Protecting your baby against sudden infant death syndrome

Learn about SIDS and what you can do to prevent it.

By: Giridhar Guntreddi, MD, FAAP .

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Sudden infant death syndrome, or SIDS, is still the leading cause of death among infants 1 month to 1 year old. It can strike without warning, even in babies who appear healthy. There is no single risk factor that appears likely to cause a SIDS death. Instead, several combined risk factors may contribute to a SIDS death.

Most SIDS-related deaths occur between 2 to 4 months of age with the incidence increasing during cold weather. SIDS is more likely to occur in boys than girls and in African-American and Native American infants. Most SIDS deaths are associated with sleep (cot death/crib death) and infants who die of SIDS show no signs of suffering. Nearly 3,500 U.S. infants die suddenly and unexpectedly each year. SIDS incidences have been reduced with implementation of practices advocated by the American Academy of Pediatrics (AAP).

Risk factors for SIDS

  • Smoking, drinking, drug abuse during pregnancy
  • Poor prenatal care during pregnancy
  • Premature birth/low birth weight
  • Young mothers (Below 20 years)
  • Tobacco smoke exposure (active, secondhand smoke)
  • Overheating, bedding in cribs
  • Stomach sleeping and over lying in bed
  • Bed sharing and co–sleeping with other children/adults
  • Baby with previous episodes of apparent life-threatening events (ALTE)
  • Apnea; temporarily stops breathing
  • Color change
  • Goes limp
  • Choking or gagging

To help protect your baby, follow these tips.

Sleep habits

  • Always place your baby on his/her back to sleep, even during naps as well as at nighttime.
  • Place your baby on a firm mattress for sleep. Never put him/her on a pillow, waterbed, sheepskin, couch, chair or other soft surface.
  • Do not put blankets, comforters, stuffed toys or pillows near your baby when sleeping.
  • If you bring your infant into your bed for comforting or cuddling, always return him/her to the crib or bassinet for sleep. Keep the crib or bassinet in your bedroom.
  • Do not use bumper pads in cribs. They can be a potential risk for suffocation or strangulation.
  • Make sure your baby does not get too warm while sleeping. Keep the room at a temperature that feels comfortable for an adult in a short-sleeve shirt. Some research suggests that a baby who gets too warm could go into a deeper sleep, making it more difficult to awaken him/her.
  • Put your baby to sleep with a pacifier during the first year of life. If your baby rejects the pacifier, don’t force it. Pacifiers have been linked with lower risk of SIDS. (If you’re breastfeeding, try to wait until after the baby is 1 month old so that breastfeeding can be established.)

Preventative steps

  • Receive early and regular prenatal care.
  • Do not smoke, drink or use drugs while pregnant. Infants of mothers who smoked during pregnancy are three times more likely to die of SIDS than those whose mothers were smoke-free.
  • Do not expose your baby to secondhand smoke. Exposure to secondhand smoke doubles a baby’s risk of SIDS.
  • Make sure your baby receives all recommended immunizations. Research shows that immunized babies are 50 percent less likely to be a victim of SIDS.
  • Make sure your baby has regular well-baby checkups.
  • Breastfeed, if possible. There is some evidence that breastfeeding may help decrease the incidence of SIDS. It is thought that breast milk may protect babies from infections increasing the risk of SIDS.
  • If your baby has gastroesophageal reflux disease (GERD), follow your doctor’s guidelines on feeding and sleep positions.
  • Never sleep with your baby or allow other children to sleep with baby.
  • Give your baby plenty of interactive tummy playtime.
  • When you travel with your baby, be sure to plan a safe place for him/her to sleep.
  • Contact hotels regarding the availability of a safe crib for a short overnight trip.
  • If you take your baby to day care or leave him with a baby sitter, provide a copy of this list to them. Make sure they follow all these recommendations.

Where can I get more information?

AMERICAN SIDS INSTITUTE conducts research and offers education and round the clock support to pediatricians and families. Call (800) 232-7437 or (239) 431-5425.
SAFE TO SLEEP® sponsored by National Institute of Health offers information, support and referrals. Call (800) 505-CRIB (2742).

Worrying about the possibility of SIDS will not help your baby and it will make you sleepless and less capable of caring for your baby. Do what you can and try to leave the worries behind; focus instead on enjoying your baby and this time in your life. If the possibility of SIDS haunts you, talk to your doctor or your pediatrician.