In the United States, approximately 3500 infants die annually from sleep-related infant deaths, including Sudden Infant Death Syndrome (SIDS), accidental suffocation and strangulation. SIDS is the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and review of the clinical history of the family and infant. SIDS is the leading cause of death in infants from one month to one year of age. Most SIDS deaths occur when babies are between two and four months of age. Although SIDS can be frightening for parents and caregivers because of what we do not know, there are many things parents can do that have been proven to reduce the risk of SIDS, as well as other sleep-related deaths.
Listed below are the most recent recommendations from the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. These recommendations were updated in 2016 based on the latest research and evidence. It is important that every parent, grandparent, childcare provider and anyone else who cares for a baby know and follow these twelve recommendations.
- Back to sleep for every sleep. Infants should be placed for sleep on the back for every sleep until age one. Side sleeping is not as safe. Back sleeping does not increase the risk of choking and aspiration, even in infants with reflux. Supervised, awake "tummy time" is recommended to promote the development of upper body strength and avoid the development of flat area on the head.
- Use a firm sleep surface. A firm crib mattress covered by a fitted sheet with no other bedding or soft objects is the recommended sleeping surface. A firm surface maintains its shape when the infant is placed on the surface.
- Provide breastmilk. The protective effect of breastfeeding increases with exclusivity. It is recommended when possible for infants to consume only breastmilk for the first 6 months. However, any breastfeeding has been shown to be more protective against SIDS than no breastfeeding.
- Use a separate surface designed for infants but close to the parents' bed. There is evidence that sleeping in the parents’ room but on a separate surface decreases the risk of SIDS by as much as 50%. A crib, bassinet, or portable crib that conforms to the safety standards of the Consumer Product Safety Commission (CPSC) is recommended. There is no recommendation for or against the use of bedside sleepers or in-bed sleepers due to insufficient studies.
- Keep soft objects and loose bedding away from baby's sleep area. Soft objects such as pillows, blankets and bumper pads can pose a suffocation risk. Infant sleep clothing, such as a wearable blanket, is preferable to blankets to keep the baby warm.
- Consider offering a pacifier at nap time and bedtime. Pacifiers have been shown to have a protective effect against SIDS. There should be nothing attached to the pacifier and it does not need to be reinserted once the infant falls asleep. For breastfed infants, pacifier use should be delayed until breastfeeding is firmly established.
- Avoid smoke exposure and alcohol and illicit drug use during pregnancy and after birth. Exposure to smoke, alcohol and illicit drug use during pregnancy and after birth significantly increases the risk of SIDS.
- Avoid overheating and head covering. Over bundling and covering of the face and head should be avoided. Baby should be checked for signs of overheating, such as sweating or the infant’s chest feeling hot to the touch.
- Obtain regular prenatal care. There is a strong link between adequate prenatal care and a lower risk of SIDS.
- Immunize according to recommendations. Recent studies suggest that vaccinations may have a protective effect against SIDS.
- Avoid commercial devices that are inconsistent with safe sleep recommendations. Be wary of devices that claim to reduce the risk of SIDS, such as wedges, positioners, and “flow-through” mattresses. There is no evidence that these devices reduce risk. Information about a specific product can be found on the CPSC website www.cpsc.gov.
- Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS. There is no evidence that these devices decrease risk.
For additional information: https://www.cdc.gov/sids/index.htm