SIDS - Reducing the Risk

There are few things as tragic to the parents of a new baby as SIDS or Sudden Infant Death Syndrome. Unfortunately, even with all that has been done in recent years to raise awareness about how to reduce the risks of SIDS, we still don't know all of the risk factors and SIDS remains the leading cause of death for infants outside the newborn period.

Although the rate of SIDS has fallen greatly in recent years, an updated policy statement from the American Academy of Pediatrics, although a little controversial, will hopefully help to reduce the rate of SIDS even more.

Reducing the Risk of SIDS

The biggest gains in reducing the rates of SIDS has come from reducing known risk factors, especially with the recommendations that all babies be put to sleep on their back - the 'Back to Sleep' campaign that began in 1994. Since then, the rate of SIDS has decreased by just over 50 percent, but remains at a steady rate of about 0.57 deaths per 1000 live births.

Part of the reason that SIDS is still a problem is that experts just don't know all of the things that put a baby at risk, but there are some measures to avoid risk factors that parents and other caregivers simply aren't practicing. For example, about 10 to 20 percent of parents still put their babies to sleep on their stomach and many child care centers aren't aware of the importance of back sleeping.

SIDS Facts

SIDS, also known as 'cot death' or 'crib death,' is usually defined as the sudden and unexplained death, even after a careful and complete investigation, of an infant under 1 year of age.

According to the AAP, other facts about SIDS include that it:

• is rare during a baby's first month of life
• peaks when an infant is 2 to 3 months old
• is associated with the following risk factors:
  • prone (stomach) sleeping
  • babies who sleep on a soft surface, including using a pillow, soft mattress, soft bedding, etc.
  • having a mother who smoked during her pregnancy
  • having a mother who had late or no prenatal care
  • getting overheated
  • young maternal age
  • preterm birth and/or low birth weight
  • male gender
• is more common in black and American Indian and Alaska Native children
• is a little more common during colder months of the year
• may be less common in babies who use a pacifier

New SIDS Recommendations

Although many of the recommendations to reduce the risk of SIDS have been well known for some time, in its new policy statement, the AAP makes a stronger statement against two risk factors, side sleeping and cosleeping, and endorses pacifier use, which may protect babies from SIDS.

While the original Back to Sleep SIDS' policy statements emphasized that you shouldn't put your baby to sleep on his stomach, it really didn't discourage side sleeping. Even when the policy was later revised, it was felt that side sleeping was still safer than sleeping on their stomach, although sleeping on their back was still safest for a baby. The latest recommendation from the AAP encourages parents and other caregivers to always put babies to sleep on their back, since many babies on their side can roll over on their stomach. If your younger baby doesn't sleep well on their back, you might try to swaddle them in a blanket or buy a special swaddling blanket if you can't get the hang of swaddling on your own.

The AAP's recommendation against cosleeping and bedsharing is likely to be the most controversial, but since many studies have found it 'is more hazardous than infant sleeping on a separate sleep surface and, therefore, recommends that infants not bed share during sleep.' Instead, the AAP recommends a separate bassinet, crib, or cradle, close to the parent's bed in the same bedroom.

The use of a pacifier is also likely to be a little controversial, since many parents probably thought they were supposed to discourage their kids from getting hooked on a pacifier. Many experts actually think a pacifier is a good way to help a baby soothe herself though and is only a problem if it interferes with breastfeeding. To avoid any breastfeeding problems, the AAP recommends that you wait until you baby is at least a month old and then only offer the pacifier at sleep times, but don't reinsert it once your baby falls asleep.

To reduce a baby's risk of SIDS, the AAP also recommends that:

• babies be put to sleep on a firm crib mattress that is covered by a sheet, without any soft objects, loose bedding, pillows, stuffed toys, or any other soft objects in the crib
• mothers not smoke during pregnancy and not expose infants to second hand smoke
• you avoid letting your baby get overheated when he is sleeping
• you not use devices that claim to reduce the risk of SIDS or a home monitor
• you make sure that all caregivers are aware of these recommendations to reduce the risk of SIDS