SIDS and safe sleep are both topics that you wish parents didn’t have to go through but topics that all parents need to be aware of. This extremely dangerous condition impacts nearly 4,000 babies each year in the United States alone and remains mostly unexplained.
This article explains what SIDS is, reducing the risks, and when parents can stop worrying about it affecting their child.
Jump to Sections:
- What is SIDS?
- What Causes SIDS?
- Ways to Help Reduce the Risks of SIDS
- When You Can Stop Worrying About SIDS
- Our Take
- Sources & Further Reading
What Is SIDS?
SIDS, or Sudden Infant Death Syndrome, is a mostly unexplained condition that causes death in known-to-be healthy children under one-year-old.
This typically occurs during sleep, which is why the condition has been called “crib death”. I fully understand that this topic is hard to discuss, especially having a six-month-old myself, but I feel that SIDS is extremely important to understand and spread awareness on.
SIDS is a sub-category for SUIDs, which is Sudden Unexpected Infant Death. Once investigations and data have been collected and no clear cause of infant death can be concluded, only then is it categorized as SIDS. Most Medical Examiners, however, prefer to use the term “unexplained sudden death in infancy”, so most of the research that I have done has used that term in place of SIDS for research and documentation continuity.
SUID is responsible for nearly 4,000 infant deaths each year, in the United States alone. The SUID rate has been broken down into three subcategories: SIDS, suffocations and/or strangulations, and unknown. SIDS is responsible for 41%, accidental suffocation and strangulations account for 27%, and the remaining 32% are unknown.
Unknown cases are any cases that display the qualifying factors for SIDS, but the health of the baby before death was not known and could not be determined. The CDC associates this number with infants who are not seen regularly by a pediatrician and have limited medical records.
What Causes SIDS?
As stated before, SIDS is very unexplained, so the actual understanding of its causes is still up for debate. Since the early 90s we have seen a down-trend in SIDS-related deaths, but a slight up-trend in accidental suffocation and strangulation-related deaths, starting to rise in the early 2000s.
The American Academy of Pediatrics believes that this is caused by awareness of SIDS/SUID, but a flooded market of crib and bed accessories for infants and babies. While we still do not have a true grasp on the causes of SIDS, we do know what causes strangulations and suffocations during sleep: using toys, blankets, and crib bumpers that directly go against pediatrician recommendations.
There are many factors associated with SIDS-related deaths each year. Some are outside of a parent’s control and some are well within control.
Factors Not In Your Control
Birth Weight
During the first few days and weeks after your baby is born their weight will fluctuate a lot. You should however speak with your pediatrician when you notice that weight fluctuation not coming back up. Babies with low birth weights are historically at a much higher risk of SIDS. This is most common in premature babies and babies that have experienced some sort of birth complication.
Respiratory Infection
Babies that are born with medical complications and issues with their respiratory system are at a higher risk for SIDS.
Brain Issues
Infants born with abnormal or slowly-developing brain stems, the section of the brain responsible for automatics functions like breathing and heart rate, are at a greater risk of being affected by SIDS. This brain stem condition is, like birth weight, typically associated with premature and complicated deliveries.
Factors In Your Control
Stomach Sleeping
Before 1995, advice would have been given to ensure that your baby was stomach sleeping. This was due to research that discovered infants were far less likely to choke on their spit-up in this position. This advice has since changed. Now parents are urged to ensure that their baby is sleeping on their back. This is due to newer research by the AAP that shows that prone sleeping can lead to overheating and increase the chances of hypoxia. Babies should always be placed on their backs for sleep.
Cozy Sleeping
As much as we want to make our baby cozy during sleep, research shows that blankets, toys, and even crib bumpers can cause suffocation. It is better to swaddle them or make the temperature cozy for them.
Sleeping In A Parent’s Bed
Letting your baby sleep in the bed with you, also called co-sleeping, can be extremely dangerous for them. Depending if you toss and turn, you could injure your baby. The number of pillows and blankets/comforters can also play into this negative effect on your child.
Related Post: Why Is My Baby Fighting Sleep?
Ways To Help Reduce the Risks of SIDS
Even though we do not know what causes SIDS exactly, researchers are aware of plenty of contributing factors. Taking these into account when you put your baby down for sleep can benefit them greatly when it comes to combating SIDS.
Infant Sleep Position
As stated previously, changing from pre-1995 advice, all babies should be placed on their backs for sleep. This can alleviate concerns of hypoxia, and reduce the chances of overheating and suffocation. Babies will eventually learn to roll over. When they can roll left and right, still place them on their back, but know that if they roll to their stomach in their sleep they are okay. They have gained the ability to support themselves lying down and are at much less of a risk for suffocation and any other concerns in the prone position. All babies should continue to be placed on their backs until they are around one year old.
Sleep Surfaces
Any bed or crib purchased should be vetted and approved by the CPSC (Consumer Product Safety Commission). The CPSC recommends using a flat, firm mattress with a tightly fitted sheet. No other bedding should be placed on the mattress. Other bedding (such as blankets or pillows) only increases your infant’s risk of SIDS or suffocation during sleep. Firm mattresses eliminate the chance of your newborn’s head sinking, even if ever so slightly, into the material which can lead to suffocation. Firm mattresses have also been researched to provide a much cooler temperature as the material does not “mold” to the baby, creating a sort of cushion barrier that traps heat.
Please be aware that some companies are selling angled beds claiming that the angle is beneficial for newborns. There is no evidence to support this. The CPSC has found that any bed with a large angle is detrimental for newborns, as it increases the chances of rolling over before they are ready which can lead to suffocation.
Check here to ensure that your product has not been recalled and still meets the CPSC’s standards.
Sleep Location
The recommendation is that all infants sleep in their parent’s bedrooms on their sleeping surfaces for at least the first six months, but highly recommended to go until the first year. This can be a crib, bassinet, or any other CPSC-approved baby bed. This allows you to closely monitor their sleeping, learn their sleeping patterns and movements, and be more aware if complications arise that require you to notify your pediatrician.
Tummy Time
Tummy time is a great way to facilitate your baby’s development. This supervised time allows them to develop motor skills, increase head and neck stability, and alleviate the chances of developing positional plagiocephaly, also known as Flat Head Syndrome. Flat Head Syndrome is when your baby spends too much time in one sleeping position and improper head growth is the result. The muscles they strengthen through tummy time allow them to control head movement and they are less likely to keep it in one position while resting. Increasing head stability alone can greatly reduce the risks.
Related Post: Kangaroo Care
Room Temperature
Your newborn’s temperature plays a huge part in sleeping, development, and unfortunately, the chances of SIDS. Keeping your child in a balanced temperature environment and ensuring that their clothes are not too hot or too cold, can keep SIDS at bay. Clothing and bedding play a major role in this, but fans and air conditioning within your home can also hurt, or possibly even hurt, your baby. This one is easy to set up, but ensure you are altering your strategy as your baby changes and as seasons come and go.
When You Can Stop Worrying About SIDS
“Although there are many illnesses that parents cannot control, they are luckily extremely rare. Parents should take great comfort if they are providing their infant with a safe sleeping environment.”
Dr. Bernstein of the American Academy of Pediatrics
The AAP’s data shows that past six months, the likely hood of SIDS affecting your child is very rare. Cases that involve infant deaths past six months are typically related to accidents involving your child’s newfound mobility.
As your baby begins to roll, wiggle, crawl, or even walk, be sure that their sleeping area is free of any dangers. This is where baby-proofing your house comes into play. Hammering home a huge topic, the AAP suggests keeping extra bedding, pillows, toys, bumpers, etc., away from your child’s bed for the first year.
“They may have the ability to play with toys (under supervision), but more times than not the motor skills displayed unsupervised are not enough to keep them completely safe.”
APA (2022)
Our Take
During those first six months be sure to be aware of factors causing SIDS and mitigate those that are in your control. Discuss with your spouse/partner different ways to stay focused on SIDS as a cause of concern. Communication is a big key, so being on the same page as a family is always a great start. When you do have concerns or notice things while your infant is sleeping, make sure to bring them up to your pediatrician. They will be able to give you suggestions that best fit your situation.
For any questions please visit www.aap.org and be sure to contact your pediatrician for all baby-related concerns.
Sources & Further Reading
Sources
CDC/NCHS, National Vital Statistics System, Mortality Files. Rates calculated via CDC WONDER
Moon RY. Task Force on Sudden Infant Death Syndrome, SIDS and other sleep-related infant deaths: updated 2016 recommendations for a safe infant sleeping environment. Pediatrics. 2016;138(5):e20162938
Bundock EA, Corey TS, eds. National Association of Medical Examiners’ Panel on Sudden Unexpected Death in Pediatrics, Unexplained Pediatric Deaths: Investigation, Certification, and Family Needs. San Diego, CA: Academic Forensic Pathology International; 2019
Centers for Disease Control and Prevention. Sudden unexplained infant death investigation reporting form (SUIDIRF). Available at: www.cdc.gov/SIDS/SUIDRF.htm. Accessed June 1, 2022
NICHD, National Institutes of Health. Safe to sleep campaign. Available at: www.nichd.nih.gov/sts/Pages/default.aspx. Accessed June 1, 2022
NICHD, National Institutes of Health. Fast Facts about SIDS. Available at: safetosleep.nichd.nih.gov/safesleepbasics/SIDS/fastfacts. Accessed June 1, 2022
Further Reading
Shapiro-Mendoza CK, Tomashek KM, Anderson RN, Wingo J. Recent national trends in sudden, unexpected infant deaths: more evidence supporting a change in classification or reporting. Am J Epidemiol. 2006;163(8):762–769
Fu LY, Colson ER, Corwin MJ, Moon RY. Infant sleep location: associated maternal and infant characteristics with sudden infant death syndrome prevention recommendations. J Pediatr. 2008;153(4):503–508
Erck Lambert AB, Parks SE, Cottengim C, Faulkner M, Hauck FR, Shapiro-Mendoza CK. Sleep-related infant suffocation deaths attributable to soft bedding, overlay, and wedging. Pediatrics. 2019;143(5):e20183408
Sowter B, Doyle LW, Morley CJ, Altmann A, Halliday J. Is sudden infant death syndrome still more common in very low birthweight infants in the 1990s? Med J Aust. 1999;171(8):411–413
Disclaimer
All data shown in this article was researched thoroughly using scholarly journals, reports, research, and pediatric reviews, but I am not a medical professional. This article just allows readers to better grasp complicated research reports conducted by the AAP. For questions regarding the information below, please read our sources or contact your healthcare provider. Any questions regarding your child should always be brought to their pediatrician.
