Top 10 Questions About sleep

Stopping SIDS

Sudden Infant Death Syndrome (SIDS) is the death of an infant, frequently while sleeping, which cannot be explained after an autopsy and extensive examination of the place of death. A baby’s risk for SIDS is low during the first month of life and peaks between 2 and 3 months of age, and almost all SIDS deaths occur before 6 months of age, with 10 percent occurring between the ages of 6 months and 1 year. Boys, African-American and American Indian babies and babies whose parents smoke are at highest risk.

Since the American Academy of Pediatrics (AAP) released its first SIDS-prevention guidelines in 1992, the death rate has been cut in half. However, SIDS continues to be the leading cause of death in infants 1 month to 1 year of age, claiming about 2,000 lives each year in the United States, according to the AAP. Last year, the AAP updated its SIDS-prevention advice as follows:

• All babies should be placed on their back to sleep, not on their side or stomach.
• Babies should sleep in their own crib in their parents’ room.
• Bedding should be minimal—just a firm mattress covered by a sheet. Excessive blankets, stuffed animals and pillows should be kept out of the sleeping space. Bed-sharing is not recommended.
• Pacifiers are now recommended to be offered (not forced) when the baby is put down to sleep but not to be replaced once the baby falls asleep. For breastfeeding babies, pacifiers should be used after 1 month of age to ensure that breastfeeding is well established.
• Babies should be dressed comfortably but not too warmly while sleeping to avoid overheating.
• Devices such as home monitors and positional aids are not proven to decrease the risk of SIDS.
• To avoid flattening of the back of the head, give your baby tummy time Hold him upright when he’s awake, and alternate the side of the head he sleeps on each week. Avoid frequent use of carseat carriers and bouncy seats.
• All caregivers (babysitter, daycare provider, friend, relative, etc.) should be aware of these guidelines since 20 percent of SIDS deaths occur when a baby is in nonparental care.

Katherine Finn Davis, PHD, RN, CPNP, is a pediatric researcher at the Emory University School of Medicine in Atlanta, specializing in infectious disease and sleep. She has authored numerous articles and book chapters on pediatric sleep issues.

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