When putting newly-born babies to sleep, most mothers prefer having them lie on their tummies instead of their backs. The observation is that babies in this position sleep much longer with limited distractions.

Unfortunately, several findings reveal that those who succumb to a rare disorder during sleep, do so in this resting position.

Dr Tharcisse Ngambe, a pediatrician at King Faisal Hospital describes this type of death as sudden infant death syndrome (SIDS).

"It occurs in seemingly normal babies who are less than a year old during their sleep. This anomaly continues to puzzle medical professionals around the world because there are no theories to explain it,” says Ngambe.Since most babies die from their cribs, SIDS is sometimes referred to as ‘crib death’

The pediatrician explains that much as findings are not conclusive, certain practices like having infants lie on their tummy during sleep increase pressure on the stomach a factor that could be behind this sudden death."Pressure exerted on the stomach causes regurgitation or throw-back on vomiting. This kind of reaction could cause aspiration of stomach contents into the lungs that eventually suffocates the baby,” explains Dr Ngambe.

Babies with birth defects more prone

Available research shows that SIDS is common in babies between 1 and 12 months of age and most registered deaths occur between 2 and 4 months of age.

However, mothers who don’t access proper healthcare during pregnancy, smokers or those involved in multiple births such as twins are likely to encounter this syndrome more frequently.

Also, certain features at birth are leading signs towards the possibility of SIDS.

"Premature and babies born with low birth weight are highly susceptible to this syndrome,” explains, Dr Rachna Pande, a specialist in internal medicine at Butaro Hospital.

She adds that sometimes such infants experience malfunction in some parts of the body including the brain which controls sleep patterns.

"As a result, sleep and arousal may not have developed adequately to trigger waking up and there is increased risks in prematures and those born below normal weight,” she adds.

Risk factors

Other studies reveal that the idea of parents preferring soft mattresses and covering for their newborns is a risk factor for inadequate air supply of which asphyxia is more likely during sleep.

According to US-based Mayo Clinic, placing babies face-down on a fluffy comforter or a waterbed can block an infant’s airway while draping a blanket over a baby’s head is equally risky.

Swaddling babies increases the risk of SIDS in babies according to a recent study published in the Journal of Pediatrics.

Researchers found that increased risk for the syndrome was greatest for swaddled babies but in all cases, the sleep position matters. The increase in risk was greatest for swaddled babies placed to sleep on their front, less for those put down on their side and still less for back sleepers.

During sleep, part of the nervous system is inactive, the eyes are closed, the postural muscles relaxed and consciousness is practically suspended.

Dr Rachna further warns that babies who sleep with their parents stand high chances of being rolled over during sleep and such a death would correspond to SIDS.

"Even those who sleep with soft toys or objects lying around are prone to SIDS. If one is on the same bed with one or more parents, there is a potential risk of them rolling over in sleep and accidentally suffocating the baby,” warns Pande.

In fact some societies for long considered sleeping with babies a bad omen just to prevent the occurrence of these sudden deaths.

Lying on the back safer

Much as babies are delicate, Dr Ngambe explains that in any sleeping position children should have a normal coughing reflex when something enters the wrong side of the air pathway.

"Even when they swallow something in another pathway, children are supposed to cough in such an unfortunate event unless there are problems in the brain which are associated with coordination,” he explains.

When infant’s sleep facing down, they become more stable although lying on the back is safer.

For the same reason, mothers always want babies to lie on the tummy just to sleep longer, a practice, Dr Ngambe believes, only offers stability and adequate ventilation but limited safety.

"In such a position, babies would have all their four limbs on the ground, they cannot roll over and again the ventilation is improved. When you look at the anatomy of the lungs, the biggest portion is at the back of the chest compared to the front where there are other organs,” elaborates Ngambe.

Over 3,500 deaths due to SIDS are estimated annually in the developed world. However, figures are likely to be higher in Sub-Saharan Africa.

While confusion surrounds SIDS and sudden cardiac arrest, Dr Nathan Ruhamya, a cardiologist at King Faisal Hospital, explains that the two are totally different.

"Like in most cases, living a sedentary lifestyle, smoking, alcoholism and strenuous activities, among others, are the known causes of sudden cardiac arrest and in such a situation, we are able to warn people because the predisposing factors are now especially in adults. SIDS is however a case for infants,” explains Dr Ruhamya.

The causes over SIDS remain largely unknown but sometimes acute respiratory tract infections can block breathing of a baby in sleep. Other studies suggest that SIDS is influenced by genetics across family lines.

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EXPERTS SHARE TIPS

Solange Mutangana, a nurse Some cases of sudden death syndrome in infants are brought about by an infant being born with low weight. Pregnant women should make sure to eat healthy, take all the prenatal vitamins that are required and attend all antenatal visits. Parents should ensure that they check their infants frequently when they take them to sleep.

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Fulgence Kamali, a medic at Ruhengeri HospitalThe sleeping environment for infants should be organised and not stuffy. Soft and comfy beddings should be avoided because it is easy for infants to suffocate in them and die suddenly. Besides, ensuring that the infant has a safe sleeping environment which is warm is ideal.

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Esperance Akayezu, a practitioner at Gikondo HospitalSudden infant death syndrome normally occurs in infants below one year. For this reason, parents should avoid making their infants sleep while facing down. At this age, a baby may not be able to inhale enough oxygen in this position, which can lead to sudden death. First time mothers should seek advice from experts on how to take care of their infants.

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Iba Mayale, a gynecologistParents should not sleep with their infants in the same bed; rather, they should keep them close but in a separate bed. This can help to prevent sudden infant death syndrome where the infant may get trapped in the beddings and suffocate. Breastfeeding the baby well is vital and reduces the chances of sudden deaths.

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Aline Gihoza, a medical student at UR’s College of Medicine and Health SciencesInfants should be put to sleep on their backs. This reduces the chances of unnecessary suffocation and ensures safe sleep. Parents should not let their babies to sleep in a very hot room. An infant should not be dressed in many clothes and shawls when sleeping.

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WHAT YOU CAN DO TO PREVENT SIDS