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SIDS stands for sudden infant death syndrome, a term used to describe the sudden and unexplained death of a baby younger than 1 year. Some people call it crib death, because most babies are found in their cribs, but cribs do not cause SIDS.
Who's at risk?
- Most SIDS deaths occur in babies who are between 2 and 4 months old.
- African-American babies are twice as likely to die of SIDS as Caucasian babies, and Native-American babies are nearly three times more susceptible.
- Boys are at a greater risk than girls.
- Babies born to mothers who smoked during pregnancy or exposed to passive smoke in the household after birth.
- Babies born to mothers younger than 20 at the time of their first pregnancy.
- Babies born to mothers who had no or late prenatal care.
- Premature or low-birth weight babies.
What causes SIDS?
Doctors don't really know what causes SIDS, but many studies are under way to learn why. Scientists are exploring the nervous system, brain, heart, breathing and sleeping patterns, body chemical balances, autopsy findings, and environmental factors. Experts say it's likely that SIDS may have more than one explanation.
Some evidence shows some SIDS babies are born with brain abnormalities that may stem from prenatal exposure to a toxic substance or possibly not getting enough oxygen in the womb.
Scientists believe these abnormalities make babies more vulnerable after birth and that other possible events after birth, such as lack of oxygen, overheating or an infection, could trigger SIDS. Infections, for example, may explain why more SIDS cases occur during the colder months of the year, when respiratory and intestinal infections are more common.
Can SIDS be prevented?
No, not yet. However, there are certain steps you can take to reduce the risk of SIDS. For example:
Stop smoking. Mothers who smoke during pregnancy are three times more likely to have a SIDS baby, and exposure to passive smoke from smoking by mothers, fathers and others in the household doubles a baby's risk of SIDS.
Get good prenatal care. Proper nutrition, abstaining from smoking, drug or alcohol use by the mother, and frequent medical checkups beginning early in pregnancy, might help prevent a baby from developing an abnormality that could put the baby at risk for SIDS.
Put babies to sleep on their backs. Studies show placing healthy babies on their backs to sleep, at nighttime and naptime, has reduced the number of SIDS cases by as much as half in countries where infants had traditionally slept on their stomachs. Babies placed on their sides to sleep also have a lower risk of SIDS than those placed on their stomachs. But the back sleep position is the best position for infants from 1 month to 1 year. Babies placed on their sides to sleep should be placed with their lower arm forward to help prevent them from rolling onto their stomachs.
Place your baby on a firm mattress, such as in a safety-approved crib. Do not put babies on soft or previously used mattresses, sofas, sofa cushions, waterbeds, sheepskins or other soft surfaces.
Remove all fluffy and loose bedding from the sleep area. Make sure you take all the pillows, quilts, stuffed toys and other soft items out of the crib. These may smother your infant.
Make sure your baby's face stays uncovered during sleep. Keep your baby's mouth and nose clear of blankets and other coverings during sleep. Use sleep clothing with other covering over the baby. If you use a blanket, make sure your baby is "feet-to-foot" in the crib. Feet to foot means the baby's feet are at the bottom of the crib, the blanket is no higher than the baby's chest and the blanket is tucked in around the crib mattress.
Don't let your baby overheat. Keep your baby warm, but not too warm, during sleep. Your baby's room should be at a temperature that is comfortable for an adult. Wrapping a baby in too many layers of clothing or blankets can cause overheating. Research shows overheating may greatly increase the risk of SIDS for a baby with a cold or infection. (Signs that your baby may be overheated include sweating, damp hair, heat rash, rapid breathing, restlessness and sometimes fever.)
Breastfeed your baby, if possible. Studies show babies who died of SIDS were less likely to be breastfed. Breast milk helps to protect the baby from some infections and gastrointestinal and respiratory illness.
Take your baby for well-baby checkups. Also, make sure your baby receives shots on time.
Is it OK to sleep with my baby?
Many organizations such as the American Academy of Pediatrics (AAP), the National Institute of Child Health and Human Development, Maternal and Child Health Bureau, SIDS Alliance, and Association of SIDS and Infant Mortality Programs discourage bed-sharing, saying it increases the risk of smothering the baby and may contribute to SIDS.
The AAP says there have been reports of infants being suffocated by adults rolling over onto them, particularly in situations when the grownup has been drinking or using drugs. Sleeping on cushy sofas, or other soft surfaces, is another risk factor. In a study reported on the AAP's Web site, researchers found shared sleep surfaces in the United States are unsafe for infants, and that cribs are the safest places for babies to sleep.
Although some doctors condone bed-sharing, saying it boosts breastfeeding and promotes the bond between a mother and infant, no scientific proof says bed-sharing between the baby and an adult reduces SIDS.
If you choose to have your baby sleep in bed with you while you breastfeed, the same recommendations for sleeping safely applies as if the child is in the crib. Make sure your baby sleeps on the back. Don't use pillows and loose covers. Make sure the baby can't get trapped between the mattress and the framework of the bed (headboard, footboard), a wall or other furniture.
You may wish to discuss bed-sharing further with your baby's doctor.
This article was reviewed and updated June 2007.
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