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Sudden Infant Death Syndrome: How to Keep Babies Safe While Sleeping

baby boy asleep on his back in a crib A baby sleeps on his back in a crib that just has a fitted sheet on it and nothing more. To prevent SIDS, always place babies on their backs for naps and at nighttime with no extras in the sleeping space – no toys, bumpers, or blankets.

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More than 1,000 young babies die in their sleep every year in America due to Sudden Infant Death Syndrome, also known as SIDS.

It’s a terrifying thought for parents – the unexplained death of a seemingly healthy child less than a year old. The exact cause of SIDS remains unclear; doctors have been unable to fully explain the cause despite years of research.

However, there are several important precautions that parents of newborns can take to reduce the risk. Some of those safety measures for newborns include:

  • Always put a baby down to sleep on their back – not the stomach. 
  • Keep objects out of the crib or bassinette -- no pillows, no toys, no crib bumpers, no blankets.
  • Consider having the baby sleep in the same room as a parent – but never in the same bed. 

SIDS accounts for more than one out of three sudden or unexpected infant deaths in the United States each year.

For military families, the Family Advocacy Programs at military installations offer a New Parent Support Program, which can provide one-on-one advice at home. The program offers up-to-date parenting practices supported by the latest research.

Although the incidents of SIDS and other sleep-related infant deaths have decreased in recent years, it remains a risk that parents and other caretakers should be aware of.

Most SIDS deaths happen among babies who are between 1 and 4 months’ old, and 90% of SIDS deaths involve babies less than 6 months of age. However, SIDS deaths can happen anytime during a baby's first year.

Slightly more boys die of SIDS than girls but the reason for the gender difference is unknown, according to Dr. Stacey Frazier, a retired Air Force colonel who is now chief of inpatient pediatrics at William Beaumont Army Medical Center in El Paso, Texas.

A leading factor in SIDS is unsafe bedding, such as soft or loose blankets. “Some of the reason for SIDS may be overheating,” Frazier said, as “there is some evidence” that it affects a baby’s breathing.

SIDS also may result from some object in the crib or bassinet that restricts a baby’s ability to breathe as they move around in their sleep. Therefore, pediatricians recommend that “sleeping babies have no pillows, no toys, no crib bumpers, no blankets – nothing that can be pulled over the head,” Frazier said.

There are special sleep sacks that can be used so that a baby cannot pull an item over his or her head. The sleep sacks are used in the maternity wards of some military hospitals.

One hard rule that must be followed: Babies should never sleep in the same bed as their parents, also known as “co-sleeping,” said Dr. Rita Moreck, the chief of outpatient pediatrics at Fort Bliss’s Hugo V. Mendoza Soldier Family Care Center in Texas. Babies should be in a separate crib or bassinet next to a parent’s bed. She said she regularly has to emphasize that directive to parents, and that co-sleeping still is a cause of sudden unexpected infant death.

Pacifiers during the night and sleeping in the same room with a parent are also recommended to reduce the potential for SIDS.

Babies should sleep in the same room as a parent for at least six months, or, ideally, until they are a year old. “There may be some protective effect” from a pacifier and the presence of others in the room that keep a baby’s brain more alert, Frazier said, “and a little bit more arousable.”

The baby’s sleeping space should have a hard flat surface and a mattress that meets Consumer Product Safety Commission standards, Moreck explained. Only a fitted sheet should be used on the surface, with no additional sheets or blankets, she added.

Breastfeeding your baby is important for many reasons. Frazier said there are theories that SIDS is caused by some minor viral illness, and breastmilk has all the necessary antibodies to provide protection. 

Recommendations from the American Academy of Pediatrics on how to reduce the risk of SIDS are one of the most cited sources of information for parents. The AAP recommendations include:

  • Do not smoke during pregnancy, and do not smoke or allow smoking around your baby. 
  • Do not drink alcohol or use illegal drugs during pregnancy.
  • Visit the baby’s health care provider for regular well-baby checkups and vaccinations to prevent disease. Evidence suggests that immunizations can reduce the risk of SIDS by up to 50%.

Finally, there are many myths about SIDS:

  • SIDS is not caused by vaccines, immunizations, or shots
  • SIDS is not contagious
  • SIDS is not caused by cribs
  • SIDS is not caused by vomiting or choking

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