Ways to Reduce Your Baby's Risk of SIDS

Sudden infant death syndrome (SIDS) is responsible for about 3,400 infant deaths every year. While rates are declining, it's still necessary for parents to learn ways to reduce the risks.

A baby under one year old dies suddenly and without apparent cause, which is known as sudden infant death syndrome (SIDS). The actual origin of SIDS is unknown, although experts hypothesize that its peak incidence between 2 and 4 months of age may be related to infants' quickly developing respiratory and circulatory systems, particularly in the first few months of life.

SIDS continues to be a painful problem for families and the medical community despite years of research. According to Steven A. Shapiro, D.O., chair of the Pediatrics Department at Abington-Jefferson Health, SIDS is a symptom of a condition known as sudden unexplained infant death syndrome (SUIDS).

The good news is that since the Safe to Sleep (formerly Back to Sleep) program was introduced in 1994, the incidence of SIDS has significantly decreased. However, according to the Centers for Disease Control and Prevention (CDC), 3,400 unexpected newborn deaths occur in the United States each year.

Many new parents are understandably terrified by the unexpected nature of SIDS and want nothing more than to keep their babies safe, but there are steps you can take to lessen their risk. Here are the most important SIDS prevention tips and information for parents.

According to Marian Willinger, Ph.D., special assistant for SIDS at the National Institute of Child Health and Human Development in Bethesda, Maryland, "the greatest danger is between 2 and 4 months old." However, until your child becomes 1, you should keep taking precautions to protect them from SIDS.

SIDS's underlying causes are not fully understood. According to Rachel Moon, M.D., a pediatrician at Children's National Medical Center in Washington, D.C., and head of the American Academy of Pediatrics' SIDS Task Force, "most kids who die of SIDS appear totally normal."

However, experts concur that the arousal area in the brains of infants who die from SIDS is immature. Simply put, when they are experiencing problems breathing, they cannot wake up on their own. SIDS is more common in infants who sleep on their stomachs, probably because doing so increases the likelihood that they may breathe in oxygen-depleted air again.

Dr. Moon continues, "We do know that there are demographic and environmental factors," noting that three out of five SIDS fatalities are male and that infant mortality rates among African American and Native American babies are two to three times higher than the national norm. Premature infants, newborns with low birth weights, and children who have been exposed to cigarette smoke are among categories who are more at risk.

Unfortunately, not all cases of SIDS are preventable, and studies like one published in The Lancet in May 2022 raise the possibility that there may be a biological component to SIDS. However, there are actions you may take to lessen your baby's risk of SIDS.

Never Let Your Baby Sleep on Their Stomach

By improving a baby's access to fresh air and lowering their danger of overheating, back-sleeping lowers the chance of SIDS (another factor linked to SIDS). However, some parents continue to use stomach sleeping: 18% of Parents readers and 13% of other readers say they regularly put their infants to sleep on their stomachs.

Infants often sleep better and deeper on their stomachs, therefore some exhausted new parents may resort to this desperate measure, claims Jodi Mindell, Ph.D., author of Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night's Sleep.

In actuality, however, stomach napping is linked to higher risks of SIDS: Babies who typically sleep on their backs are really 18 times more likely to pass away from the condition when brought down for a nap on their stomach. According to Dr. Moon, infants "seem to have trouble adjusting to the change."

Despite the risks associated with stomach sleeping, you shouldn't be concerned if your child starts to roll over on their own. A baby's brain is developed enough to warn them of breathing problems once they can roll over on their own, according to Dr. Moon. Additionally, by the time they are 6 months old, they will be able to save themselves thanks to their better motor skills, which significantly lowers the chance of SIDS.

However, keep in mind that awake tummy time is still crucial for your baby's growth. Still, your infant has to engage in a number of supervised "tummy time" sessions each day. This promotes your baby's growth and guards against flat patches on the head caused by sleeping on their back. Dr. Shapiro says, "Babies require tummy time when parents are awake, alert, and carefully observing." "Tummy time is development time, not sleep time."

Skip Side-Sleeping

According to studies, laying a baby down on his or her side as opposed to their back increases the chance of SIDS. According to Dr. Moon, it's simpler for a baby to roll onto their stomach from their side than from their back. And it's possible that they lack the expertise to turn around just yet.

Don't Use Positioners or Other Baby Gadgets for Sleep

Breastfeeding pillows and "lounge" pillows, for example, can be useful when your baby is awake, but they raise the risk of SIDS and should never be used when your baby is sleeping. Additionally, only an authorized crib or bassinet with a flat resting surface should be used for your baby's sleep. Never use a baby swing, car seat, baby seat, or products like the recalled "Rock 'n Play" for sleep.

Don't Put Anything in the Crib Except a Fitted Sheet

By obstructing your child's breathing, blankets, pillows, comforters, and stuffed animals can raise the risk of SIDS; soft or uncomfortable mattresses can also be risky. Therefore, do not put a pillow or blanket in your baby's crib until the first birthday.

Use a sleep sack or swaddle your baby in a receiving blanket if you're concerned that they could get cold. A 2017 study found that swaddling enables fussy babies to sleep more soundly on their backs and may prevent SIDS by making them more susceptible to startling. However, always use good swaddling techniques and avoid wrapping too tightly. According to Dr. Shapiro, "Your kid has to be able to move around and be able to kick and wriggle."

Be Careful with Co-sleeping

Numerous studies have shown that co-sleeping increases the risk of SIDS, although many parents still do it. A survey by Parents found that 52% of readers do it all the time or occasionally, citing the ease it provides for overnight feedings and the security it provides to have their newborns close by.

Your baby could be strangled by a pillow or a loose blanket while co-sleeping in bed. If you or your partner mistakenly roll over onto them, their air supply may be cut off. Additionally, if their head becomes wedged between the headboard and mattress, they risk strangulation. The same risks apply when sharing a couch or armchair.

It's critical to understand the dangers of co-sleeping and SIDS. If you choose to co-sleep, avoid placing the infant directly in the bed. Additionally, Dr. Shapiro advises against using a co-sleeping crib that clamps onto your bed's frame since "parents might still suffocate their infant with an arm or leg." The AAP advises room-sharing by bringing your baby's crib into your room, as it does in its updated safe sleeping recommendations from 2022.

Maintain a Comfortable Temperature in the Nursery

According to Warren Guntheroth, M.D., a pediatrics professor at the University of Washington in Seattle, "A nursery that's too warm substantially increases an infant's SIDS risk." So be careful not to overheat your child by swaddling or by setting the ambient temperature too high.

The association between higher temperatures and SIDS may be due to the fact that warm babies experience deeper slumber, making it more challenging for them to wake up in an emergency. Don't place the crib close to a radiator, set the thermostat to 68 degrees, and outfit your infant in lightweight layers that you can take off quickly if they start to become warm.

Make Sure Your Baby Has Enough Room

Your infant should be able to move around and wriggle while sleeping to lower the risk of SIDS. According to Dr. Shapiro, "A baby that can't move very well can get into dangerous positions that become compromising." He encourages parents to stay away from small beds and extremely narrow bassinets. If you're going to swaddle your baby, position them with their hands out in front of them so they can move around freely. Also, don't wrap their hips too tightly.

Give Your Baby a Pacifier

In fact, pacifiers help lower the incidence of SIDS. Dr. Moon explains, "We don't know why yet, but it may be that sucking on a pacifier brings a baby's tongue forward, which opens the airway a little bit more." It's also possible that pacifier-using newborns don't get as deep sleep as pacifier-free babies.

The AAP now advises that you think about giving your child a pacifier during their first year of life, especially at night and during naps. Reminder: If you're breastfeeding, you might want to wait until your child is one month old and latching normally before introducing a pacifier.

Breastfeed, If Possible

Breastfed babies are less likely to die from SIDS because they are more quickly woken from sleep than formula-fed babies are. A baby's exposure to smoking, both in the womb and through secondhand smoke, raises the risk for SIDS, according to Dr. Shapiro, and breastfeeding parents are also less likely to smoke.

However, all those late-night feedings could also be dangerous, so go out of your way to put your baby to bed in their crib. (And if you require assistance, don't be reluctant to ask your partner!)

"If you are feeding your baby and think that there's even the slightest possibility that you may fall asleep, feed your baby on your bed, rather than a sofa or cushioned chair," said Lori Feldman-Winter, M.D., FAAP, a member of the American Academy of Pediatrics (AAP) Task Force on SIDS. "If you do fall asleep, as soon as you wake up be sure to move the baby to their own bed," she said.

Skip Anti-SIDS Gadgets

According to the AAP, using an electronic breathing monitor doesn't help prevent SIDS unless your infant has a confirmed cardiac or respiratory ailment, and it may even give parents a false sense of security. Additionally, there is little evidence to support the effectiveness of products promoted to lessen carbon dioxide rebreathing, such as baby mattresses with built-in fans. Likewise, stay away from wedge-shaped sleepers that guarantee to keep your child on her back: It can cause a baby to slide off and suffocate against.

SIDS can happen at any time throughout a baby's first year of life, but it becomes incredibly rare after that. Doctors are aware that the risk of SIDS appears to peak between 2 and 4 months of age and declines after 6 months, despite the fact that the reasons of SIDS are still largely unknown.