SIDS and safe sleep guidelines for babies

A sudden and silent medical disorder, sudden infant death syndrome (SIDS) is the leading cause of death among babies from ages 1 month to 1 year. SIDS most often occurs in babies between 1-4 months of age, with 90% of SIDS deaths occurring before 6 months of age. Fortunately, research has taught us ways to help reduce the risk of SIDS and save more babies' lives.

What causes SIDS?

Researchers don't know the exact cause of SIDS and it can happen to an infant who seems healthy. It affects boys more often than girls. It is believed that a combination of several conditions, including medical vulnerability, rather than a single risk factor, contributes to SIDS. Some contributing factors may include:

  • Problems with brain functioning: Some babies have problems with the part of the brain that helps control breathing and waking during sleep.
  • Differences in genes: Some genes and the environment may work together to increase risk.
  • Problems with heart functioning: Some studies found a link between heart function and SIDS.
  • Infection: Some babies who die from SIDS have respiratory infections before death.

SIDS is not the cause of every sudden infant death. SUID, or “sudden unexpected infant death,” includes all unexpected deaths: those without a clear cause, such as SIDS, and those from a known cause, such as suffocation. Unfortunately, there are no symptoms or warning signs of SIDS.

Who is at risk for SIDS?

Some risk factors for SIDS and other sleep-related deaths include:

  • Preterm birth and/or low birth weight
  • Sleeping on the belly and/or on a soft surface
  • Having a sibling who had SIDS
  • Not getting routine childhood shots/immunizations
  • Being around cigarette smoke
  • Sleeping with loose blankets, pillows or other objects
  • Sharing a bed with parents or siblings
  • Being too warm or overbundled

Babies are at higher risk of SIDS if their mother is young, didn’t breastfeed, received late or no prenatal care, and/or smoked, drank alcohol or used substances during pregnancy. 

What does safe sleep look like?

SIDS is sometimes called “crib death” because an unsafe sleep environment can increase the risk. In June 2022, the American Academy of Pediatrics (AAP) released updated safe sleep guidelines for babies, including no co-sleeping and crib safety guidelines. Get more information about safe sleep.

Remember these guidelines to reduce the risk of SIDS:

  • Do not co-sleep with your baby. Only put your baby to sleep in a safety-approved crib or bassinet — NEVER in bed with you or other children.
  • Have your baby sleep in your room, but in a separate crib or bassinet close to your bed, for at least for the first 6 months.
  • Always place your baby on his/her back for every sleep, including naps and at night. This AAP recommendation has since reduced the incidence of SIDS by almost one-half.
  • Use proper bedding. Place your baby on a firm, flat, non-inclined sleep surface that is covered only by a flat, tight-fitted sheet. Remove all pillows, comforters, bumpers, blankets and stuffed toys from the crib.
  • Do not let your baby get too hot (don't overdress). The room temperature should be cool and comfortable. Avoid overbundling or covering your baby’s face or head.
  • Don’t smoke! Always keep your baby in a smoke-free environment.
  • Offer your baby a dry pacifier (that’s not attached to a string) at naptime and bedtime. Wait until breastfeeding is well established (by 3-4 weeks) before offering a pacifier.
  • Try to breastfeed. Give your baby only your own milk for at least 6 months. Breastfeeding is associated with a reduced risk of SIDS.
  • Get trained in infant CPR. Make sure all your caregivers are trained.
  • Make sure your baby has regular checkups, including all recommended immunizations.
  • Get early and regular prenatal care, follow a healthy diet and don’t smoke or use alcohol or drugs while pregnant.
  • Avoid products that claim to reduce the risk of SIDS, as well as wedges, positioners, and any products such as baby rockers that have more than a 10 percent incline.
  • Give your baby plenty of supervised tummy time when he/she is awake.
  • Do not use home cardio-respiratory monitors as a strategy to reduce the risk of SIDS.
  • If swaddling, wrap your baby in a thin blanket and place on his/her back. When your baby exhibits signs of attempting to roll, swaddling is no longer appropriate because it could increase the risk of suffocation if swaddled baby rolls to the prone position.
  • Avoid parent and infant exposure to alcohol, marijuana, opioids and illicit drugs.

Everyone who cares for your baby should know the ways to reduce the risk of SIDS.

ABCs of safe sleep

Need help remembering all this information? The three most important items to remember are the ABCs of safe sleep:

  • Alone. Share your room with your baby, but not your bed. Babies need to sleep in their own sleeping place.
  • Back. Babies are safest sleeping on their back. They are not more likely to choke while laying on their backs.
  • Crib. Your baby’s sleeping place should be on a firm mattress. The sleeping place should be clear of blankets, pillows, stuffed animals, and crib bumpers.

Breastfeeding benefits and safety

Breastfeeding has many health benefits for mother and baby, including protection from SIDS. Babies who are breastfed or are fed breast milk from a bottle for the first 6 months are at lower risk for SIDS.

Be mindful of how tired you are before and during your baby’s feeding. Avoid couches and armchairs for breastfeeding if you think you might fall asleep. Have someone stay with you while you’re breastfeeding to keep you awake. When finished, put your baby back in a separate safe sleep area made for infants.

In addition, skin-to-skin contact with baby has many health benefits including better responses to stress, better nervous system functioning and more stable sleep patterns. It may even help to reduce crying. And it’s a great way to bond with baby.

Learn about safe skin-to-skin care with your baby.

SHARE Bereavement Program

If you have lost a child to SIDS, there are many resources to help you cope. The SHARE Program supports those who experienced the loss of a child through miscarriage, stillbirth or early infant death. For more information, call 630-527-3263. Learn more about SHARE.