Sudden Infant Death Syndrome (SIDS) is the leading cause of infant mortality in the United States. Approximately 3500 infants in the United States die each year suddenly from sleep-related deaths, including SIDS. Although often there is no identified cause of these tragic and unexpected deaths, there are precautions we can take to help keep our babies safe.
What is SIDS? Sudden unexpected infant death (SUID) describes the unexpected death of an infant less than 1 year of age. A subset of these deaths are unexplained after further investigation and are subsequently classified as SIDS. In the United States, SIDS occurs in approximately 1 in 1000 live births.
Who is at risk? All infants less than one year of age are at risk for SIDS. What’s more, African American and Native American/Alaskan children are at even greater risk, approximately 2-3 times higher risk than the average infant in the United States. For African American families there were 181 deaths for non-Hispanic Blacks per 100,000 live births in 2013-2016, compared to 52 for Hispanics and 85 for non-Hispanic Whites. For our pregnant mothers, factors that increase the likelihood of SIDS include young maternal age, maternal smoking, and a lack of prenatal care (delayed care, or a lack of access to prenatal care). Risk factors for SIDS include infants born premature or small for gestational age/low birth weight, infants sleeping on their stomachs, sleeping on a inclined surface (not flat), sleeping on a soft surface with loose blankets, crib bumpers, and pillows, and co-sleeping (infants sharing a bed with their parents).
What efforts have we made to protect infants from SIDS? Sleep position is one of the most important and modifiable risk factors that can help to protect our children from SIDS. The Back to Sleep campaign (now better known as the Safe to Sleep campaign) was started to promote safe sleep for infants. This campaign is focused on educating families about safe sleep habits. In 1992, the American Academy of Pediatrics recommended that all infants be placed on their backs for sleep. As a result of this recommendation, the incidence of SIDS decreased by 50%.
What can you do?
- Back to sleep. All babies should be placed on their back to sleep until they are one year of age. Avoid side sleeping and prone sleeping. Rest assured that sleeping on their back does not increase your baby’s risk of choking. Babies have protective mechanisms in their airway anatomy that protect them from choking.
- Use a firm flat sleep surface. The safest sleep furniture for your baby is a flat, firm mattress with a tight-fitting sheet. Unsure what to buy? Check to see if your crib or bassinet meets safety standards set by the Consumer Product Safety Commission (www.cpsc.gov). Avoid loose blankets, pillows, crib bumpers, and stuffed animals to reduce the risk of SIDS, suffocation, and strangulation.
- Room-sharing is recommended, but bed-sharing is not! When nursing, it makes sense to bring your baby in bed to feed or comfort. However, when feeding is over, SIDS risk is reduced when the back is placed in their crib and back on their back.
- Avoid smoking exposure during pregnancy and after your child is born. Also, keep your baby safe from smokers by keeping your home and car smoke-free.
- Pregnant women should receive routine prenatal care. And when the baby is born, be sure to see your pediatrician for baby’s well-child checks.
- Breastfeeding may be protective against SIDS. The American Academy of Pediatrics recommends exclusively breastfeeding for 6 months and continuing for at least 12 months.
Stay updated on safe sleep guidelines and inform your baby care team (babysitters, partners, grandparents, etc.). Brochures and printouts are available here: https://safetosleep.nichd.nih.gov/ A specific kit for African American families is available here: https://www.nichd.nih.gov/sites/default/files/publications/pubs/documents/SIDS_resourcekit_rev.pdf