SIDS: 10 Tips to Reduce the Risk


What is SIDS? Sudden Infant Death Syndrome (SIDS) is the sudden, unexplained death of a baby younger than 1 year of age. SIDS is sometimes called “crib death” or “cot death” because it is associated with the timeframe when the baby is sleeping. Cribs themselves don’t cause SIDS, but the baby’s sleep environment can influence sleep-related causes of death. The majority (90 percent) of SIDS deaths occur before a baby reaches 6 months of age, and the number of SIDS deaths peaks between 1 month and 4 months of age. However SIDS deaths can occur anytime during a baby’s first year, so parents should still follow safe sleep recommendations to reduce the risk of SIDS until their baby’s first birthday.

When it comes to parent fears, the risk of SIDS is a chart-topper.

In a world where we’re used to getting immediate answers to even our toughest questions, it’s frustrating and downright scary to be told that SIDS isn’t one hundred percent preventable, nor can we determine why some babies are more vulnerable than others.

As with any anxiety-inducing concern, try to focus on what you can control. Anyone who cares for a baby should follow these tips to lower that child’s risk for SIDS.

Always place a baby on his or her back to sleep, for naps and at night

Always place a baby on his or her back to sleep, for naps and at night. Babies who sleep on their backs will not choke if they spit up or vomit during sleep. Babies have a reflex to help them cough up or swallow fluid that they spit up or vomit, helping keep their airway clear. Studies show no increase in the number of deaths from choking among babies who sleep on their backs. In fact, babies who sleep on their backs might clear these fluids better because in back sleep positions the windpipe lies on top of the esophagus, which leads to the stomach. Anything regurgitated or refluxed from the stomach through the esophagus has to work against gravity to enter the trachea and cause choking. When the baby is sleeping on its stomach, such fluids will exit the esophagus and pool at the opening for the trachea, making choking much more likely. Cases of fatal choking are very rare except when related to a medical condition. The number of fatal choking deaths has not increased since back-sleeping recommendations began. In most of the few reported cases of fatal choking, an infant was sleeping on his or her stomach.

Furthermore, once a child can roll, you do not need to reposition them to their backs. Rolling over is an important and natural part of your baby’s growth. Most babies start rolling over independently around 4 to 6 months of age. If your baby rolls over on his or her own during sleep, you do not need to turn the 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.

Use a firm, properly fitted sleep surface - such as a mattress in a crib or bassinet - covered by a fitted sheet

Use a firm, properly fitted sleep surface – such as a mattress in a crib or bassinet – covered by a fitted sheet to reduce the risk of SIDS and other sleep-related causes of infant death. Cribs themselves do not cause SIDS, but features of the sleep environment—such as a soft sleep surface—can increase the risk of SIDS and other sleep-related causes of infant death. Car seats, carriers, swings, or similar products should not be used as a baby’s everyday sleep area. Never place baby to sleep on soft surfaces, such as on a couch or sofa, pillows, or blankets.

Room sharing – keeping baby’s sleep area in the same room where you sleep – is believed to reduce the risk of SIDS and other sleep-related causes of infant death

Room sharing – keeping baby’s sleep area in the same room where you sleep – is believed to reduce the risk of SIDS and other sleep-related causes of infant death. Your baby should not sleep in an adult bed, on a couch or sofa, or on a chair alone, with you, or with anyone else. If you bring your baby into your bed to breastfeed, make sure to put him or her back in a safe, separate sleep area in your room. Because SIDS occurs with no warning or symptoms, it is unlikely that any adult will hear a problem and prevent SIDS from occurring. Sleeping with a baby in an adult bed increases the risk of suffocation and other sleep-related causes of infant death.

Keep soft objects such as toys and loose bedding out of your baby’s sleep area

Keep soft objects such as toys and loose bedding out of your baby’s sleep area to reduce the risk of SIDS and other sleep-related causes of infant death. Don’t use pillows or blankets anywhere in your baby’s sleep area. Loose bedding and soft bedding, placed over or under the baby, such as quilts, comforters, and pillows increase the risk of SIDS regardless of sleep position. It is reported that the majority of other sleep-related infant deaths are due to accidental suffocation involving pillows, quilts, and extra blankets. For these reasons, do not use pillows, blankets, quilts, sheepskins, stuffed animals, or soft crib bumpers anywhere in your baby’s sleep area.

Embrace a healthy lifestyle

Embrace a healthy lifestyle. Get regular prenatal care during pregnancy and don’t smoke, drink alcohol, or use illegal drugs during pregnancy or after the baby is born. According to the American Cancer Society and the American Congress of Obstetricians and Gynecologists, babies born to women who smoked during pregnancy die from SIDS three times more often than babies born to nonsmokers. Once baby is born, do not smoke or allow smoking around your baby, and make sure to bring your baby to all of his or her doctor recommended check-ups.

Breastfeed to help reduce the risk of SIDS

Breastfeed to help reduce the risk of SIDS. While breastfeeding is natural, it is not always easy, so seek out help when needed. Most hospitals have lactation consultants on staff, and you can always seek out your local La Leche League group for additional support.

Give your baby a dry pacifier (never attached to a string or cord) for naps and at night to reduce the risk of SIDS, but don't force the baby to use it

Give your baby a dry pacifier (never attached to a string or cord) for naps and at night to reduce the risk of SIDS, but don’t force the baby to use it. Holding a pacifier in place to help avoid fussing and crying is not necessary. If the pacifier falls out of baby’s mouth during sleep, there is no need to put the pacifier back in. If you are breastfeeding, you might want to wait a few weeks after birth before introducing the pacifier to help avoid nipple confusion. Do not dip the pacifier in sweet or sticky solutions.

Do not let your baby get too hot during sleep

Do not let your baby get too hot during sleep. When possible, adjust your baby’s room temperature to support healthy sleep – 68-72 degrees is ideal. Dress your baby in no more than one layer more of clothing than you would wear to be comfortable.

Avoid products like wedges and sleep positioners that can create a risk of entrapment

Avoid products like wedges and sleep positioners that can create a risk of entrapment. Wedges, positioners, and other products that claim to reduce the risk of infant death have not been tested for safety or effectiveness. The U.S. Food and Drug Administration, the Consumer Product Safety Commission, and the American Academy of Pediatrics warn against using these products because of the dangers they pose to babies. Parents and caregivers should also avoid using products made from foam rubber or Memory Foam™ because of the risk of suffocation.

Give your baby plenty of tummy time when he or she is awake and when someone is watching

Give your baby plenty of tummy time when he or she is awake and when someone is watching. Supervised tummy time helps your baby’s neck, shoulder, and arm muscles get stronger, which can help your baby push away if he or she has rolled into a corner or against the side of the crib. It also helps to prevent flat spots on the back of your baby’s head.

Do not use home heart or breathing monitors to reduce the risk of SIDS

Do not use home heart or breathing monitors to reduce the risk of SIDS. Research shows that home heart or breathing monitors that claim to be able to detect SIDS and other life-threatening events are not effective at detecting or reducing SIDS. For this reason, you should avoid using home monitor devices to detect and prevent SIDS. In some cases, health care providers prescribe a home heart or breathing monitor for babies with certain medical conditions. These babies are under medical care for conditions not related to SIDS, and the monitors arenot used to detect or reduce SIDS risk. If you have questions about using home heart or breathing monitors for medical conditions, talk to your baby’s health care provider.

Follow heath care provider guidance on your baby’s vaccines and regular health check-ups

Follow heath care provider guidance on your baby’s vaccines and regular health check-ups. Following the recommended schedule for your baby’s vaccines has a protective effect against SIDS. Research shows that immunizations reduce the risk of SIDS by 50 percent. There is no evidence of a causal relationship between vaccines and SIDS. For this reason, follow your health care provider’s recommendations for vaccines and for regular health checkups for your baby. The American Academy of Pediatrics maintains a recommended vaccine schedule that your health care provider will follow for your baby’s immunizations.

Courtesy of Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)