Unexpected infant death: what you need to know

Sudden infant death syndrome, which is now known as unexpected infant death, affects between 350 and 400 families a year in France.

It’s a drama beyond comprehension. If it is so difficult to understand and accept, it is probably because it is, as the name suggests, unpredictable, brutal and sometimes inexplicable. Unexpected infant death (MIN) is defined as "The sudden death of a child under the age of 1, occurring when nothing in his known history could have predicted it". Its name was changed a few years ago by the international medical community in order to clarify that, even if this death is still sudden, it can however be expected or unexpected. The name sudden infant death syndrome (SIDS) is now reserved only for cases of death that could not be explained medically.

A MIN occurs in 90% of cases in the First 6 months of life of a child, with a peak of mortality observed between 2 and 4 months.

Today, the term MIN is used by the French National Authority for Health to group multifactorial situations of death of children 0 to 2 years old, which remain after all post-mortem examinations, unexplained or occurring:

  • consequences of pathologies unknown at the time of death
  • as a result of pathologies first considered without life risk or evolving rapidly
  • in special circumstances (bedding accident, trauma, poisoning)

Causes and risk factors

By listing the cases, several diagnoses of sudden infant death have thus been reclassified as unexpected deaths. We find :

  • respiratory or general infections, with a peak in winter mortality
  • heart muscle disease or metabolic disease
  • delays in taking care of the child (dehydration, for example).

Among the main risk factors, there is first non-compliance with the sleeping rules. These errors, still far too widespread, would prevent nearly one in two deaths if they disappeared. We can never say it enough: a baby should be lying on his back, not on his stomach. Since a change in practices that occurred in the early 1990s, MSNs have been able to drop by 75%! However, there are still recalcitrant customs in certain families, who prefer to trust the old rules, despite all the scientific studies carried out on this subject.

Objects in a baby's bed are also prohibited. No cushion, no bumper, blanket, comforter, hat … the risk is to obstruct baby's breathing and cause death by suffocation.

Other risk factors: undetected heart or brain malformations, bacterial or viral infections, a defect in cardiopulmonary regulation in the context of exposure to nicotine during pregnancy and parental smoking, cosleeping, etc.

Note that the baby's age, medical history and prematurity are risks against which the parents can do nothing. The gender of the child too, as it appears that boys are more affected by MIN.

How to prevent unexpected infant death?

About 200 deaths could be avoided each year if parents and professionals respected the rules of sleeping to the letter, and in their entirety.

The baby should sleep on their back. The prone position increases the risk of suffocation, especially in premature babies. Putting the baby to sleep on his side is considered to be "intermediate" on the risk scale, because the latter is likely to turn over and end up on his stomach. Here is a list of things to do to create a healthy and safe sleeping environment for the baby.

  • do not cover him in his sleep (avoid swaddling in particular)
  • do not overheat the room, the correct temperature is between 18 and 20 ° maximum
  • install (if possible) the baby's bed in the parents' or mother's room for the first 6 months, which reduces the risk of MIN by at least 50%
  • Do not cosleep (make the baby sleep in the parents' bed)
  • use a firm mattress, covered by a sheet
  • remove ALL items or equipment from the bed (pillow, duvet, comforter, comforter …)
  • do not expose the baby to tobacco during and after pregnancy.

Breastfeeding, vaccines and the use of a pacifier at night would also decrease MINs.

In addition, even if MINs are very rare after the first 1 year, parents are advised to remain vigilant until the child is two years old, due to the risk of infection.