Sudden infant death syndrome (SIDS) was once called crib death. SIDS is an unexplained death of a healthy infant under 1 year of age that occurs during sleep. What could be more frightening to a new parent?
The good news is that pediatricians understand much more about SIDS than they once did, and they are doing a very good job of preventing it. One of the biggest discoveries was the very simple strategy of putting babies on their back for sleep.
The History of SIDS
Sudden death of babies during sleep has been recognized for centuries:
- In the early 1900s, sleep deaths were blamed on drunk mothers who rolled over on their babies. These were the days when most children shared beds with their parents.
- In 1905, a prominent pediatric journal blamed sleep deaths on cats snuggling up on a baby’s chest and suffocating the child. The myth of cats stealing a baby’s breath still lives in the imagination of some grandmothers.
- From 1943 to 1988, the official recommendation of pediatricians was to have babies sleep on their stomachs (front sleeping). This was partly due to the belief that babies sleeping on their backs might choke on vomit or regurgitation of feedings. We now know this was exactly the wrong advice.
- In 1989, the first official definition of SIDS was developed by the National Institutes of Health.
- Due to an accumulation of studies linking SIDS to front sleeping, The American Academy of Pediatrics (AAP) developed its first set of safe sleep recommendation in 1992. In 1994, these recommendations became the basis of the AAP Back to Sleep Campaign.
- In 2003, studies found that there was no link between SIDS and immunizations.
We now think that most SIDS deaths are caused by an incomplete development of part of the brain that controls sleeping and waking. SIDS is most common between ages 2 and 3 months. By one year, the danger is past. We also know some of the risk factors for SIDS. These include:
- Low birth weight, prematurity, or multiple birth (twins or more)
- A previous history of SIDS in a sibling
- Recent upper respiratory infection
- Boy baby (boys are at higher risk than girls)
- Sleeping on the back or stomach
- Sleeping on a soft surface
- Sharing a bed
- Being exposed to cigarette smoke
- Being born to a mother who did not get good prenatal care, is under age 20, a smoker, or a drug or alcohol abuser.
The best news is that you can do a lot to prevent SIDS. Since the AAP started putting out safe sleep recommendations, SIDS deaths have dropped from 130 per 100,000 babies in 1990 to 39 deaths per 100,000 in 2015.
Last year, the AAP released their latest recommendations. One of the major recommendations is to have your baby sleep in a crib in your bedroom for at least the first 6 months, even better for the first year. Studies show that room sharing decreases SIDS by 50 percent. Other recommendations for the first year of life include:
- Put your baby to sleep on his or her back. Once your bay is old enough to roll to the side or front, you don’t need to reposition. If your baby falls asleep in a car seat or stroller, transfer to a firm flat sleeping surface as soon as possible.
- Make your sure baby’s crib is firm and flat. Do not put blankets or cushioning under the sheet. The sheet should fit tightly on the mattress.
- Keep toys, stuffed animals, extra blankets, pillows, or pads out of the crib.
- If you can, breastfeed your bay exclusively for 6 months. After you start introducing foods at 6 months, continue breast-feeding for another 6 months.
- Do not smoke and do not let your bbay be exposed to secondhand smoke.
- Don’t let your baby get overheated while sleeping.
- If your baby will take a pacifier, offer a pacified at sleep time. Do not use a pacifier attached to clothing or stuffed animals.
- Make sure to keep all your well baby visits.