Family Health Guide

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SIDS: Reducing the Risk

Experts say many new parents think SIDS can’t happen to them. Or, they believe that since you can’t do anything to prevent it, why worry about it? While parents shouldn’t drive themselves nuts with worry, there are some ways to reduce the risk:

The first line of defense: Put your baby to sleep only on his back—every time he sleeps, including every nap. Provide “tummy time” every day when your baby is awake and someone is watching—it’s a good way to help her strengthen her muscles. It’ll also help to prevent excessive flattening of the head (plagioscephaly).

The AAP has made these recommendations as well:

Don't use crib bumpers. In 2011, the AAP expanded its safe sleep guidelines to advise against using bumpers. According to the AAP, there is no evidence that bumpers protect against injury, but they do carry a potential risk of suffocation, strangulation, or entrapment because infants lack the motor skills or strength to turn their heads should they roll into something that obstructs their breathing.

Let your baby use a pacifier when he’s sleeping.  Experts aren’t sure why a paci seems to protect babies from SIDS, but they suspect it helps keep airways open, changes the sleep state of the baby. Up to 6 months, the paci can add protection. If your baby’s not into the binkie, don’t force the issue; it may take a while before she accepts it. 

Ditch the soft stuff. There is also a strong relationship between a soft bedding surface, and SIDS and suffocation. Never place your baby to sleep on pillows, quilts, sheepskins, or other soft surfaces, like sofas, cushions, or waterbeds.  Also, keep soft toys and loose bedding out of your baby’s sleep area.

Avoid overbundling—or cranking the thermostat.  Keep the room where your baby sleeps a comfortable-to-you temperature. The baby should have no more than one layer beyond what the grown-ups are wearing (and remember, no wrapping baby in loose blankets). Note: babies lying on the stomach are not able to dissipate body heat as easily as a baby on its back—yet another danger of stomach sleeping. 

Enforce a no-smoking rule in your home. Yes, we know how uncomfortable it can be when family or close friends are smokers, but put your foot down and ask them to go outside for the sake of your baby. Researchers think nicotine and other chemicals in cigarette smoke may blunt the brain’s response to a suffocation threat in the infant’s environment; the more exposure, the greater the risk to baby.  And of course, don’t smoke during pregnancy.

Keep him close early on. The baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing). Several studies have revealed that an infant sleeping in the same room as her mother, with easy access to breastfeeding (also shown to lower the chances of SIDS) and physical contact, has a reduced risk.  But letting your baby sleep in your actual bed increases risk. If you nurse your baby in bed, you can cuddle together and even let him fall asleep there, but put him in his own safe sleeping space before you go back to sleep. After 6 months, he can sleep in his own room.

Breastfeed. There is very strong evidence that has come out in recent years showing a clear-cut benefit to reducing SIDS risk by breastfeeding.  AAP encourages mothers to exclusively breastfeed through first 6 months when possible, and continue through the first year of life.

Avoid side sleeping.  Infants in this position are unstable, and can easily turn over, ending up on their stomachs. The increased risk of death is just as high as from stomach sleeping.

Be vigilant about daycare. Establish with your caregivers on the very first day that you want your baby on her back every time.

Put preemies on their backs, too. Some are kept on their tummies or sides in the neonatal intensive care unit to ease their breathing. But once they go home, it's time to switch to back sleeping.