Sudden Infant Death Syndrome (SIDS) Prevention

Having a newborn can be very exciting (albeit exhausting) time in your life, but it can also be scary to think about the potential dangers for your new baby. Especially if you are a first-time mom, you may have a lot of questions about the “right” way to do things, such as putting your baby down to sleep. Although there is no 100% way to prevent Sudden Infant Death Syndrome, there is a lot you can do lower your baby’s risk.

What is SIDS?

SIDS, or Sudden Infant Death Syndrome, is the sudden, unexplained death of an infant under 1 year of age. It is also known as “cot/crib death.” The infants affected are typically otherwise healthy, and SIDS is nearly always associated with sleep. The Centers for Disease Control and Prevention (CDC) places SIDS in a larger category called sudden unexpected infant deaths (SUID), which also includes accidental suffocation and other unexplained deaths. It may be difficult for a death to be classified as one of these three options, and so is often just referred to as SUID.

What causes SIDS?

Part of the trouble with SIDS is that the specific cause is often unknown. It is most often associated with a breathing issue during sleep, which may be due to physical or environmental factors.

Recently, studies have hypothesized that a defect in a certain part of the brain that deals with awakening from sleep and/or autonomic breathing could play a part in some SIDS deaths. Premature births and low birth weight babies are most at risk for this brain defect, as their brain development may not have been full at birth. Both physical (body) and environmental factors play a part in making an infant more at risk for SIDS. As far as physical factors, there is the brain defect as mentioned above that can either be due to prematurity or low birth weight or just as a natural defect. This defect has to do with the autonomic nervous system (automatic, unconscious behaviors) that controls a baby waking his or herself from sleep if they stop breathing/are not getting enough oxygen. Additionally, a recent cold or respiratory infection may have affected the infant’s ability to breathe normally.

Environmental factors include a pet or family member rolling on top of the infant (in a co-sleeping environment), anything that could cause an infant’s head, neck, or whole body to become caught, or excess pillows and blankets that could cause suffocation.

Are there ways that I can reduce my baby’s risk for SIDS?

The biggest area that you can help in deals with how your baby sleeps:  his/her sleep position and the environment in which he/she sleeps.

  • Always, always, ALWAYS place your baby on her back to sleep! Tell everyone who takes care of your baby (babysitter, family member) to always place your infant on his back, NEVER the stomach or side. These positions put your baby’s face in the mattress or sleeping area which can smother him. If you’re worried your baby might choke while sleeping on his back, don’t be. Choking is very rare, and healthy babies tend to swallow or cough up fluids automatically. If you’re concerned, ask your pediatrician about elevating the head of your baby’s bed.
  • Have your baby sleep in the same room as you. This allows you to keep a closer eye on your sleeping baby (monitoring tools just don’t cut it!).
  • Do not have your baby sleep with you, your children, or your pets. Co-sleepers have higher rates of SIDS due to the fact that your baby is not ready for an adult bed:
    • Fluffier mattresses, blankets, and pillows can suffocate the baby;
    • A child, adult, or pet could roll over on top of and suffocate the baby;
    • The baby could get stuck in a headboard or between the mattress and a hard surface, causing injury or suffocation.
  • Firm Bed, no soft toys or bedding. To prevent smothering or suffocation, always lay your baby down to sleep on either a firm mattress or surface in a crib or bassinet. All your baby’s crib needs is the fitted sheet — don’t put blankets, quilts, pillows, sheepskin, stuffed toys, or crib bumpers in your baby’s crib.To confirm the safety of your baby’s mattress or crib, contact the Consumer Product Safety Commission at 800-638-2772 or www.cpsc.gov.
  • Avoid smoking. Babies born to women who smoked during pregnancy die from SIDS three times more often than babies born to nonsmokers. Smoking when you’re pregnant is a major risk factor for SIDS, and secondhand smoke around your infant also increases the chances of SIDS. Don’t let anyone smoke around your baby.
  • Breastfeed! Breastfeeding for 6 months or more reduces the risk of SIDS by as much as 50 percent.
  • Immunize Your Baby. Evidence shows babies who’ve been immunized in accordance with recommendations from the American Academy of Pediatrics and the CDC have a 50% reduced risk of SIDS compared with babies who aren’t fully immunized.
  • Keep your baby warm, but not overheated. If your baby can sleep in sleep clothing without an extra blanket, that is preferred and reduces clutter.
  • Take care of any colds or possible respiratory infections right away, since these can affect your baby’s breathing.

Consider Using a Pacifier to Put Baby to Sleep. Putting your baby to sleep with a pacifier may also help prevent SIDS, though researchers aren’t sure why. There are a few tips to follow when using a pacifier:

  • If you’re breastfeeding, wait until your baby is breastfeeding regularly (at least 1 month old) before starting to use a pacifier. Introducing a pacifier too soon can lead to nipple confusion and cause your baby to prefer the pacifier’s nipple over your own.
  • Don’t force your baby to take the pacifier if he doesn’t want it.
  • Put the pacifier in your baby’s mouth when you put him down to sleep, but don’t put it back in his mouth after he falls asleep.
  • Keep the pacifier clean, and buy a new one if the nipple is damaged.
  • Don’t coat the pacifier with honey, alcohol, or any other substance.

What are the risk factors for SIDS?

Since SIDS, as the name states, happens without warning, it is more helpful to look at risk factors than symptoms or warning signs.
Risk factors in the infant include:

  • Sleeping on the stomach or side (may make breathing more difficult)
  • A recent respiratory infection (may still be affecting his or her breathing ability)
  • Being born prematurely or with a low birth weight – including multiples births (brain autonomic functions may be less developed)
  • Having a smoker in the house/secondhand smoke (may interfere with the baby’s lungs)
  • Co-sleeping with a parent or sibling (may be trapped in a tight space, rolled on top of, and/or suffocate in excess pillows and blankets)
  • Having a crowded crib (blankets, pillow, and stuffed animals can block a baby’s nose or mouth)
  • Overheating (may affect an infant’s breathing)
  • Being in the range of 2 to 4 months old (although SIDS may occur up to 12 months of age, it is most common from 2 – 4 months)
  • Having a sibling or cousin who was affected by SIDS (may be partially related to a genetic brain defect)

Risk factors in the mother include:

  • Smoking
  • Using or abusing drugs or alcohol
  • Those under age 20
  • Those who do not receive enough prenatal care

Are there populations/groups who are more at risk?

Specific populations are not necessarily more at risk, but there is a higher incidence of SIDS among non-whites (African Americans, Hispanics/Latinos, Asians, etc.) for reasons that are not currently understood.

Male infants tend to have a higher rate of developing SIDS than do females. Additionally, babies born to mothers under 20 years old also tend to see higher rates of SIDS (this may be due to a lack of education or support about how to care for an infant).

Using a baby monitor

Video & audio baby monitors have been easing parent’s minds for decades now, and can definitely be a helpful tool. Though the APA, CDC, and many medical professionals do NOT suggest having a newborn or infant sleep in a separate room during the night, a baby monitor can be extremely helpful during nap times or when the babysitter is staying with your child.

Moms and dads are busy, and it is crazy to think that one might just sit still next to the crib while the baby takes a nap. No! This is the time you can use to do tasks around the house that you need both hands and more attention to complete. This is a great situation in which to use a baby monitor.

Combine all the techniques above (place the infant on his or her back to sleep, keep clutter out of the area, make sure the infant is not too warm, etc.) along with a video and/or audio baby monitor (and possibly the sleep sock monitor!) during naps, and you boost the safety of your baby!

Where can I find support if I’ve lost my baby to SIDS?

There are many ways to find support and to cope with your recent loss. This doesn’t mean that the transition will be easy, but it may help you and your partner and/or family find some peace in a troubling time.

Support groups and organizations

There are support groups out there for parents who have faced infant loss. Here are some organizations that may be able to help:

  • The Compassionate Friends:  online support as well as local chapters for in-person support
  • First Candle:  grief counseling line (1-800-221-7437) and the option to find local chapters
  • Friends of Maddie:  an organization that gives grants to families in financial hardship after the loss of a child
  • Kelly Ryan Foundation:  an organization that provides funds to help with burial costs for families enduring stillbirth or infant loss
  • Mommies Enduring Neonatal Death (M.E.N.D.):  online support as well as local chapters for in-person support (Christian)
  • Resources in other countries:

Counseling and ways to process

We encourage you to find a local therapist that can help you process through your grief and find ways to go about your life again. If you have a partner/spouse and/or children, you might look into family counseling as well. This can help keep communication flowing through your relationships when many people act withdrawn in a time of loss.
There are some other helpful ways to process the loss of a child, such as:

  • holding a funeral
  • having a memorial service
  • writing letters to your baby
  • setting up a small memorial area in your home
  • spending an afternoon or evening with friends and family recalling good and funny memories about your child
  • Making a scrapbook of any keepsakes and photographs you and your family/friends have collected

Want to Know More?

How to Ensure Safe Sleep for Your Baby

Compiled using information from the following sources:

1. Mayo Clinic: Sudden Infant Death Syndrome (SIDS)

2. Centers for Disease Control and Prevention: Sudden Unexpected Infant Death and Sudden Infant Death Syndrome

3. National Institute of Child Health and Human Development: About SIDS and Safe Infant Sleep