Protecting Your Baby From SIDS

Any parent who has ever checked on a sleeping infant in the middle of the night knows the fear. In the United States, sudden infant death syndrome (SIDS) is the third leading cause of death in babies one month to one year of age. Its cause is unknown.

Since 1992, the American Academy of Pediatrics' (AAP) "Back to Sleep" campaign has recommended placing babies on their backs for naps and at bedtime. Since then, SIDS in the U.S. has decreased by 53 percent, but there are still about 2,000 infants per year who die from it.

Importance of sleeping position

The AAP now says babies should be placed only on their backs to sleep. Previously, they did not oppose the side-sleeping position, but studies now show that the side-sleeping position can contribute to SIDS.

Can pacifiers protect your baby?

Research has shown a protective effect when pacifiers are given to babies before they fall asleep. There are several theories for this protection, but no clear reason has been found. The AAP now recommends giving babies pacifiers at bedtime and naptime.

Some experts argue that pacifiers interfere with breastfeeding or cause later dental complications, but there is no compelling evidence that this is true. In fact, the American Academy of Pediatric Dentistry considers pacifier use normal and unlikely to cause long-term problems as long as it ends by age five.

When giving your baby a pacifier, follow these rules:

1. Offer the pacifier when putting him to bed. If he pushes the pacifier out after falling asleep, don't reinsert it. Don't force him to take an unwanted pacifier.
2. Clean and replace pacifiers often.
3. If baby is being breastfed, don't offer the pacifier until she is one month old and used to breastfeeding.

Caregiver education

Ask caregivers to place the baby on his back when sleeping, and include directions on offering the pacifier. Make sure caretakers know about SIDS prevention. SIDS often occurs when day care center workers, grandparents or babysitters put babies to bed without knowing the facts about SIDS. In the U.S., approximately 20 percent of SIDS deaths occur when someone other than the parent is caring for a child.

Other risk factors

If the mother is young, smokes during pregnancy or doesn't get adequate prenatal care, her baby can be at risk. Babies who are male, premature or have low birth weights are also at a higher risk. In addition, African-American, American-Indian or Alaska-native infants are more prone to SIDS. Additionally a valid statistical association exists between sleeping on a used infant mattress and an increased risk of SIDS, especially if the mattress is from another home.

How to prevent SIDS:

1. Remember "back to sleep." Don't place baby on her side or tummy.
2. Offer a pacifier.
3. Place baby on a firm mattress to sleep. Cover him with a sheet.
4. Keep soft objects and loose bedding out of the crib. They can cover a baby's mouth and nose.
5. Don't smoke during pregnancy. Also, protect your infant from second-hand smoke.
6. Avoid overheating and swaddling. Keep temperature comfortable. Your baby should not feel hot to the touch.
7. Don't buy monitors that claim to prevent SIDS. None of them have had enough testing to prove they're effective or safe.
8. Keep baby out of your bed, but in the same room. Bed-sharing is associated with SIDS. Keep baby in your room, but in a crib. Sleeping in the same room decreases the risk for SIDS.

Related Articles What Is SIDS? Sudden Infant Death Syndrome Thumb-Sucking: Is it Time to Break the Habit?

External Sources American Academy of Pediatrics SIDS Alliance Tappin D, Brooke H, Ecob R, et al. Used infant mattresses and sudden infant death syndrome in Scotland: casecontrol study. BMJ. 2002;325:1007-1009.

This article was reviewed and updated June 2007.

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