DEFINITION

It is the sudden and unexpected death of a nursing one or small child in whom the autopsy does not manage to reveal a suitable cause.

INCIDENCE

• The Syndrome of Sudden Death of the Nursing (SMSL) is the most frequent cause of death between 2 weeks and 1 year of life, being responsible for 30 % of all the deaths in this age group.

• Fond of 1-2/1.000 living newborn babies.
• The biggest incidence observes between 2.th and 4.th months of life.

• It increases during the cold months and in the most disadvantaged socioeconomic groups, in the premature babies, in brothers of other victims of the Syndrome of Sudden Death of the Nursing one and in children of smoking mothers during the pregnancy and after him.

• Almost all the deaths for SMSL take place when it seems that the child sleeps.

CAUSES

• The cause is not known, although very probably it resides in an anomaly of the mechanisms of the nervous system that control the function of the heart and the respiration.

• In some studies a relation has been between the sleep in recumbent prone (knocked down mouth below) and an increase of the risk of SMSL. For it, it is recommended to put the side nursing one to bed.

• Other risk factors are a soft cradle (woolen mattress), the water mattresses, the ambience with smoke of tobacco and an excessive environmental heating.

DIAGNOSIS

The diagnosis, although it is done especially by exclusion, cannot be established without a suitable autopsy in which there discard other causes of sudden and unexpected death (e.g., intracraneal hemorrhage, meningitis, miocarditis).

PREVENTION

• To place the children in supine decubitus (mouth arrives) or of side while they sleep, unless there exist other medical problems that it prevent (for example, ebb gastroesofágico).

• To prevent the ambience from being excessively warm.
• Not to make clothes too much to the child.
• To eliminate the soft parts of the cradle, like the leather blankets of lamb, pillows or comforters.
• Not to smoke during nor after the pregnancy.

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