Safest Sleep for Your Baby

The American Academy of Pediatrics first recommended that babies  sleep on their backs in 1992.  This campaign, known as “Back to Sleep”, was a major breakthrough in protecting babies from Sudden Infant Death Syndrome, or SIDS.

SIDS describes the sudden death of an infant less than one year of age that remains unexplained after a thorough evaluation and autopsy.  This has sometimes been referred to as “crib death”.  Two to four months of age is the highest risk period for SIDS, with more than 90% of cases occurring before 6 months.

In the 1980’s, before Back to Sleep, more than 1 out of every 1,000 babies in the United States would die from SIDS.  After the Back to Sleep Campaign was launched, this number steadily decreased until the risk had been cut in half!  Since the early 2000’s, however, the rate has stayed the same.  Approximately 3500 babies still tragically die from SIDS every year in the U.S., more than from any other cause between one month and one year of age.

Thankfully, there are steps that every parent can take to protect their baby from SIDS.  More than 95 percent of cases occur when one or more risk factors are present, many of which are modifiable.

Some risk factors are maternal.  Maternal smoking and late or no prenatal care both increase the risk for SIDS.  It is important to avoid smoking before and after delivery, and to ensure good prenatal care.

There are also infant and environmental risk factors for SIDS. Special care should be taken with premature babies, who are at higher risk.  Here are steps parents should take to ensure safe sleeping:

1. Always place a baby on the back for sleep, whether for naps or at night.
2. Use a firm, flat mattress with a tightly fitted sheet. Do not place any other bedding/pillows/bumpers or stuffed animals in the sleep area.
3. Place the baby in a sleep area designed for infants (bassinet/crib/portable crib) in your room close to your bed.
4. Do not place the baby in your bed. Sharing a room, but not a bed, is recommended ideally for the first year of life.
5. Never place the baby on a couch or armchair for sleep, as these are extremely high-risk locations for infant sleep.
6. Breastfeed your baby and ensure up to date vaccinations.
7. Avoid overheating your baby.
8. Consider using a pacifier during sleep.
9. Do not use a car seat/swing/sling for routine sleep.
10. Use a “wearable blanket” or thin swaddling blanket to keep your baby warm.      Once your baby can roll (usually around 4 months) swaddling is no longer recommended.
11. Avoid products that claim to reduce the risk of SIDS, such as wedges, positioners and heart or breathing monitors.
12. Place your baby on his or her tummy while awake and you are watching (“tummy time”).

Many parents worry that babies are at higher risk of choking when they are on their backs.  In fact, the opposite appears to be true! Babies cough up and swallow fluids easier when on their backs.

At about 6 months of age, many babies can roll from their back to their stomach.  When babies do this on their own, parents do not need to worry about turning them onto their backs during the night.

Every parent can take steps to ensure the safest possible sleep for their baby.  Making the baby actually sleep is the subject for another article!