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Keeping Your Baby Safe from SIDS

by Robert Needlman, M.D., F.A.A.P.
reviewed by Lynn Cates, M.D., F.A.A.P.
Sudden Infant Death Syndrome (SIDS) is when an infant one month or older dies suddenly with no apparent cause, usually while sleeping. SIDS is also called crib death, although cribs do not cause the syndrome, and children can die of it when they are not in their cribs. SIDS mostly strikes infants between two and four months of age. Once a child is six months old, the risk of SIDS goes down substantially.

Although we do not know what causes SIDS, we have learned how to prevent many cases: Infants should always sleep face up, on their backs, never face down. The national "Back to Sleep" campaign, which teaches parents to put their babies to sleep on their backs, has cut the rate of SIDS in half, saving thousands of babies each year.

Because this is such an important message, I'm going to repeat it: Always put your baby to sleep on his back, never face down.

Lying on the side is not as safe as face up because infants can easily turn from their sides to their fronts, ending up face down. Some babies fuss when placed face up, but most get used to the position in a short time (a few days, usually). Sleeping face up does not lead to choking on saliva. Babies who frequently spit up (see our article on gastroesophageal reflux) should sleep with their heads higher than their feet, but they usually are still safer on their backs. (If your child seems to spit up too much, ask your child's doctor to find out the cause and proper treatment.)

Here are some other things you can do to lower the risk of SIDS:
  • If you're pregnant, don't smoke. Infants born to women who smoked have a higher risk of SIDS. The same is true of women who used cocaine, heroin, and other illegal drugs when they were expecting.


  • Protect your baby from secondhand smoke. Any cigarette smoke in the air your baby breathes increases her risk of SIDS. Even if no one smokes in the baby's room, smoke anywhere in the house affects the baby.


  • Use a firm crib mattress. Feather beds, sheepskins, water beds, and other soft surfaces increase the odds of suffocation if a baby does turn face down. Stuffed animals, other soft objects, and bedding (such as quilts, comforters, and pillows) can also cause suffocation, so it's best to keep these things out of the crib and playpen.


  • Dress your baby lightly for sleep. Overheating may increase SIDS risk. A baby in a one-piece cotton sleeping suit that covers arms, legs, hands, and feet (commonly called a onesie) doesn't need a blanket for warmth as long as the room is a comfortable temperature.


  • If you do use a blanket, tuck it in. To prevent suffocation with a blanket, tuck it snugly under the sides of the crib mattress and at the foot. Babies like the feeling of being held firmly, or swaddled, while they sleep.


  • Co-sleeping can be safe if you take precautions. Many parents choose to sleep with their young infants. Some experts feel that co-sleeping increases the risk of SIDS; others argue that it decreases it. Their is no clear-cut right answer. If you co-sleep, take all the same precautions already mentioned (face up, no smoke, no soft surfaces, light clothing). If you are a naturally heavy sleeper, or use medications (or drugs or alcohol) that make it harder for you to wake from sleep, it's not safe to co-sleep. Instead, put your baby to sleep in a crib or cradle near your bed.

 RELATED INFORMATION
*  Co-sleeping
*  Myth: Vaccines Can Cause Sudden Infant Death Syndrome (SIDS)
*  Secondhand Smoke and Children's Health
*  Sleep: Why and How Much?
*  Health Promotion
*  Sleep: Specific Problems


Created December 01, 2001
Reviewed December 05, 2001
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