Helping infants sleep safely

EDWARDS AIR FORCE BASE, Calif. – October is Sudden Infant Death Syndrome Awareness Month. Pediatricians make it a point to discuss how SIDS can be prevented at all newborn and infant wellness visits.

Since 1992, when the American Academy of Pediatrics began the “Back to Sleep” campaign, the annual rate of SIDS has dramatically gone down compared to previous years. By adopting policies encouraging non-prone sleeping the first year of life, other countries have seen similar reductions in cases during the same time period. Sadly, it remains the leading cause of infant mortality in the United States.

Sudden Infant Death Syndrome was first defined in the late 1960s. It describes the sudden death of an infant “under one year of age which remains unexplained,” despite a thorough investigation.

The syndrome has also been known as “crib death” or “cot death.” It is currently theorized accidental suffocation may be a cause of, or significant factor in, most sleep-related cases of SIDS. It is also felt infants who were victims of SIDS most likely had an unidentified vulnerability (such as genetic or brain abnormalities).

Studies have established that SIDS more commonly affects infants who are born prematurely or whose mothers did not get regular prenatal care. Studies have also shown there is no increased risk of SIDS associated with vaccines. In fact, since the mid-1980s, while the number of available vaccines has risen steadily, more than halving the number of SIDS cases.

Parents can do several things to prevent SIDS from affecting their children. No monitoring system or test yet exists to accurately predict a baby’s risk. But several strategies now have a proven track record over several decades.

During pregnancy, it’s best if the mother receives regular prenatal care and abstains from smoking. After the birth, it’s safest for babies to be placed on their backs to sleep. Room-sharing, but not bed-sharing, is recommended, as it is shown to decrease the risk of SIDS. A firm sleep surface, free of soft objects such as stuffed animals and pillows, is optimal for keeping the child’s airway free and reducing the risk of overheating.

It’s helpful to remember, the guiding principles behind the safe sleep (“Back to Sleep”) practices are: keep the infant’s airway free from obstruction; don’t do anything to decrease the child’s arousal, which overheating can do.

Additional recommendations for parents: do not smoke; do not use car seats, strollers or swings routinely for sleep. If the child falls asleep in one of these devices, they do not need to be woken up and removed, but should be supervised by an adult.

Other factors shown to protect against SIDS are breastfeeding; a fan in the bedroom, or maintaining a temperature of about 65 degrees Fahrenheit in the bedroom when the child is sleeping to avoid overheating and diminishing the child’s arousal.

The use of a pacifier is also recommended. It is believed the pacifier decreases the risk of SIDS by maintaining an open airway, thus decreasing the chance of suffocation.

Home monitors are not recommended because studies show them to be ineffective and often inaccurate, which can become a significant cause of unnecessary stress for parents.

Unfortunately, SIDS still affects approximately 4,000 infants a year in the U.S. But this is much less than annual rates predating the campaigns strongly recommending the safe sleep practices described above.

If you would like to learn more about SIDS and safe sleep, visit your baby’s pediatrician for regular well visits. You can also learn more by visiting sids.org/.