Sleeping Safely

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Sudden Infant Death Syndrome, or SIDS, is the sudden and unexplained death of an infant under the age of one. This syndrome has been around for possibly hundreds of years under the guise of different names, with most deaths occurring in sleep between the ages of two and four months. Although it continues to be the most common cause of death in infants one month to one year, SIDS deaths are down in the past ten years, as risk factors and preventative measures have been identified. During SIDS Awareness Month, we want to spread the word about what increases the risk of these tragic and scary deaths, and what can be done to hopefully prevent SIDS. 

With SIDS continuing to claim about 2,500 infant lives per year, education and awareness about risk factors continues to be very important. The most significant precaution parents and caregivers can take in reducing SIDS is putting a baby to sleep on his or her back, not on the stomach or side, on a firm mattress without soft blankets, toys or bumpers. Other controllable risk factors that increase the risk of SIDS include: poor prenatal or postnatal care, drug or alcohol use in pregnancy, exposure to tobacco smoke, overheating while asleep, bed sharing, or sleeping on soft surfaces. 

In 1992, the American Academy of Pediatrics recommended back sleeping for all infants, and began their “Back to Sleep” campaign. Since then, the occurrence of SIDS has decreased by 50%. Many believe that stomach sleeping puts pressure on infants’ airway and face, thereby reducing oxygen and regular breathing. Other theories suggest that stomach sleeping decreases the likelihood of a baby waking itself up when not getting enough oxygen, eventually leading to death in sleep. Always put a baby to sleep on their back, until they can roll over on their own between 4 and 7 months, in which case they can pick their own sleeping position. Using a sleep sack in young infants that cannot roll over is also seen as beneficial, because it helps them to maintain a sleeping position on their back, and avoid an arm or hand inhibiting their airway while asleep. 

If you are concerned about a baby choking on spit up, rest assured that the AAP states that there is no increased risk of this because of back sleeping, as long as your baby does not have a gastrointestinal disorder. If you are concerned about spit up or vomit, consult your baby’s pediatrician about this issue. Another common concern with back sleeping is positional plagiocephaly, an increasingly common condition where a baby develops a misshapen head from spending too much time on their back. To avoid this, try to put your baby on his or her stomach and change positions more often when they are awake.

Sleeping with soft, fluffy toys, pillows, bumpers, or blankets in the crib, or bed-sharing with parents, all increase the risk of SIDS. Soft objects can similarly inhibit the airway, decreasing airflow and oxygen. It is also important to keep the nursery or sleep environment at a cool, comfortable temperature, as it is suspected that an overheating baby is less likely to wake up when they are not breathing adequately. 

There are even precautions that can be taken during pregnancy to prevent future risk of sudden infant death. Women with poor prenatal care, and exposure to alcohol, drugs, or tobacco smoke during pregnancy are all putting infants at higher risk. This is because the development of the fetus’ brain or respiratory system can be affected. A baby with poor reflexes is less likely to wake up and cry because of decreased oxygen levels, or can have an underdeveloped respiratory system. See a doctor for regular checkups throughout pregnancy and after giving birth, and take prenatal and postnatal vitamins. Breastfeeding and giving pacifiers before sleep have also been linked to lower SIDS risk. Breastfeeding is believed to improve development, including brain development, which could be linked to the reflexes that encourage a baby to wake up when they stop breathing.

While this article has discussed external factors that can be controlled, there are a number of inheritable conditions that may increase the instance of SIDS, although SIDS itself is not hereditary. Babies born prematurely, less developed, or with infection, are at higher risk. Keep in mind that good prenatal care, regular doctor’s visits, and education about healthy pregnancy can in some ways help to reduce these. There are also appears to be higher incidents of SIDS in certain racial groups, with American Indians and African Americans having the highest numbers of SIDS cases, double or more than Caucasian and Hispanic infants. 

In conclusion, Sudden Infant Death Syndrome continues to be a frightening reality for many parents. While there are certainly still SIDS deaths that appear to be unexplained, thanks to research in the past decade this syndrome may not be as unavoidable as was once believed. Here are some precautions you can take to decrease the risk of the syndrome in infants: 

  • Put babies to sleep on a firm mattress, not on a blanket, couch, chair, or other soft surface.
  • Avoid soft blankets or toys in the crib.
  • Do not use crib bumpers.
  • Put babies to sleep on their backs until they are able to roll over on their own.
  • Make sure your baby does not get too warm while sleeping.
  • Do not smoke, drink, or use drugs while pregnant.
  • Breastfeed if possible.
  • Once breastfeeding is established, give a pacifier before sleep.
  • Take your baby for regular check ups.

If you would like to find out more about SIDS, or need support, the North Texas SIDS Alliance serves DFW, Greater Houston, North, West, and East Texas. Their number is 1–800–650–SIDS. 

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