Understanding Sudden Infant Death Syndrome (SIDS)

The unexplained death of a baby less than a year old is tragic and often a source of worry for parents to be. This phenomenon, once called “crib death,”  while rare, is still the cause of over 3500 deaths per year in the United States. 

And while SIDS is uncommon, it’s important to note that children under the age of one are 20 times more likely to die from SIDS than from many common causes in the next 17 years of their life. Incidents such as car accidents, firearms, overdoses, drugs, or suicide are less likely to kill a child than SIDS, so it’s essential to be informed.

We Look to Science

Over the last few decades, the research on SIDS has vastly improved, and we know a lot more about some common risk factors. This is important data because as we learn more, we can do more to help prevent this tragic loss of life.

Caregivers Need to Understand the Risks

As you learn more about SIDS, share this information with anyone who may be caring for your baby. In just the past decade, the data has shown that babies who sleep on their backs have less risk of dying from SIDS. Your caregiver (grandparent, aunt, friend) may have had babies in the time where it was advised to let babies sleep on their tummies or to put them on their sides with a pillow as a prop. We now know that a baby should always be put to sleep on their back to decrease the risk of SIDS. 

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Prenatal & Postnatal Care Matters

  • Do not smoke during pregnancy or after your baby is born. Even secondhand smoke from a partner puts an infant at risk. Keep your baby away from areas where people are smoking, and keep your home and your car smoke free.
  • For the first hour after birth, you should have skin to skin contact with your newborn, but not sleep with them. 
  • Breastfeed your baby for at least six months. Even expressed breastmilk fed by bottle helps reduce the risk of SIDS. Even when you add in solid foods, it’s a great idea to continue breastfeeding until you or your baby feel it’s time to wean.
  • Do not use alcohol or drugs. Not only do these affect the baby, but they can also make it difficult for you to wake up during the night if your baby is in distress.
  • Schedule and attend all  prenatal, postnatal, and well-baby visits as your practitioner advises.
  • Immunize your infant according to the standard of care advised by your practitioner.

Back to Sleep

The golden rule, “Put your baby back to sleep,” is under one year of age. As they grow older, they may naturally roll onto their tummies or sides, and that’s fine; you don’t need to wake them to put them on their backs. The important thing is that you always start them on their back.

After the birth of your baby, your provider will want you to experience skin to skin contact with your baby (if possible), but as soon as you feel sleepy, it’s important to place your baby on a nice firm mattress on his/her back or let a loved one have some snuggle time. Even at just a few hours old, it’s important to place your baby on their back to reduce SIDS risk.

If your baby is younger than four months and likes being swaddled, that’s fine as long as you keep the covering loose around their hips and watch for signs of overheating. A good rule of thumb is one layer more than you are comfortable in. Zipper or velcro swaddlers are a great solution! As soon as baby starts to roll over, their arms should be left out of the swaddle.  

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Where Baby Should Sleep

While cuddle time with your baby in bed can provide closeness, the baby should always be placed in their own sleeping area once you or your baby get sleepy.

Ideally, for the first year of life, the baby should sleep in your room, but not in your bed. We advise a “baby nook” in an area of your room where you feed, soothe, and put baby to sleep. Keeping the baby on a separate surface designed for infants can reduce SIDS risk by an astonishing 50 percent.

Beds, Bedding, and Beyond

It may feel counterintuitive to put your sweet, soft little baby on a firm surface with no coverings or stuffed animals, but we know for sure that this greatly reduces the risk of suffocation. Your baby will get used to sleeping on their back very quickly.

The mattress in the crib or bassinet should be firm enough that there is no indentation when they are laid on it. Do not use crib bumpers, blankets, pillows, toys, or use in-bed sleepers, which have not been proven to make sleeping in bed with you “safe”. 

Be wary of any device that claims to make your baby sleep better like wedges or positioners! 
Similarly, home cardiorespiratory monitors show no evidence of reducing the risk of SIDS, and can make it more difficult for you and your baby to rest peacefully. 

Experts aren’t sure why, but studies have consistently shown that pacifiers are protective! If breastfeeding, wait until breastfeeding is established and then consider introducing a pacifier when laying baby down. It’s okay if the pacifier falls out after baby falls asleep but make sure you do not attach the pacifier to clothing or around the neck.

Also make sure:

  • To check for recalls on the baby’s bed
  • Keep baby’s bed away from cords
  • Don’t place a baby that is asleep in a sling or carrier in the bed with the sling
  • Do not place car seats in the bed or on a raised surface 
  • Do not use strollers, infant swings or car seats for routine sleep

Biggest risk factors of SIDS

    The key to the reduction of the possibility of SIDS is reducing the risk of it happening.  Practice good prenatal and postnatal care, keep baby in a safe sleep environment and always back to sleep!

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