A sudden, tragic event – no matter how unexpected – can often be explained. But too frequently no reason can be given when a baby dies without warning. Thousands of infants die suddenly and unexpectedly each year in the U.S. In approximately half these cases, the cause of death can be traced to a previously undiagnosed disease, terrible accident or child abuse. But in 50 percent of instances when a baby younger than 1 year of age dies, the cause remains a mystery even after a complete autopsy, examination of the death scene and review of the apparently healthy baby’s clinical history.
Whether or not these tragedies have an identifiable cause, they are called SUID (pronounced SOO-idd), which stands for “sudden unexpected infant death.” Only the unsolved mysteries are referred to as sudden infant death syndrome (SIDS).
SIDS is a diagnosis of exclusion, and it leaves devastated parents with many unanswered questions. Due to its unknown cause, SIDS cannot be prevented. However, research has uncovered several ways to lower its risk.
“As a member of multiple county death review teams, there is not one month that goes by that there is not a death related to unsafe sleep in our region,” said Leanne Kozub, registered nurse and child advocacy coordinator for The Guilds Child Abuse Prevention and Treatment Center at Children’s Hospital Central California. “Unsafe sleep is a major factor in SUID.”
Because SIDS normally occurs while an infant sleeps, the National Institute of Child Health and Human Development (NICHD) helped introduce the Back to Sleep campaign in 1994. Since then, the rate of SIDS has declined more than 50 percent in the U.S.The Centers for Disease Control and Prevention is collaborating with NICHD to present theSafe to Sleep® Public Education Campaign, an expansion of the Back to Sleep outreach. Children’s Hospital encourages you to learn what a safe sleep environment looks like and adopt safe sleep practices for your baby.
Top Tips for Safe Sleep
1. Always lay your baby on his or her back to sleep for naps and at night.
Side and tummy positions are not as safe as placing your baby face up. Babies who sleep on their tummies have a five times greater risk of SIDS. And because healthy babies automatically swallow or cough up fluids, choking or other breathing problems do not increase for babies who sleep on their backs. Check with your doctor if your baby has breathing problems.
2. Every sleep time counts.
The risk for SIDS increases significantly when babies who normally sleep on their backs are placed on their stomachs to sleep – even for a nap. Tell everyone who cares for your baby to always lay him or her to sleep face up. Vary the direction your baby lays in the crib each night and at naptime, as well as on the changing table with each diaper change. This helps prevent flat spots on the back of your baby’s head and also helps stretch neck muscles equally.
3. Always lay your baby to sleep on a firm mattress in an approved crib.
Do not let your baby sleep on soft surfaces like a couch, chair, quilt, pillow, sheepskin, foam pad or waterbed. A Scottish study found that 87 percent of SIDS deaths occurred in unsafe sleep environments, while only 13 percent happened in a crib or bassinet.
4. Remove all loose bedding, crib bumpers, stuffed animals and pillows from crib.
Consider using a wearable blanket or other type of sleeper instead of placing a blanket over your baby. Studies have shown that babies who sleep on soft bedding have a five times greater risk of SIDS, and babies who sleep on their tummies on top of soft bedding have a 21 times greater risk of SIDS.
5. Do not share sleep surfaces.
“Bed sharing is unsafe no matter who you are,” said Kozub. “I have seen cases of siblings rolling over on the baby and suffocating them. I have seen it in grandparents, aunts and uncles babysitting children. It can happen to anyone.” After nighttime feedings, put your baby back in his or her crib, cradle or bassinet.
6. Do share a bedroom.
Keep your baby’s sleep area close by – even bedside. “Room sharing is the recommended practice,” said Kozub. “Bring the crib or bassinet into the parents’ room.”
7. Consider breastfeeding.
Studies show that the likelihood of SIDS is 60 percent lower for infants who receive any breast milk for any length of time.
8. Offer your baby a clean, dry pacifier at all sleep times.
Pacifiers have been shown to reduce the risk of SIDS. If your baby doesn’t take the pacifier, don’t force it. If it falls out during sleep, don’t replace it. If you are breastfeeding your baby, wait until your child is 1 month old or is used to breastfeeding before using a pacifier.
9. Do not let your baby get too hot.
Overheating is a leading risk factor for SIDS. Dress your baby in as much or as little as you would wear. If your baby is sweating, has damp hair or a heat rash, he or she may be too hot. Room fans have been shown to reduce the risk of SIDS.
10. Do not smoke (even during pregnancy) or allow smoking around your baby.
Babies of mothers who smoke during pregnancy have a three times greater risk of SIDS, and babies who breathe secondhand smoke have a 2.5 times greater risk of SIDS.
11. Do not use home monitors or products that claim to reduce the risk of SIDS.
Your baby’s doctor may recommend a home monitor for a medical condition, but these monitors do not reduce the risk of SIDS in healthy babies. In addition, many products that claim to lower the risk of SIDS have not been tested for safety or efficacy.
In your efforts to keep your baby safe while sleeping, don’t forget babies benefit from lying on their tummies for supervised playtime.
When babies spend too much time on their backs, it can:
- cause flat spots on the back of the head
- constrict neck and back muscles
- keep hands from coming together
- limit ability to push up with arms
- prolong learning to roll over, sit, crawl, stand and/or walk
When babies spend playtime on their tummies, it can:
- build muscle strength in shoulders, neck and arms
- improve balance
- increase head control
- teach hand-eye coordination
Top Tummy Time Tips
1. Supervise tummy time when your baby is alert, like after a nap or diaper change.
2. Start with 3-5 minutes two to three times a day and increase playtime as your baby learns to enjoy it.
3. Lie on your back with your baby on your chest to encourage your baby to push up to see your face.
4. Place your baby on the floor on a blanket or mat with an interesting pattern or texture.
5. Tuck a pillow or small towel under your baby’s chest to help position head upright.
6. Get down on the floor so your baby can see your face and socialize with you.
7. Place toys on both sides of your baby to encourage reaching and turning.
October is SIDS Awareness Month. Even though SIDS cannot be entirely explained or prevented, its tragic toll has been drastically reduced due to greater awareness. By adopting safe sleep practices and engaging in tummy time, you provide an environment for your baby that encourages healthy growth and development. Children’s Hospital invites you to access available online resources on SUID and SIDS. Together we can continuously improve the health and wellbeing of all babies.