Sudden Infant Death Syndrome
Sudden infant death syndrome (SIDS) is the death of an apparently healthy infant (younger than 1 year of age) for which no cause can be determined. It generally occurs while the infant is sleeping; for this reason, it was once known as "crib death."
SIDS is the leading cause of death in infants 1 month to 1 year old, with most cases occurring between 2 and 4 months of age. It strikes boys slightly more often than girls. African-American and Native-American babies are at 2 to 3 times greater risk than the national average.
Since 1992, when the American Academy of Pediatrics (AAP) recommended placing healthy babies to sleep on their backs rather than their stomachs, the rate of SIDS in the United States has been cut in half. However, recent research shows that unsafe sleeping conditions still threaten young lives, and in response, the AAP has issued new guidelines for parents on how to protect a baby from SIDS, as well as other sleep-related infant deaths.
Healthy, full-term babies should be placed wholly on their backs for every sleep until 1 year of age. This includes naps and nighttime, at home and at day care. It is important that everyone who cares for your baby knows to always use the back sleep position.
While putting babies on their sides was once considered an option, it is no longer recommended because sometimes babies roll from their sides to their stomachs. Once a baby starts rolling over by himself, put him down to sleep on his back, but let him choose his sleep position. It is not necessary to put him on his back again if he changes position. By the time a baby is old enough to roll over, the risk of SIDS is significantly reduced.
Some babies develop a flat spot on the back of their heads from sleeping on their backs. The flattened area poses no harm and is temporary. Make sure your baby spends some time on his stomach while awake to help to prevent the flat spot and to aid neck and shoulder muscle development.
Some parents worry that babies placed on their backs will choke if they spit up or vomit. There is no evidence that sleeping on the back causes choking. Healthy babies know how to swallow or cough up fluids. However, a few babies, including premature babies and those with certain medical conditions such as breathing problems, heart defects and severe gastroesophageal reflux (spitting up), are better off sleeping on their stomachs or sides. Talk with your doctor about which sleeping position is best for your baby.
The new AAP recommendations for parents emphasize creating a safe sleeping environment for your baby. Besides placing your baby on his back to sleep, parents should take the following precautions:
- Don't place pillows, soft bedding, stuffed toys, or loose bedding like comforters or quilts in your baby's crib. Bumper pads should also be removed from the crib. They can cause babies to be strangled, entrapped or suffocated.
- Don't put a baby to sleep on a soft surface, such as a waterbed, sofa or soft mattress. A firm crib mattress, covered by a fitted sheet, is the recommended sleeping surface.
- Keep the temperature cool in the room where your baby sleeps; the temperature should be comfortable for a lightly clothed adult. Don't swaddle your baby, and don't cover him with a heavy blanket or quilt.
- Do not bed-share. Do not let your baby sleep in your bed and do not place other children in the crib with your baby. The safest place for your baby to sleep is in his crib by himself.
- Consider offering a pacifier at naps and bedtime. Use the pacifier when you're placing the baby down to sleep, but there is no need to put it back in the mouth once the baby falls asleep. If the infant refuses the pacifier, do not force it.
- Breastfeed your baby if possible. Breast milk contains infection-fighting substances and nutrients to keep your baby healthy.
- Don't smoke in your home or car. Minimize your baby's exposure to secondhand smoke in other environments. Exposure to secondhand smoke doubles a baby's risk of SIDS.
- Encourage "tummy time." Make sure your baby spends some time on his stomach while awake to help keep the back of the head from becoming flat and to aid neck and shoulder muscle development.
- Make sure your baby receives all recommended immunizations.
- Make sure your baby has regular well-baby checkups.
There is no evidence that devices that monitor a baby's breathing and heart rate help to prevent SIDS. However, home monitoring may be useful for some infants with certain conditions. Discuss any concerns you may have with your doctor.
There is also no evidence showing a link between vaccines and SIDS. In fact, the risk of SIDS is cut in half for babies who get all of their recommended shots.
Lastly, prevention of SIDS can start before a baby is born. A woman can take the following steps while pregnant to protect her baby from SIDS:
- Receive regular prenatal care.
- Avoid smoke exposure, alcohol and illicit drug use.