Parents who know about SIDS may think of it as their worst nightmare. Sudden infant death syndrome is known as SIDS or crib death. It’s when a baby 12 months or younger dies during sleep with no warning signs or a clear reason.
Although there is no 100% way to prevent SIDS, there is a lot you can do to lower your baby’s risk. Since the American Academy of Pediatrics issued its safe sleep recommendations in 1992 and launched its "Back to Sleep" campaign in 1994, the SIDS rate has dropped dramatically. That year, the SIDS death rate was 103 per 100,000 live births, compared to 35 per 100,000 live births in 2018.
Put a Sleeping Baby on Their Back
Your baby’s risk of SIDS is much higher any time they sleep on their side or stomach. (A baby placed on their side can roll over on their stomach.) These positions put your baby’s face in the mattress or sleeping area, which can smother them.
So, every time you put your baby in their bed to sleep -- for naps, at night, or any time -- lay them down on their back. Don’t let them sleep in a stroller, car seat, baby seat or swing for a prolonged period of time. Get them out and lay them on a flat surface or bed.
Tell anyone who takes care of your baby how essential it is to lay your sleeping baby on their back each time. That includes grandparents, babysitters and childcare providers, older siblings, and others. They may think one time won’t matter, but it can. When a baby who usually sleeps on their back is suddenly laid on their stomach to sleep, the risk of SIDS is much higher.
If you’re worried your baby might choke while sleeping on their back, don't be. Choking is very rare, and healthy babies tend to swallow or cough up fluids automatically. If you’re concerned, ask your pediatrician about elevating the head of your baby's bed.
Once your baby can roll over both ways, which usually happens around 6 months, they may not stay on their back. That’s OK. It’s fine to let them choose their own sleep position once they know how to roll over.
Firm Bed, No Soft Toys or Bedding
To prevent smothering or suffocation, always lay your baby down to sleep on either a firm mattress or surface in a crib or bassinet. All your baby’s crib needs is the fitted sheet -- don't put blankets, quilts, pillows, sheepskin, stuffed toys, or crib bumpers in your baby's crib.
To confirm the safety of your baby's mattress or crib, contact the Consumer Product Safety Commission at 800-638-2772 or www.cpsc.gov.
Don't Smoke Around Your Baby
If you smoke, here's a huge reason to stop before you get pregnant: Babies born to women who smoked during pregnancy die from SIDS three times more often than babies born to nonsmokers. Smoking when you're pregnant is a major risk factor for SIDS, and secondhand smoke around your infant also increases the chances of SIDS. Don't let anyone smoke around your baby.
Keep Your Sleeping Baby Close, but Not in Your Bed
When a baby sleeps in the same room as mom, studies show it lowers the risk of SIDS. But it's dangerous for a baby to sleep with another child or an adult in the same bed, in an armchair, and on a couch.
If you bring your baby into your bed for comforting or breastfeeding, be sure to put the baby back in their own cradle, bassinet, or crib when you're ready to sleep. If you are tired, don’t breastfeed while sitting in a chair or on a couch in case you fall asleep.
Never bring the baby to bed with you when you're very tired or using medicines that affect your sleep.
Breastfeed as Long as You Can
Breastfeeding your baby can lower the risk of SIDS by as much as 50%, though experts aren't sure why. Some think breast milk may protect babies from infections that raise their SIDS risk. Do not drink alcohol if you breastfeed, because that raises your baby’s risk of SIDS. In addition, the simple touch is helpful. Skin-to-skin contact is important for your baby’s development.
Immunize Your Baby
Evidence shows babies who’ve been immunized in accordance with recommendations from the American Academy of Pediatrics and the CDC have a 50% reduced risk of SIDS compared with babies who aren’t fully immunized.
Putting your baby to sleep with a pacifier may also help prevent SIDS, though researchers aren't sure why. There are a few tips to follow when using a pacifier:
- If you're breastfeeding, wait until your baby is breastfeeding regularly (at least 1 month old) before starting to use a pacifier. Introducing a pacifier too soon can lead to nipple confusion and cause your baby to prefer the pacifier's nipple over your own.
- Don't force your baby to take the pacifier if they don't want it.
- Put the pacifier in your baby's mouth when you put them down to sleep, but don't put it back in their mouth after they fall asleep.
- Keep the pacifier clean, and buy a new one if the nipple is damaged.
- Don't coat the pacifier with honey, alcohol, or any other substance.
Keep Your Baby From Overheating
Because overheating may raise a baby's risk of SIDS, dress your infant in light, comfortable clothes for sleeping, and keep the room temperature at a level that's comfortable for an adult.
If you're worried about your baby staying warm, dress them in a "onesie," pajamas that cover arms, legs, hands, and feet, or place them in a "sleep sack" (a wearable blanket). However, don't use a regular blanket -- your baby can get tangled in it or pull the blanket over their face.
Steer Clear of Products That Claim to Reduce the Risk of SIDS
It's best to avoid any product that says it can lower your baby's risk of SIDS, because they haven't been proven safe or effective. Cardiac monitors and electronic respirators also haven't been proven to reduce SIDS risk, so avoid these, too.
Don't Give Honey to an Infant Under 1 Year Old
Because honey can lead to botulism in very young children, never give honey to a child under 1 year old. Botulism and the bacteria that cause it may be linked to SIDS.
Remember, your baby's health care provider is always available to answer any questions you have about SIDS, SIDS prevention, and keeping your baby warm, happy, and safe.