Who among the following is at the greatest risk of sudden infant death syndrome SIDS quizlet?

Tobacco, alcohol and drugs can have harmful effects on anyone's health. When a pregnant or nursing woman uses these substances, her baby also is exposed to them, for all substances cross the placenta through the umbilical cord and enter into the baby's bloodstream.

While pregnant, it is best to eat well, stay healthy and avoid ingesting anything that might be harmful to the mother's or baby's health. A health care provider can give you more information about these issues.

"Street" Drugs

A pregnant woman who uses drugs like cocaine, crack, heroin and methadone may have a baby born addicted to the substances she took during her pregnancy. Cocaine is one of the most harmful drugs to unborn babies. Cocaine can cause a woman to miscarry and may cause preterm birth, bleeding, fetal death and fetal strokes, which can lead to brain damage and death. After birth, a baby who has been exposed to cocaine prenatally goes through withdrawal, signs of which include jitters and irritability. These babies are hard to comfort and are often unable to respond to their mothers. Cocaine use during pregnancy also may be linked to an increased risk of sudden infant death syndrome, or SIDS.

Amphetamines or "speed" also are harmful to unborn babies. One study showed that the fetuses of mothers who used speed during pregnancy had decreased weight, length and head size. Another study showed that these babies had more strokes, or bleeding into their brains.

Marijuana

Marijuana can affect fetal and infant development and may cause miscarriage. Although the effects of marijuana on an unborn baby are still unknown, studies have indicated that prenatal marijuana use is linked to premature births, small birth size, difficult or long labor and an increase in newborn jitteriness.

Marijuana smoked by a pregnant woman remains in the baby's fat cells for seven to 30 days. Smoking marijuana can affect the amount of oxygen and nutrients the baby receives, which may affect growth. Marijuana is never safe during pregnancy and it can harm the baby at any stage. In addition, marijuana can have long-term effects on infants and children, such as having trouble paying attention or learning to read.

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Alcohol

Drinking alcohol can increase the risk of miscarriage, stillbirth, newborn death and fetal alcohol syndrome (FAS). Babies with FAS have low birth weight, heart defects, facial defects, learning problems and mental retardation. Since it is not known if there is a safe level of alcohol during pregnancy, the best advice is not to drink at all. Even one drink a day has been shown to have effects on the growing fetus. The best time to stop drinking alcohol is before you conceive. If your pregnancy is unplanned, you should stop drinking as soon as you suspect you are pregnant.

Tobacco

Women who smoke during pregnancy are more likely to have babies who are too small. Smoking also increases the risk of miscarriage, preterm labor, stillbirth and newborn death. Babies born weighing less than 5 pounds may have more health problems early in life and learning problems later in school. If you smoke, quit now. Ask your health care provider for information about classes or support groups for pregnant women who want to quit smoking.

Prescription Drugs

Some prescribed medications may be harmful to your unborn or nursing baby. If you are taking any prescribed drugs, tell your health care provider as soon as possible so that your medications can be changed or adjusted as needed.

Over-the-Counter Medicines and Vitamins

Avoid over-the-counter medicines such as antacids, laxatives, sleeping pills, cold medications and pain relievers. While some are safe for pregnant women, many are not. If you feel you need any of these medications, first check with your health care provider. This applies to large doses of over-the-counter vitamin preparations as well, for taking large doses of extra vitamins can be harmful to you and your baby.

Caffeine

Caffeine is present in coffee, tea, cola drinks and some medications. For at least 10 years, there has been controversy over whether caffeine is harmful during pregnancy. Some studies suggest caffeine is harmful, pointing to an increased risk of miscarriage, early delivery or lower birth weight. Other studies have shown that women who consume a moderate amount of caffeine do not experience these problems. Because results are conflicting, no one knows the true risk. We recommend drinking as little caffeine as possible.

Ask your health care provider for more information about substances and their effects on pregnancy. Remember -- your baby needs a healthy mom!

Overview

Sudden infant death syndrome (SIDS) is the unexplained death, usually during sleep, of a seemingly healthy baby less than a year old. SIDS is sometimes known as crib death because the infants often die in their cribs.

Although the cause is unknown, it appears that SIDS might be associated with defects in the portion of an infant's brain that controls breathing and arousal from sleep.

Researchers have discovered some factors that might put babies at extra risk. They've also identified measures you can take to help protect your child from SIDS. Perhaps the most important is placing your baby on his or her back to sleep.

Causes

A combination of physical and sleep environmental factors can make an infant more vulnerable to SIDS. These factors vary from child to child.

Physical factors

Physical factors associated with SIDS include:

• Brain defects. Some infants are born with problems that make them more likely to die of SIDS. In many of these babies, the portion of the brain that controls breathing and arousal from sleep hasn't matured enough to work properly.
• Low birth weight. Premature birth or being part of a multiple birth increases the likelihood that a baby's brain hasn't matured completely, so he or she has less control over such automatic processes as breathing and heart rate.
• Respiratory infection. Many infants who died of SIDS had recently had a cold, which might contribute to breathing problems.

Sleep environmental factors

The items in a baby's crib and his or her sleeping position can combine with a baby's physical problems to increase the risk of SIDS. Examples include:

• Sleeping on the stomach or side. Babies placed in these positions to sleep might have more difficulty breathing than those placed on their backs.
• Sleeping on a soft surface. Lying face down on a fluffy comforter, a soft mattress or a waterbed can block an infant's airway.
• Sharing a bed. While the risk of SIDS is lowered if an infant sleeps in the same room as his or her parents, the risk increases if the baby sleeps in the same bed with parents, siblings or pets.
• Overheating. Being too warm while sleeping can increase a baby's risk of SIDS.

Risk factors

Although sudden infant death syndrome can strike any infant, researchers have identified several factors that might increase a baby's risk. They include:

• Sex. Boys are slightly more likely to die of SIDS.
• Age. Infants are most vulnerable between the second and fourth months of life.
• Race. For reasons that aren't well-understood, nonwhite infants are more likely to develop SIDS.
• Family history. Babies who've had siblings or cousins die of SIDS are at higher risk of SIDS.
• Secondhand smoke. Babies who live with smokers have a higher risk of SIDS.
• Being premature. Both being born early and having a low birth weight increase your baby's chances of SIDS.

Maternal risk factors

During pregnancy, the mother also affects her baby's risk of SIDS, especially if she:

• Is younger than 20
• Smokes cigarettes
• Uses drugs or alcohol
• Has inadequate prenatal care

Prevention

There's no guaranteed way to prevent SIDS, but you can help your baby sleep more safely by following these tips:

• Back to sleep. Place your baby to sleep on his or her back, rather than on the stomach or side, every time you — or anyone else — put the baby to sleep for the first year of life. This isn't necessary when your baby's awake or able to roll over both ways without help.

  Don't assume that others will place your baby to sleep in the correct position — insist on it. Advise sitters and child care providers not to use the stomach position to calm an upset baby.

• Keep the crib as bare as possible. Use a firm mattress and avoid placing your baby on thick, fluffy padding, such as lambskin or a thick quilt. Don't leave pillows, fluffy toys or stuffed animals in the crib. These can interfere with breathing if your baby's face presses against them.
• Don't overheat your baby. To keep your baby warm, try a sleep sack or other sleep clothing that doesn't require additional covers. Don't cover your baby's head.

• Have your baby sleep in in your room. Ideally, your baby should sleep in your room with you, but alone in a crib, bassinet or other structure designed for infant sleep, for at least six months, and, if possible, up to a year.

  Adult beds aren't safe for infants. A baby can become trapped and suffocate between the headboard slats, the space between the mattress and the bed frame, or the space between the mattress and the wall. A baby can also suffocate if a sleeping parent accidentally rolls over and covers the baby's nose and mouth.

• Breast-feed your baby, if possible. Breast-feeding for at least six months lowers the risk of SIDS.
• Don't use baby monitors and other commercial devices that claim to reduce the risk of SIDS. The American Academy of Pediatrics discourages the use of monitors and other devices because of ineffectiveness and safety issues.

• Offer a pacifier. Sucking on a pacifier without a strap or string at naptime and bedtime might reduce the risk of SIDS. One caveat — if you're breast-feeding, wait to offer a pacifier until your baby is 3 to 4 weeks old and you've settled into a nursing routine.

  If your baby's not interested in the pacifier, don't force it. Try again another day. If the pacifier falls out of your baby's mouth while he or she is sleeping, don't pop it back in.

• Immunize your baby. There's no evidence that routine immunizations increase SIDS risk. Some evidence indicates immunizations can help prevent SIDS.

May 20, 2022

1. About SIDS and safe infant sleep. National Institute of Child Health and Human Development. https://safetosleep.nichd.nih.gov/safesleepbasics/about. Accessed May 5, 2020.
2. Corwin MJ. Sudden infant death syndrome: Risk factors and risk reduction strategies. https://www.uptodate.com/contents/search. Accessed May 5, 2020.
3. Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: Updated 2016 recommendations for a safe infant sleeping environment. Pediatrics. 2016;138:e20162938.
4. Kliegman RM, et al. Sudden infant death syndrome. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed May 5, 2020.

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