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Liz Kreiger
Contributing Writer

Sudden Infant Death Syndrome: What Is SIDS—and How To Prevent It

It’s scary because the cause of SIDS is unknown. But learning about this rare diagnosis can help you take precautions to protect baby.

Sudden Infant Death Syndrome (SIDS) is probably a new parent’s greatest fear, and reason no. 1 why you’re not sleeping these days (along with the 500 other worries keeping you up at night). It’s admittedly terrifying to think about, but thankfully, there are ways you can reduce SIDS risk, and the latest SIDS statistics can teach us a lot about SIDS prevention. Armed with the right info, you and baby can both sleep soundly—and, more importantly, safely.

As the name implies, Sudden Infant Death Syndrome is the sudden and unexplained death of an infant who seems otherwise healthy. Since it strikes when baby is sleeping, it’s also sometimes called “crib death.” Of course, cribs themselves don’t cause SIDS, and while the precise cause is still unknown, “fortunately we do know about plenty of things that can impact it, so parents can take steps to protect their child,” says pediatrician Laura Jana, MD, co-author of Heading Home With Your Newborn.

Let’s break down the stats: SIDS is the leading cause of death among very young babies—between one month and one year of age—and about 1,500 babies died of Sudden Infant Death Syndrome in the US in 2014. The majority of those deaths occurred in babies between one and 4 months of age, and 90 percent of SIDS deaths happen before baby is 6 months old. Past data suggested there were more SIDS deaths during the colder months of the year, but statistics now show that the numbers are actually evenly spread throughout the entire year.

These facts may seem alarming, but it’s reassuring to remember that SIDS is rare (.0004 percent of almost 4 million births annually), and SIDS rates are on the decline. Thanks to the Back to Sleep campaign, which started in 1994, the numbers have dropped steadily now that parents are a lot more aware and informed about putting babies to sleep on their back (one of the safest ways to prevent SIDS) and other healthy sleep habits.

WHAT CAUSES SIDS?

The unsettling truth is that no one's entirely sure why SIDS happens—by definition, SIDS has no known cause. But recently there’s been growing evidence that suggests babies who die from SIDS may have underlying abnormalities in the portion of the brain that controls breathing, heart rate, blood pressure and sleep arousal. “We have a sense that there’s some mechanism that gets triggered—or not triggered—when the baby gets into a position where there’s not enough oxygen,” Jana says. Researchers are still working to try and develop screening tests that will help find out if baby’s brain might have these defects.

SIDS RISK FACTORS

There may not be a known cause for SIDS yet, but luckily experts do have an idea of what factors can contribute to SIDS and which babies have a higher SIDS risk. Knowing if baby falls into any of these categories can help you take additional steps to prevent SIDS. Here are several things that might increase baby’s risk:

  • Sex. Boys are slightly more likely to die of SIDS.
  • Age. Infants between 2 and 3 months are most vulnerable.
  • Race. African-American, American Indian or Alaskan Native infants are much more likely to die from SIDS—although the reasons are unclear.
  • Family history. Babies with siblings or cousins who died of SIDS are at higher risk.
  • Secondhand smoke. Babies who live with smokers have a higher risk of SIDS.
  • Premature birth. Being born early as well as having a low birth weight both increase baby’s risk of SIDS.
  • Certain maternal factors. SIDS risk is higher in babies whose mothers are younger than 20, smoke cigarettes, use drugs or alcohol, or have a history of inadequate prenatal care.

It’s equally important to think about how and where you’re putting your child to sleep. Babies under 11 to 14 weeks old are at a higher risk if they:

  • Sleep on their stomach
  • Sleep under soft or loose bedding
  • Get overheated while sleeping
  • Sleep in an adult bed with other adults, children or even pets

HOW TO PREVENT SIDS

Rather than focusing on your fear or obsessively staring into baby’s crib as he or she sleeps, channel your energy into all the ways you can protect baby. From day one, here are some simple and easy things you can do to help prevent SIDS:

Put baby to bed on his or her back
When it comes to SIDS prevention this is the no. 1 weapon you have in your arsenal. “We’ve seen incredible drops in the data since parents began placing their children on their back to sleep,” Jana says. Concerned that too much time on the back could lead to flat-head syndrome? Not to worry— just be sure to include enough tummy time sessions throughout the day, so baby gets a break from laying back-down.

Sleep in the same room (not bed) as baby
Where baby sleeps is also very important, Jana says. While you may think that having baby in your bed, mere fingertips away from you, is the best way to ensure safe sleep, co-sleeping hasn’t been shown to help reduce SIDS. In fact, babies who sleep in the same bed as their parents are actually at risk of SIDS, as well as other sleep dangers like suffocation or strangulation. No one ever thinks it could happen to them, but if you’re tired enough (and when aren’t new parents tired?), you can easily roll onto baby in your sleep, or baby can quickly become tangled in bed sheets or blankets.

Being in the same room, however, is protective, Jana says, which is why putting baby in a co-sleeper bassinet right next to your bed, or in a crib a few feet away, is a perfect option. For parents who want to co-sleep, this is a great compromise that still allows you to be in arm’s reach without the added risk.

Be firm about baby’s sleep spot
Place baby to sleep on a firm mattress that meets current safety standards. Check to see if the crib you bought or got handed down is up to snuff and hasn’t been recalled. Things to avoid: a crib that is broken or missing parts, or one with drop-side rails. Keep in mind that that the following locations are not considered safe sleep spots: chairs, sofas, water beds, cushions or sheepskins.

Choose baby’s bedding carefully
Sure you want baby’s crib to look adorable, but it’s more important that you create a safe sleeping space. Ditch the crib bumpers, toys, pillows and other loose items, as they can all increase baby’s risk of suffocation. If you must toss them back in to capture those cute monthly photo shoots, feel free, but anytime baby is using the space for sleep, those items need to go. While no one knows for sure when it’s safe to have them back in the crib, most experts agree that after about one year you can leave the loveys in during nighttime and for naps.

Keep baby from overheating
It’s tempting to worry that baby is going to feel cold at night, especially without any cozy bedding, but the general rule of adding just one extra layer than what you are wearing will do the trick. So if you’re fine in a T-shirt, put baby in a lightweight onesie and an infant sleep sack. Sleep sacks are a safe way to keep baby toasty without the risk of covering his or her head. Check in periodically: If baby is sweating or if his or her chest feels hot, that’s a sign of overheating and you may want to strip off a layer.

Breastfeed as much and for as long as you can
Studies show that breastfeeding baby for as long as you can is a way to help reduce the risk of SIDS.

Stick to your doctor schedule
Make and keep all regular well-child visits, particular for immunizations. Recent evidence suggests that vaccinations may have a protective effect against SIDS.

Avoid smoke
Make your home a smoke-free environment, and don’t smoke or let anyone else smoke around baby.

Offer up a pacifier
There’s evidence that using a pacifier can reduce SIDS risk. This could be because it keeps babies at just a slightly higher level of alertness, Jana says. Not all babies will take to it right away (or ever) though, and that’s okay if you tried.

Avoid letting baby sleep for extended periods in car seats, swings or strollers
Doing this puts baby at risk for accidental asphyxiation due to the position of his or her body or strap strangulation. (These aren’t always considered cases of SIDS, particularly when the positioning is an obvious cause, but still a risk you want to avoid.) Of course, in the real world, dozing off on-the-go is unavoidable (babies love motion!), but avoid making a habit of intentionally letting baby sleep in places other than the crib unattended for long periods of time.

WHEN CAN YOU STOP WORRYING ABOUT SIDS?

By definition, SIDS only affects infants. After 6 months there’s a definite drop in SIDS risk, and once baby hits one you can rest easy. Ninety percent of cases happen before 6 months, and of that group the majority of deaths are between one and 4 months old.

DO SIDS PREVENTION PRODUCTS REALLY WORK?

In this day and age, where there’s a problem, there’s usually a solution for sale. You’ve probably seen an increase in the number of high-tech products that claim to help with SIDS prevention, like cardiorespiratory monitors made for at-home use. These gadgets may be of some use for babies who have breathing or heart rate problems, but otherwise they haven’t been found to reduce the risk of SIDS in healthy infants, so you’re better off saving your money and relying on practices that are known to work, Jana says. That said, if having a high-tech monitor will give you extra peace of mind, it’s totally up to you if you want to invest in one. “Just be aware they’re more likely to have you running for false alarms (which could end up increasing your stress levels!) than if you simply decided to sleep near your child, with baby in a co-sleeper instead,” Jana says.

As for other less-techy, but just as enticing, products that claim to reduce the risk of SIDS—items like wedges, sleep positioners, special sleep surfaces and mattresses—none of these have been shown to make a difference in SIDS risk either. And in rare cases, some infants have actually suffocated due to these products, so definitely skip them.

Expert: Laura Jana, MD, an Omaha, Nebraska, pediatrician and co-author of Heading Home With Your Newborn.