SIDS Prevention And Safe Sleeping

Fewer children overall are dying from sudden infant death syndrome, or SIDS. Yet, according to the CDC, SIDS and other causes of sudden infant death still strike about 3,500 newborns every year. Parents need to be up-to-speed on the best tactics for the prevention of SIDS in their infants.

What Is SIDS?

Sudden Infant Death Syndrome (SIDS) is the unexpected, sudden death of a baby under one year of age that remains unexplained even after an autopsy and thorough medical investigation. Most deaths from SIDS occur in the first four months, and 90 percent of SIDS deaths occur before six months of age.

Sudden unexpected infant death (SUID) includes all unexpected deaths, those without a clear cause (such as SIDS) and those from a known cause, such as suffocation. Half of all SUID cases are SIDS. Many unexpected infant deaths are accidents, not SIDS-related. Many times, these accidents are related to how or where the baby was sleeping.

What Causes SIDS?

The exact cause of SIDS is not known, however there are common factors that can contribute to increased risks of SIDS, according to The Sleep Foundation.

Environmental factors related to SIDS include:

• Infant sleeping in the prone position (stomach sleeping)
• Used of soft bedding or unsafe beds (couches, daybeds, waterbeds)
• Use of loose bedding materials such as blankets and pillows
• Overheating due to clothing, blankets or room temperature

Risk factors from pregnancy include:

• Mother’s age younger than 20 years
• Mother smoking during pregnancy
• Mother receiving late or no prenatal care
• Premature birth or low birth weight
• Exposure to secondhand smoke
• Breathing disorders, such as those sometimes found in premature infants, also may contribute to SIDS.

How Can I Reduce The Risk Of SIDS?

Placing your baby on his or her back to sleep for every sleep time is the best way to reduce the risk of SIDS. Babies who sleep on their backs are much less likely to die of SIDS than babies who sleep on their stomachs or sides. This is true for all babies, including preterm babies.

The American Academy of Pediatrics recommends these steps to reduce the risk of SIDS and sleep-related deaths in infants.

• Make sure your baby is vaccinated. An infant who is fully immunized can reduce his or her risk for SIDS by 50 percent. Follow health care provider guidance on your baby's vaccines and make sure your baby gets regular checkups.
• Breastfeed your baby. The World Health Organization recommends breast milk exclusively for the first six months of life.
• Place your infant on his or her back for sleep or naps. Sleeping on the back can decrease the risk for SIDS, aspiration and choking. Never place your baby on his or her side or stomach for sleep or naps. If your baby is awake, you can allow your child supervised time on his or her tummy.
• Always talk with your baby's doctor. Infants with routine gastroesophageal reflux should sleep on their backs flat. Elevating the head of the bed is ineffective in reducing gastroesophageal reflux and is not recommended. Elevating the head of the crib may cause the infant to slide to the foot of the crib which might compromise their respirations.
• Use a firm mattress (covered by a tightly fitted sheet) to prevent gaps between the mattress and the sides of a crib, a play yard or a bassinet. This can decrease the risk for entrapment, suffocation and SIDS.
• Avoid using illicit drugs and alcohol, and don't smoke during pregnancy or after birth.
• Avoid overbundling, overdressing or covering an infant's face or head. This will prevent him or her from getting overheated, reducing the risk for SIDS.
• Avoid using home cardiorespiratory monitors and commercial devices that increase the risk for SIDS and sleep-related infant deaths. These devices have never been shown to reduce the risk of SIDS. In rare cases, they have caused infant deaths.  
• Always place cribs, bassinets and play yards in hazard-free areas with no dangling cords or wires to reduce the risk for strangulation.

What Is The Safest Way For My Baby To Sleep?

The safest way for your baby to sleep is on his or her back, laying on a crib with only a mattress and a fitted sheet. Always put your child to sleep on his or her back until one year of age, even if it's a short nap. This sleep position is safest for newborns.

Experts have long stressed that blankets, cushions, pillows, stuffed animals, toys, crib bumpers and other bedding don’t belong in a crib. These items can block a child’s airway while sleeping. In fact, the sale of crib bumpers and sleep incliners, which have been linked to more than 200 infant deaths, will be banned under a new law signed in May

“Keep stuffed animals and objects like that away from cribs,” said Marcia Cherry, MSN, RN, Director of NICU and Pediatric Care Center at Franciscan Health Lafayette. “Doing this prevents creating an environment where they can suffocate because when they are young, they don’t have that ability to get away from the material that could smother them.”

Placing babies in other areas than a crib may raise your child’s risk for SIDS and suffocation. These include chairs, adult beds, sofas and car seats. Avoid using infant seats, car seats, strollers, infant carriers and infant swings for routine sleep and daily naps. These may lead to obstruction of an infant's airway or suffocation.

Will My Baby Choke If Placed On The Back To Sleep?

No. Healthy babies normally swallow or cough up fluids – it's a reflex all people have. Babies might actually clear fluids better when on their backs.

Is Co-Sleeping Linked To SIDS?

Consider room sharing, but avoid sharing a bed with your baby. Putting your baby in bed with you raises the risk for strangulation, suffocation, entrapment and SIDS.

Share your room instead of your bed with your baby. If possible, place your child’s crib in the same room, so you can more easily tend to his or her needs. Keeping baby's sleep area in the same room where you sleep does reduce the risk of sleep-related causes of infant death.

“It’s important that infants are sleeping in their own beds, but it is recommended that they sleep close to their parents bed, so room sharing not bed sharing, for at least the first 6 months,” Cherry said.

Don’t fall asleep with infants laying on you. “The risk is that you may accidently suffocate them and they can slip in between you or they can become entrapped or wedged between the seat cushions,” Cherry said. “If you’re tired, lay the baby down in their bed.”

Bed sharing is not recommended for twins or other higher multiples.

Do Pacifiers Help Prevent SIDS?

While not all children will use a pacifier, studies suggest pacifiers may reduce the risk for SIDS. Don't use a pacifier with a string or other attachment as it may cause strangulation. Offer your baby a pacifier for sleeping or naps. Talk with your child's health care provider about when to start using a pacifier.

Do Wedges Help Prevent SIDS?

Don’t use wedges or other devices that claim to keep a child in a safe sleeping position. They have not been proved to prevent SIDS.

Is SIDS Linked To Secondhand Smoke?

Smoking in pregnancy increases risk of secondhand smoke risk. Chemicals in secondhand smoke impacts brain in ways that interfere with how it regulates breathing.

Don’t smoke in or near a child’s sleep space. Children exposed to cigarette smoke are more likely to die from SIDS.

A recent study in the medical journal The Lancet found that the risk of SIDS increases 12 times in babies whose moms smoked and drank past their first trimester.

What If My Baby Rolls Over During Sleep?

Rolling over is an important and natural part of your baby’s growth. Most babies start rolling over on their own around four to six months of age. If your baby rolls over on his or her own during sleep, you do not need to turn your baby over onto his or her back. The important thing is that your baby starts every sleep time on his or her back to reduce the risk of SIDS and that there is no soft, loose bedding in the baby’s sleep area.