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SIDS: Serotonin, Triple Risks, Culture, & Prevention

SIDS: Serotonin, Triple Risks, Culture, & Prevention

I had the idea to start publishing homework assignments as blog posts.  They'll all fit under the general psychology umbrella, but dealing with whatever different areas I happen to be involved in at the time.  As part of my human development class, I was tasked with learning/writing about SIDS. Here's what I learned.


            Sudden Infant Death Syndrome, or SIDS is the name for unexpected death of an infant in the first year of life when the cause of death remains unexplained following a thorough investigation, including an autopsy (NIH, 2017).  SIDS itself isn’t a specific viral or biological disease that is identified, we’re essentially putting a label on something we’re still trying to more fully understand.  However, there have been exciting developments in SIDS research recently and we are beginning to gain a better understanding of what might contribute to the untimely infant death.

            One thing that the research from the NIH (2010) & (2017) and the University of Adelaide (2017) agree on and seek to further understand is the link between abnormalities in Serotonin levels and SIDS.  However, there’s no simple explanation.  A 2017 study from the NIH found high levels of serotonin in blood samples from infants who died of SIDS, while a 2010 study coming from the same organization linked SIDS to low levels of serotonin, as they observed in tissues from infants who died of SIDS.  In any case, it seems we can agree that SIDS is linked to abnormal serotonin levels.

            The serotonin link explains one component, but it’s certainly not the only factor.  The “Triple Risk Model” is used to explain SIDS cases.  There are basically three elements that combine to put an infant at heightened risk of SIDS.  First, SIDS cases occur during a Critical Development Period, the first year of life while rapid growth and development is taking place.  Second,  (First Candle, 2009).  The next is that the infant is Vulnerable in some way, perhaps by a defect in the brainstem or abnormal levels of Serotonin.  The third element is the presence of External Challenges, like an infant who is not receiving enough oxygen.  It’s cases where all of these components, or obstacles are present when a child is most at risk for SIDS.

            Various studies paint a similar tragic picture of SIDS – an infant sleeping face down, suffocating in it’s own CO2.  The infant’s brain doesn’t jolt it awake as it would in a fully developed person.  The baby dies alone in it’s room.  One might think, ‘if only someone was there to notice the child not breathing…’.  Turns out, in cultures where infant and parent co-sleeping is the norm, SIDS is practically unheard of, but not for the reasons one might think. (Arnett, 2012).The reasons include the sleeping surfaces, breastfeeding interactions, and back-sleeping. 

Co-sleeping cultures tend to sleep on more firm surfaces, not the soft, cushioned surfaces that might present more potential for face-down suffocation.  There’s also a correlation between co-sleeping and breastfeeding more frequently and for longer than non-cosleepers.  The intermittent arousal throughout the night helps to reduce the risk of SIDS.  Lastly, as a matter of practically, the practice of placing the infant on it’s back for ease of breastfeeding developed.  This was commonplace in other cultures long before the link between back-sleeping and SIDS was made.

Not to worry, there are steps one can take to prevent the likelihood of SIDS.  Going back to the idea of the Triple Risk Model, we know it takes multiple factors for SIDS to happen.  So, we think about what factors can be controlled, or influenced.  A healthy infant is less likely to be affected by SIDS than a child "We have known for many years that placing infants to sleep on their backs is the single most effective way to reduce the risk of SIDS," said Alan E. Guttmacher, M.D., acting director of the NICHD. (NIH, 2010).  Additionally, common sense tells us to remove breathing hazards like excessive bedding, toys, etc from the infants sleeping space.  Exposure to a recent illness or cigarette smoke can also increase the risk of SIDS, so the natural response would be to be diligent in treating infant illnesses and avoid cigarette smoke at all costs, including while pregnant. (NIH, 2010).

Most important in decreasing the risk of SIDS in the future is continuing the valuable research that is being done in the field, to continue gaining a better understanding.  The more we understand about what’s happening, the better we’ll be able to identify high-risk infants and implement preventative measures to provide the infant with the best possible shot at survival.  It’s inspiring to think of the last couple decades’ worth of research and progress and imagine what a couple more decades of research might lead to!



NIH/Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2017, July 3). Blood of SIDS infants contains high levels of serotonin: Findings from study could provide basis for forensic SIDS test. Retrieved from

University of Adelaide. (2017, September 14). SIDS research confirms changes in babies' brain chemistry. Retrieved from

NIH/Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2010, February 2). Blood of SIDS infants contains high levels of serotonin: Findings from study could provide basis for forensic SIDS test. Retrieved from

First Candle. (2009, July). Triple risk model for SIDS. Retrieved from

Arnett, J. J. (2012). Human development. Upper Saddle River, NJ: Pearson Education Inc.

Bucharest Early Intervention Project

Bucharest Early Intervention Project

I don't get it. What's depression like?  Do I need therapy??

I don't get it. What's depression like?  Do I need therapy??