, Abramson reported that prone positioning was institute in 68% of young infants who died of accidental mechanical suffocation in New York City (8). Public health campaigns, which showtime promoted not-prone positioning in the 1980s so supine placement, only beginning in the 1990s in many Western countries, take all been associated with a decline in SIDS rates. Subsequent studies take confirmed the association of decumbent slumber positioning and an increased SIDS risk (adjusted odds ratio [aOR] 2.iii-13.1) (9-11). Physiologic studies have demonstrated an clan of prone positioning with an increased risk of hypercapnia and hypoxia (12-14), overheating (15), diminished cerebral oxygenation (16), altered autonomic control (17), and increased arousal thresholds (18).

Subsequent studies have identified that the risk of side sleep positioning is similar to that of prone positioning (aOR 2.0 and 2.six respectively) (ten). Side positioning also has a higher population-attributable hazard than prone positioning (11), probable because many infants who are placed on their side are constitute prone (x). Placement in, or rolling to, the prone position, particularly when infants are unaccustomed to that position, places infants at extremely loftier hazard of SIDS (aOR 8.vii-45.4) (10, 19). Thus all caregivers, including childcare providers, family members, and friends, should place the infant in the supine position for every sleep.

Prenatal and postnatal tobacco smoke, booze, and illicit drug exposure

Multiple studies take found that both in utero and environmental tobacco smoke exposure increase the take chances of SIDS (20-24) in a dose-dependent manner (25-27). The strongest risk occurs with maternal smoking; there is a modest independent risk when fathers smoke later the baby's birth (23, 28).

While it is difficult to separate out the effects of in utero and environmental fume exposure, in utero exposure reduces lung compliance and volume, impairs arousal mechanisms, and decreases heart rate variability in response to stress (29, 30), all factors which may negatively affect an infant's power to reply appropriately to the surround. Researchers have estimated that one-third of SIDS deaths could exist prevented if in utero smoke exposure were eliminated (31, 32).

Substance abuse often involves more than i substance, and it is difficult to separate each event from the others or to split information technology from smoking. In addition, there are few studies that have examined the association between substance use and SIDS. In ane written report of Northern Plains American Indians, periconceptual maternal alcohol consumption was associated with a sixfold increased take chances of SIDS, and binge drinking during the starting time trimester of pregnancy was associated with an eightfold increase (33). In some other study, a maternal alcoholism diagnosis was associated with a sevenfold increased risk (34). Maternal drinking postnatally has likewise been plant to be associated with increased SIDS chance (34, 35), especially when it occurs within the 24 hours prior to the baby's death. Additionally, although the data for maternal drug use and SIDS are conflicting, overall, maternal prenatal drug utilise, especially of opiates, is associated with a 2- to 15-fold increased run a risk of SIDS (36-38). Thus parents should non smoke during pregnancy, and there should be no smoking effectually the babe. In addition, alcohol and illicit drugs should not be consumed during pregnancy. There is also a substantial take chances when smoking or consumption of alcohol or illicit drugs occurs in the context of infant-adult bed sharing (11, 39, 40).

Soft or cushioned sleep surfaces (including sofas, couches, armchairs)

A business firm sleep surface, such as a tight-fitting mattress in an babe cot (known in some countries as "cribs"), bassinet, play yard, or portable crib, is the safest sleep surface. Sofas, couches, and armchairs are particularly dangerous sleep surfaces; compared with a crib mattress, these surfaces confer upwardly to 67 times higher risk of infant death (41-43). A recent study in the United States (United states of america) plant that deaths on sofas comprised 12.9% of all infant sleep-related deaths in 2004-12, including SIDS, adventitious suffocation, and sick-defined deaths (44). Parents should be counseled virtually the hazard of placing the infant for slumber, or falling asleep with an infant, on a sofa, burrow, or similarly cushioned surface.

Infants are also often placed to sleep in car seats, strollers, swings, infant carriers, and slings, ofttimes because the infant volition fall asleep more quickly or because of the belief that sleeping in a sitting position will alleviate gastroesophageal reflux. However, sitting in a car seat or similar sitting device exacerbates gastroesophageal reflux (45) and is thus not recommended for that purpose. Additionally, young infants may not have adequate head command to support their airway when sleeping in such sitting devices, and sleeping in these devices may lead to accidental death (46). Slings are of particular concern in this regard, and infants who are carried in slings should have their heads visible and outside of the sling to minimize the hazard of suffocation (47).

Bed sharing

Bed sharing is defined as the babe sleeping on the aforementioned surface as another person. The exercise of bed sharing is mutual in many cultures and facilitates breastfeeding (48, 49), which is known to be a protective factor confronting SIDS (50). Notwithstanding, in case-control studies, bed sharing has been associated with an increased gamble of SIDS (39, 41), and information technology is believed that soft mattresses, other soft bedding, the take a chance of overheating, and the risk of overlay contribute to this increased risk.

It is clear that there is increased chance of infant death when bed sharing occurs when 1 or both parents are smokers (even if they exercise non smoke in the bed), when there was maternal smoking during pregnancy, when the adult bed sharer has drunkard alcohol or taken arousal-altering medications or drugs, when the bed sharing takes place on a burrow or sofa, when there is soft bedding, when bed sharing lasts for the entire night, and when the infant is <xi weeks of historic period (xi, 39, 40). Indeed, bed sharing was found in one Us analysis of baby deaths to be the most important run a risk cistron for death for infants <4 months of age (51).

However, there is controversy nigh bed sharing for infants who are breastfed and whose parents are non-smokers and have not consumed alcohol, medications, or illicit drugs. Instance-control studies have had conflicting conclusions. An individual-level analysis of 19 studies from nine datasets in the Great britain, Europe, Commonwealth of australia, and New Zealand, with 1,472 SIDS cases and 4,679 controls, plant that bed sharing for these low-adventure infants was associated with a fivefold increased risk of SIDS in the kickoff three months of life (aOR 5.1, 95% CI: 2.three-eleven.4) and an eightfold increased adventure in the offset two weeks of life (aOR 8.iii, 95% CI: iii.7-18.half-dozen) (52). In this written report, there was no increased risk of SIDS if the bed-sharing infant was >3 months old. Notwithstanding, this study has been criticized for the big corporeality of imputed missing data on parental alcohol and drug use (53). Some other analysis of data from two English studies, with 400 SIDS infants and one,386 controls, establish that, although bed sharing with a smoker or an developed who had recently consumed >2 units of alcohol was associated with an increased risk of SIDS, infants younger than 98 days of historic period who bed shared with an adult who was a non-smoker and did not recently consume alcohol were not at increased risk for SIDS (OR ane.half dozen, 95%: CI 0.96-2.vii) (43). Both of these studies are express by small sample size in the subanalyses (54).

Recommendations regarding bed sharing differ. In the Netherlands, parents are brash not to bed share if the infant is <3 months old. In the United states of america, parents are advised to avoid bed sharing for the first year just instead to have the babe sleep on a separate slumber surface close to the parents' bed (55). Considering there is no increased SIDS risk if bed sharing does not concluding the entire nighttime (xi), parents are encouraged to bring the infant to the bed for feeding and comforting, and then to return the baby to his/her ain sleep space when the parent is ready to go to sleep. Other countries, including Australia and the Britain, recommend against bed sharing, particularly when the parent is a smoker or has consumed alcohol, drugs, or arousal-altering medication (56, 57).

Soft bedding

The presence of soft bedding, including pillows, blankets, sheepskins, bumper pads, and positioners, in the infant sleep environment has been shown to increase the adventure for baby death fivefold, independent of the sleep position, and 21-fold when the baby is in the prone sleep position (9). In addition, the Us Consumer Product Safety Committee has reported an increased risk of accidental suffocation and asphyxial deaths associated with soft bedding use (58). Soft bedding increases the take chances of overheating and caput covering, both of which accept been associated with increased SIDS hazard. Finally, in an analysis of United states child deaths, the presence of soft bedding in the infant slumber surroundings was reported to be the most important risk gene for sudden and unexpected decease in infants four months and older (51).

Infants are safest when they do not slumber with blankets (53, 59). If parents are concerned that their baby will become cold, an infant sleeping pocketbook, sleeping sack, or wearable blanket is recommended as an alternative to blankets. A safe infant sleeping purse is one in which the infant cannot sideslip within the bag and the caput cannot become covered. One Dutch study found that the odds ratio for a sleeping bag was 0.30 (95% CI: 0.13-0.67); however, when adjusted for confounders, the odds ratio was no longer statistically significant (aOR 0.73 (95% CI: 0.29-6.43)) (60). Cot bumpers and similar products that attach to the cot sides are not recommended because of the risk of entrapment between the mattress or cot and the bumper, the risk of suffocation confronting the bumper, and the risk of strangulation with bumper pad ties (61, 62).

Head covering and overheating

Once-control study, 24.6% of SIDS victims had their heads covered past bedding, compared with three.2% of control infants during concluding sleep (63). Duvets, blankets, and quilts should be avoided in the infant sleep environment, as they may embrace the infant's head or face and obstruct breathing (11, 63).

Prematurity

Infants who are built-in preterm or with low birth weight are at fourfold hazard of SIDS, compared to full term, normal nativity weight infants (64, 65). Despite overall declines in SIDS rates, the rates amidst infants built-in preterm or with low nascency weight still remain higher (66). Much of this may exist due to an immature autonomic system, with impaired arousal mechanisms and an increased risk for hypercarbia. The increased SIDS risk does not appear to be related to apnea of prematurity, as there is no evidence that these episodes of apnea precede SIDS deaths (67). The increased risk of SIDS, notwithstanding, may also exist related to decumbent sleep positioning. Preterm infants are at equal or increased SIDS run a risk when placed prone (68). Further, they are more likely to be placed decumbent after hospital discharge, presumably because they were placed prone in the neonatal intensive care unit every bit a means to improve ventilatory status while requiring mechanical ventilation (69). It is therefore recommended that preterm infants be placed supine every bit soon as they are clinically stable, and then that they and their parents tin go accepted to the supine position before the infant is discharged to home. The American University of Pediatrics recommends that this transition to the supine position occur by 32 weeks postal service-menstrual historic period (70).

Protective Factors

Breastfeeding

Multiple studies have demonstrated that breastfeeding provides protection confronting SIDS (50). Studies do non distinguish between direct breastfeeding and feeding with expressed breast milk. A meta-assay of 18 case-command studies found that any breastfeeding was protective, just that the protective effect increased with increased duration and exclusivity of breastfeeding (50). A recent individual-level analysis of eight example-control studies in the U.s.a., Europe, Australia, and New Zealand found that 2 months of breastfeeding was required earlier a protective effect confronting SIDS was seen, and that this protective upshot is seen with any corporeality of breastfeeding, regardless of exclusivity (70). Parents are encouraged to feed the infant with chest milk as much and for as long as possible.

Dummy (pacifier) utilize

Several case-control studies and meta-analyses take constitute a potent protective effect with dummy (also known as pacifier) use (71-73). Although the mechanism of protection is yet unclear, proposed mechanisms include increased arousability and improved autonomic control (74). Others note that non-nutritive sucking of the pacifier may alter the upper airway diameter (75). However, information technology should exist noted that the protective effect of dummy utilize is seen if the dummy is used when the infant is falling asleep, even though the dummy often falls out of the mouth soon after the onset of sleep (76, 77). Because the mechanism past which dummy use confers protection is however unclear, some experts are reluctant to recommend dummy use as a SIDS take a chance reduction strategy. However, in some countries, such as the US, dummy utilize is promoted every bit a take a chance reduction strategy. Because in that location is some concern that dummy apply may interfere with breastfeeding initiation, introduction of a dummy for infants who are direct breastfed should be delayed until breastfeeding has been well established. In infants who are fed with formula or expressed breast milk, a dummy can be introduced at whatsoever fourth dimension. If the dummy is not accepted by the infant, it should not be forced.

Room sharing

The safest place in which an baby tin can sleep is in the parental bedroom, on a separate sleep surface; this reduces the risk of SIDS by as much every bit l% (39, 41, 42, 78, 79). Infants who have died of SIDS while sleeping in a separate room are more likely to take been found with their heads covered past bedding and to have rolled into the prone position if they had been placed on their sides for slumber (fourscore). Information technology is recommended that the baby slumber surface exist placed close to the parents' bed, to allow for piece of cake monitoring and feeding. Room sharing, without bed sharing, is recommended for the outset half-dozen-12 months of life (55, 56, 57, 81, 82).

Theories

There have been multiple theories over the years regarding the etiology and mechanisms of SIDS. This may be partly because the successes in reducing the SIDS rates take come from epidemiological studies. Thus there has been considerable enquiry into the underlying mechanisms that may underpin the chance factors identified in these epidemiological studies.

For many years, information technology was believed that apneic events, including credible life-threatening events, were precursors to SIDS. Home apnea monitors were often prescribed for these infants as a ways to preclude SIDS. Notwithstanding, subsequent research found that apparent life-threatening events and apnea did not predict SIDS. Indeed, the increase in the use of apnea monitors beginning in the 1970s did non correlate with a reject in the SIDS charge per unit (67).

Because many deaths occurred in cribs, much attention has been paid to slumber surfaces. I theory has attributed SIDS to toxic gases and has proposed that gases such as antimony, arsenic, or phosphorus can be released from infant mattresses (in particular, old mattresses) and cause toxicity when inhaled. However, no information support this theory. In addition, case-control studies have establish no do good to wrapping mattresses in plastic to reduce toxic gas emission (83, 84).

Another theory that focuses on the infant sleep environment proposed that, in specific situations, infants may rebreathe exhaled carbon dioxide. Relevant situations include when the babe is prone and/or when the infant's confront is close to bedding. It is theorized that, in these conditions, a "pocket" of exhaled carbon dioxide collects effectually the infant'south face up, and the babe, rather than inhaling oxygen, inhales the exhaled carbon dioxide. The infant thus becomes increasingly hypercarbic and eventually succumbs to decease if there is no stimulus that interrupts the rebreathing (85, 86). It has been suggested that the rebreathing theory could explain some of the chance posed by soft bedding and prone sleeping. However, there are no physiologic data from infants who died for which show supporting rebreathing has been documented.

In recent years, in that location has been growing consensus among scientists that SIDS is multifactorial in origin. The Triple Risk Hypothesis (87) (Figure 10.1) proposes that when a vulnerable infant, such equally one born preterm or one exposed to maternal smoking, is at a critical but unstable developmental period in homeostatic control and is exposed to an exogenous stressor, such equally beingness placed prone to slumber, then SIDS may occur. The model proposes that infants will die of SIDS merely if all three factors are present, and that the vulnerability lies fallow until they enter the disquisitional developmental period and are exposed to an exogenous stressor. SIDS usually occurs during sleep, and the peak incidence is between ii-4 months of age, when slumber patterns are rapidly maturing. The concluding pathway to SIDS is widely believed to involve immature cardiorespiratory command, in conjunction with a failure of arousal from sleep (86, 88, 89). Support for this hypothesis comes from numerous physiological studies showing that the major risk factors for SIDS (decumbent sleeping, maternal smoking, prematurity, caput roofing) have significant furnishings on blood pressure level, heart rate, and their control (ninety), and as well impair arousal from sleep (91).

Figure x.1:

Triple Risk Hypothesis. (Adapted past the National Institutes of Health with permission from (87).).

Conclusions

Epidemiological example-control studies accept been critical in identifying factors that are associated with an increased or decreased risk of SIDS. Equally such, great strides have been made in our understanding of the risk and protective factors for SIDS based on epidemiologic research, leading to educational interventions that have resulted in dramatic declines in SIDS rates. Theories regarding the pathophysiology of SIDS are myriad, only they all rely upon understanding the mechanisms by which these factors increase or decrease SIDS risk. Notwithstanding, further research — especially on the physiological mechanisms that contribute to or cause SIDS — is essential to achieving the reduction of SIDS rates to lowest levels possible.

Acknowledgements

The authors thank their families for their continuous support.

References

1.

Mitchell EA, Scragg R, Stewart AW, Becroft DMO, Taylor BJ, Ford RPK, et al. Results from the first year of the New Zealand cot death written report. NZ Med J. 1991;104:71-half dozen. [PubMed: 2020450]

2.

Ponsonby A-L, Dwyer T, Gibbons LE, Cochrane JA, Wang Y-G. Factors potentiating the risk of sudden baby decease syndrome associated with the prone position. N Engl J Med. 1993;329:377-82. https://doi​.org/10.1056​/NEJM199308053290601. [PubMed: 8326970]

3.

4.

five.

Taylor JA, Krieger JW, Reay DT, Davis RL, Harruff R, Cheney LK. Prone sleep position and the sudden babe death syndrome in King County, Washington: A example-control study. J Pediatr. 1996;128:626-30. https://doi​.org/x.1016​/S0022-3476(96)80126-0. [PubMed: 8627433]

half dozen.

7.

eight.

9.

Hauck FR, Herman SM, Donovan M, Iyasu S, Merrick Moore C, Donoghue Due east, et al. Slumber surround and the risk of sudden infant expiry syndrome in an urban population: The Chicago Infant Mortality Study. Pediatrics. 2003;111(5 Pt two):1207-xiv. [PubMed: 12728140]

ten.

Li DK, Petitti DB, Willinger M, McMahon R, Odouli R, Vu H, et al. Babe sleeping position and the adventure of sudden infant death syndrome in California, 1997-2000. Am J Epidemiol. 2003;157(five):446-55. https://doi​.org/ten.1093/aje/kwf226. [PubMed: 12615609]

xi.

Fleming PJ, Blair PS, Bacon C, Bensley D, Smith I, Taylor Due east, et al. Environment of infants during sleep and hazard of the sudden infant decease syndrome: Results of 1993-5 instance-control study for confidential enquiry into stillbirths and deaths in infancy. BMJ. 1996;313(7051):191-five. https://doi​.org/10.1136/bmj.313.7051.191. [PMC complimentary commodity: PMC2351639] [PubMed: 8696193]

12.

13.

Kemp JS, Livne G, White DK, Arfken CL. Softness and potential to cause rebreathing: Differences in bedding used by infants at loftier and depression risk for sudden baby death syndrome. J Pediatr. 1998;132:234-9. https://doi​.org/10.1016​/S0022-3476(98)70437-8. [PubMed: 9506633]

14.

Patel AL, Harris One thousand, Thach BT. Inspired CO₂ and O_two in sleeping infants rebreathing from bedding: Relevance for sudden babe decease syndrome. J Appl Physiol. 2001;91:2537-45. [PubMed: 11717216]

15.

16.

Wong FY, Witcombe NB, Yiallourou SR, Yorkston S, Dymowski AR, Krishnan Fifty, et al. Cerebral oxygenation is depressed during sleep in healthy term infants when they sleep prone. Pediatrics. 2011;127(3):e558-65. https://doi​.org/ten.1542/peds.2010-2724. [PubMed: 21357341]

17.

Yiallourou SR, Walker AM, Horne RS. Decumbent sleeping impairs circulatory control during slumber in good for you term infants: Implications for SIDS. Sleep. 2008;31(eight):1139-46. [PMC gratuitous article: PMC2542960] [PubMed: 18714786]

18.

Horne RS, Ferens D, Watts AM, Vitkovic J, Lacey B, Andrew S, et al. The prone sleeping position impairs arousability in term infants. J Pediatr. 2001;138(vi):811-xvi. https://doi​.org/10.1067/mpd.2001.114475. [PubMed: 11391321]

xix.

xx.

21.

22.

23.

Mitchell EA, Ford RP, Stewart AW, Taylor BJ, Becroft DM, Thompson JM, et al. Smoking and the sudden infant expiry syndrome. Pediatrics. 1993;91(5):893-6. [PubMed: 8474808]

24.

Klonoff-Cohen HS, Edelstein SL, Lefkowitz ES, Srinivassan IP, Kaegi D, Chang JC, et al. The effect of passive smoking and tobacco exposure through chest milk on sudden babe death syndrome. JAMA. 1995;273(10):795-8. https://doi​.org/10.1001/jama​.1995.03520340051035. [PubMed: 7861574]

25.

26.

Schoendorf KC, Kiely JL. Relationship of sudden infant decease syndrome to maternal smoking during and after pregnancy. Pediatrics. 1992;ninety(6):905-viii. [PubMed: 1437432]

27.

28.

29.

30.

31.

32.

33.

Iyasu S, Randall LL, Welty TK, Hsia J, Kinney HC, Mandell F, et al. Hazard factors for sudden infant death syndrome amongst northern plains Indians. JAMA. 2002;288(21):2717-23. https://doi​.org/ten.1001/jama.288.21.2717. [PubMed: 12460095]

34.

O'Leary CM, Jacoby PJ, Bartu A, D'Antoine H, Bower C. Maternal alcohol use and sudden babe death syndrome and infant mortality excluding SIDS. Pediatrics. 2013;131(3):e770-8. https://doi​.org/10.1542/peds.2012-1907. [PubMed: 23439895]

35.

36.

37.

38.

39.

twoscore.

Vennemann MM, Hense HW, Bajanowski T, Blair PS, Complojer C, Moon RY, et al. Bed sharing and the gamble of sudden infant expiry syndrome: Can we resolve the argue? J Pediatr. 2012;160(1):44-eight e2. [PubMed: 21868032]

41.

42.

43.

44.

45.

46.

47.

Bergounioux J, Madre C, Crucis-Armengaud A, Briand-Huchet E, Michard-Lenoir AP, Patural H, et al. Sudden deaths in developed-worn baby carriers: 19 cases. Eur J Pediatr. 2015;174(12):1665-70. https://doi​.org/ten.1007​/s00431-015-2593-6. [PubMed: 26174105]

48.

49.

l.

Hauck FR, Thompson J, Tanabe KO, Moon RY, Vennemann Grand. Breastfeeding and reduced gamble of sudden babe decease syndrome: A meta-analysis. Pediatrics. 2011;128(1):103-ten. https://doi​.org/10.1542/peds.2010-3000. [PubMed: 21669892]

51.

52.

53.

54.

Moon RY, & Task Forcefulness on Sudden Babe Expiry Syndrome. SIDS and other sleep-related infant deaths: Bear witness base for 2016 updated recommendations for a safe infant sleeping environment. Pediatrics. 2016;138(five):e20162940. https://doi​.org/10.1542/peds.2016-2940. [PubMed: 27940805]

55.

Moon RY, & Job Force on Sudden Baby Death Syndrome. SIDS and other slumber-related infant deaths: Updated 2016 recommendations for a safe infant sleeping environment. Pediatrics. 2016;138(5):e20162938. https://doi​.org/10.1542/peds.2016-2940. [PubMed: 27940804]

56.

The Lullaby Trust. Sudden infant death syndrome: A guide for professionals. London, England: The Lullaby Trust, 2013.

57.

58.

Chowdhury RT. Nursery product-related injuries and deaths among children under age five. Washington, DC: U.S. Consumer Product Safety Commission, 2014.

59.

Mitchell EA, Blair PS. SIDS prevention: 3000 lives saved just nosotros can practice meliorate. NZ Med J. 2012;125(1359):50-7. [PubMed: 22932514]

lx.

L'Hoir MP, Engelberts Ac, van Well GTJ, McClelland Southward, Westers P, Dandachli T, et al. Risk and preventive factors for cot death in Kingdom of the netherlands, a low-incidence country. Eur J Pediatr. 1998;157:681-eight. https://doi​.org/10.1007/s004310050911. [PubMed: 9727856]

61.

62.

63.

Blair PS, Mitchell EA, Heckstall-Smith EM, Fleming PJ. Head covering — A major modifiable risk factor for sudden babe decease syndrome: A systematic review. Arch Dis Child. 2008;93(nine):778-83. https://doi​.org/10.1136/adc.2007.136366. [PubMed: 18450800]

64.

Malloy MH, Hoffman HJ. Prematurity, sudden infant death syndrome, and age of death. Pediatrics. 1995;96(3 Pt 1):464-71. [PubMed: 7651779]

65.

Sowter B, Doyle LW, Morley CJ, Altmann A, Halliday J. Is sudden infant death syndrome still more common in very depression birthweight infants in the 1990s? Med J Aust. 1999;171(8):411-13. [PubMed: 10590743]

66.

67.

Ramanathan R, Corwin MJ, Hunt CE, Lister G, Tinsley LR, Baird T, et al. Cardiorespiratory events recorded on home monitors: Comparison of good for you infants with those at increased chance for SIDS. JAMA. 2001;285(17):2199-207. https://doi​.org/x.1001/jama.285.17.2199. [PubMed: 11325321]

68.

Oyen N, Markestad T, Skjaerven R, Irgens LM, Helweg-Larsen Chiliad, Alm B, et al. Combined effects of sleeping position and prenatal risk factors in sudden infant expiry syndrome: The Nordic epidemiological SIDS study. Pediatrics. 1997;100(4):613-21. https://doi​.org/10.1542/peds.100.4.613. [PubMed: 9310514]

69.

70.

Thompson JMD, Tanabe M, Moon RY, Mitchell EA, McGarvey C, Carpenter R, et al. A pooled analysis of breastfeeding and sudden infant death syndrome: How much is enough to reduce the run a risk? Nether review.

71.

72.

73.

74.

Yiallourou SR, Poole H, Prathivadi P, Odoi A, Wong FY, Horne RS. The effects of dummy/pacifier apply on babe blood pressure and autonomic action during slumber. Sleep Med. 2014;15(12):1508-sixteen. https://doi​.org/10.1016/j​.sleep.2014.07.011. [PubMed: 25441754]

75.

76.

Franco P, Scaillet S, Wermenbol V, Valente F, Groswasser J, Kahn A. The influence of a pacifier on infants' arousals from sleep. J Pediatr. 2000;136(vi):775-ix. [PubMed: 10839876]

77.

Weiss P, Kerbl R. The relatively short duration that a kid retains a pacifier in the mouth during sleep: Implications for sudden infant death syndrome. Eur J Pediatr. 2001;160:60-lxx. https://doi​.org/ten.1007/s004310000638. [PubMed: 11195022]

78.

79.

Mitchell EA, Thompson JMD. Co-sleeping increases the risk of SIDS, merely sleeping in the parents' bedroom lowers information technology. In: Sudden infant death syndrome: New trends in the nineties. Ed Rognum TO. Oslo, Norway: Scandinavian University Press, 1995. p. 266-nine.

80.

Blair PS, Platt MW, Smith IJ, Fleming PJ. Sudden infant expiry syndrome and the time of death: Factors associated with night-time and day-fourth dimension deaths. Int J Epidemiol. 2006;35(vi):1563-9. https://doi​.org/10.1093/ije/dyl212. [PubMed: 17148463]

81.

82.

Vennemann MM, Bajanowski T, Brinkmann B, Jorch G, Sauerland C, Mitchell EA. Sleep environment gamble factors for sudden infant expiry syndrome: The German language sudden infant death syndrome study. Pediatrics. 2009;123(4):1162-lxx. https://doi​.org/10.1542/peds.2008-0505. [PubMed: 19336376]

83.

84.

Wilson CA, Taylor BJ, Laing RM, Williams SM, Mitchell EA. Clothing and bedding and its relevance to sudden infant death syndrome: Further results from the New Zealand Cot Death Study. J Paediatr Child Health. 1994;30(6):506-12. https://doi​.org/x.1111/j​.1440-1754.1994.tb00722.x. [PubMed: 7865263]

85.

86.

87.

Filiano JJ, Kinney HC. A perspective on neuropathologic findings in victims of the sudden infant death syndrome: The triple-risk model. Biol Neonate. 1994;65:194-vii. https://doi​.org/10.1159/000244052. [PubMed: 8038282]

88.

89.

xc.

Horne RS, Witcombe NB, Yiallourou SR, Scaillet Due south, Thiriez Thou, Franco P. Cardiovascular control during sleep in infants: Implications for sudden infant death syndrome. Sleep Med. 2010;xi(7):615-21. https://doi​.org/ten.1016/j​.sleep.2009.10.008. [PubMed: 20609624]

91.

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