Sudden Infant Death Syndrome SIDS

Sudden Infant Death Syndrome SIDS Nursing Care Plans Diagnosis and Interventions

Sudden Infant Death Syndrome SIDS NCLEX Review Care Plans

Nursing Study Guide on Sudden Infant Death Syndrome (SIDS)

Sudden infant death syndrome (SIDS) is the unexpected death of an infant at the age of less than one year. Also known as “crib death”, SIDS often happens when the seemingly healthy baby is in the crib or cot.

SIDS has an unknown cause; however, it may be linked to brain defects that affect the infant’s breathing and waking from sleep.

Nursing Stat Facts 1

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Nursing Stat Facts 1

There are also risk factors that might increase the likelihood of SIDS, and parents are now widely being informed of how to prevent these contributory risks to dramatically decrease the likelihood of SIDS. In the U.S. alone, about 1,600 infants pass away every year due to SIDS.

Causes and Risk Factors of SIDS

The cause of SIDS remains unknown. Some doctors believe that there is a genetic reason behind SIDS.

Other experts associate SIDS with the congenital defect in the brain that can affect the infant’s vital body functions, such as breathing, thermoregulation, blood pressure and heart rates, and waking from sleep.

The risk factors that increase the chance of SIDS include:

  • Age – SIDS is identified in infants under the age of one; many cases particularly occur in the first 6 months of life
  • Sex- SIDS can cause death in male babies more than females
  • Race -non-white infants seem to have a higher risk for SIDS
  • Brain defects
  • Low birth weight or prematurity
  • Secondhand smoke
  • Respiratory infection
  • Family history of SIDS
  • Maternal smoking, drug use or alcohol abuse
  • Inadequate prenatal care
  • Maternal age of younger than 20 years
  • Unfavorable sleep environment
  • Poor sleep position – research shows that babies who sleep on their stomach (prone) or side might experience difficulty of breathing more than those who sleep on their backs (supine)
  • Sharing a bed – the likelihood of SIDS seems to increase when the baby shares the same bed with family members such as their parents or siblings; however, the risk is reduced when the infant sleeps in the same room as the parents but on his/her crib or cot
  • Sleeping with pillows and/or a soft surface – an infant sleeping on a prone position on a soft mattress, waterbed, fluffy comforter, or even with pillows may experience blockage of airway

Prevention of SIDS

While there is no absolute method to prevent SIDS, parents can be advised of the following measures to lower the risks of SIDS:

  1. Remember: “Back to sleep”. As per the “Safe to Sleep” campaign of the American Academy of Pediatrics, always place the baby on his/her back when sleeping during the first year of life. The baby can assume other positions when he/she is awake or already able to roll both ways without the parent’s help.
  2. Let the baby sleep in the same room as the parents. It is highly recommended that the infant’s crib or bassinet is placed in the bedroom of the parents so they can check on the baby more often. However, it is not advised for the baby to sleep on the same bed due to the risk of suffocation.
  3. Allow the baby to sleep on a bare crib or bassinet. The sleeping space must also be free from stuffed animals, toys, pillows, and other things to avoid any interference in breathing.
  4. It is recommended to place the baby on a firm mattress and avoid fluffy  padding or waterbed.
  5. Keep the baby warm but never overheat. Avoid additional blankets or covers in attempting to keep the baby warm. Instead, use a sleep sack or other sleep clothing with an appropriate thickness. Never cover the head of the baby.
  6. Promote breastfeeding as much as possible. Research shows that breastfeeding lowers the risk of SIDS, especially in the first 6 months of life. If the baby is 3 weeks old or more, the mother may offer a pacifier that has no strap or string while sleeping.
  7. Encourage infant immunization. Some common infant respiratory diseases such as pertussis (whooping cough) can be prevented through vaccination, which can then lower the risk for SIDS.

Coping After SIDS

Losing a baby to SIDS can bring emotional distress to the parents and other family members. Feelings of guilt, anger, and regret may cause dysfunctional coping.

There is also a mandatory police investigation to explore the cause of death of the infant. Therefore, it is important for the healthcare team to provide emotional support by means of the following measures:

  • Referral of the parents to a local support group on SIDS
  • Referral of the parents to counseling or psychological help if needed
  • Help in establishing communication between the parents, their family members, trusted friends or clergy member
  • Reassuring the parents that it is okay to grieve and allow time for healing

Nursing Care Plans for SIDS

Nursing Care Plan 1

Nursing Diagnosis: Risk for Fetal Injury / Death

Desired Outcome: The infant’s risk for sudden infant death syndrome (SIDS) will be reduced.

InterventionsRationales
Identify the risk factors that may increase the likelihood of SIDS.Thorough assessment of risk factors (maternal, physical, and environmental) will help reduce the risk for SIDS.
Advise the parent to always place the baby on his/her back when sleeping during the first year of life.Research shows that babies who sleep on their stomach (prone) or side might experience difficulty of breathing more than those who sleep on their backs (supine).

The baby can assume other positions when he/she is awake or already able to roll both ways without the parent’s help.
Let the baby sleep in the same room as the parents.   It is highly recommended that the infant’s crib or bassinet is placed in the bedroom of the parents so they can check on the baby more often.

However, it is not advised for the baby to sleep on the same bed due to the risk of suffocation.
Educate the parent on how to establish a favorable sleep environment for the infant:

Allow the baby to sleep on a bare crib or bassinet. The sleeping space must also be free from stuffed animals, toys, pillows, and other things.

Place the baby on a firm mattress and avoid fluffy padding or waterbed.

Keep the baby warm but never overheat. Avoid additional blankets or covers in attempting to keep the baby warm. Instead, use a sleep sack or other sleep clothing with an appropriate thickness.

Never cover the head of the baby.  
An infant sleeping on a prone position on a soft mattress, waterbed, fluffy comforter, or even with pillows may experience blockage of airway or suffocation.
Promote breastfeeding as much as possible. Research shows that breastfeeding lowers the risk of SIDS, especially in the first 6 months of life. If the baby is 3 weeks old or more, the mother may offer a pacifier that has no strap or string while sleeping.  
Encourage infant immunization.  Some common infant respiratory diseases such as pertussis (whooping cough) can be prevented through vaccination, which can then lower the risk for SIDS.

Nursing Care Plan 2

Nursing Diagnosis: Anxiety related to situational crisis of losing the infant due to SIDS as evidenced by increasing tension, decreased attention span, restlessness, shortness of breath, disorganized thought process, crying, and verbalization of feeling hopeless

Desired Outcome: The patient will be able to reduce his/her own anxiety level.

InterventionsRationales
Assess the anxiety level of the patient, anxiety triggers and symptoms by asking open-ended questions.To establish a baseline observation of the anxiety level of the patient.

Open-ended questions can help explore the thoughts and feelings of the patient regarding the situational crisis.
Ensure to speak in a calm and non-threatening manner to the patient. Maintain eye contact when communicating with him/her.

Provide a comfortable environment by providing sufficient lighting, good ventilation, and reduced noise levels. Respect the personal space of the client but sit not too far from him/her.
A calm voice and a comfortable environment can help the patient feel secured and comfortable to speak about his/her worries and fears.

The client may become more relaxed and open for discussion if he/she sees the nurse as calm and appears to be in control.
Do not leave the patient when the anxiety levels are high. Re-assure that the healthcare team are here to help him/her.To ensure the patient’s safety.  
Provide a supportive approach when the mother has anxiety by giving simple and short directions or information. Re-assure her and the partner that it is okay to grieve and allow time to heal.The patient has a limited attention span and is irritable or restless during a panic attack, thus simple and short directions are important in helping the patient cope with the situation.
Teach the mother to perform relaxation techniques such as deep breathing exercises, guided imagery, meditation, and progressive muscle relaxation.To promote relaxation and reduce stress levels.
Refer the parent/s to a local support group on SIDS and/or to counselling or psychological help if needed.  To expand the mother and partner’s support system and re-assure them that they are not alone in their healing journey.
Administer “as needed” or PRN anxiety medications.Mild sedatives may provide tranquilizing and soothing effect to the patient.

Other possible nursing diagnoses:

  • Dysfunctional Grieving
  • Interrupted Family Processes
  • Impaired Social Interaction

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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