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SIDS: A Safe Sleep Environment is Only One Part of Prevention

The Short of It

A new study shows that creating a safe sleep environment for babies is not the only factor when it comes to preventing SIDS.

The Lowdown

We already know a baby's safe sleeping environment is crucial to preventing sudden infant death syndrome (SIDS). But apparently, it's not the only factor, according to a new study published today in the journal "Pediatrics."

"It is true without any qualification that it is safest for babies to sleep on their backs," said Richard Goldstein, MD, lead author of the study and a pediatrician at Boston Children's Hospital Dana-Farber Cancer Center told Health Day. "This study raises the question of other factors being critical in declining SIDS rates, not just sleep environment. The 'Back to Sleep' campaign has been one of the most successful public health campaigns of our time. But the sleep environment is not the whole story. These days, most infants diagnosed with SIDS are not found sleeping prone [on the belly]."

He's right. While the rate of SIDS in the United States has taken a major downturn since the early '90s, when the American Academy of Pediatrics first recommended placing babies on their backs to sleep, and when the importance of reducing suffocation hazards like soft bedding in cribs was brought to light, there are still cases in which parents have done everything right and their babies die from SIDS.

The new study sheds some light on this. According to the findings, there are three major elements that contribute to a baby's overall risk of SIDS. First, there are certain intrinsic factors—like being born prematurely or being exposed to smoking in the womb—that can make infants more vulnerable. Second, infants who die of SIDS tend to be in a critical period of development; those younger than 6 months old being at the greatest risk. And third is the sleeping environment, which includes the position they sleep in and the type of bedding in the crib.

Goldstein said that one theory on SIDS is that it involves a "triple risk," meaning all three major elements are at play: SIDS strikes when infants with an underlying vulnerability face an external stressor (like belly sleeping) during a critical period of development.

The Upshot

Reseachers have long been trying to figure out exactly what causes SIDS—like, for example, the theory that links it to inner ear dysfunction. But while the phenomenon is far less common today than it was 30 years ago, there has been little recent progress.

"We've hit a plateau," Goldstein said. "And if we're going to get any farther, we need to better understand the factors that make children vulnerable. SIDS is still a mystery, and we need to apply science to try to explain it."

In the meantime, the study authors say you can do some things to reduce the risk of SIDS: get early prenatal care, avoid tobacco smoke and create a safe sleeping environment for your baby.

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