What is SIDS?

Sudden infant death syndrome (SIDS) is the sudden, unexpected death of an infant younger than 1 year of age which remains unexplained after a complete investigation, including:

• an autopsy;
• examination of death scene; and
• review of medical history.

In the United States, SIDS is the major cause of death in infants between 1 month and 1 year of age, with most deaths occurring between 2 and 4 months of age.  SIDS happens in families of all social, economic and ethnic groups.  SIDS is not contagious, predictable or preventable.  SIDS is sudden and silent, occurring most often during sleep, with no signs of suffering.  Terms used in the past to describe SIDS include “crib death” or “cot death.”  

How Common is SIDS?

The SIDS rate has dropped dramatically.  However, there are still approximately 2,500 infants that die of SIDS every year in the United States, and SIDS is the third leading cause of infant mortality.   In 2006, SIDS was responsible for 83 infant deaths in Illinois, compared with 177 infant deaths in 1996.  SIDS occurs more often in males and in African-American and American Indian or Alaskan Native infants.   More SIDS deaths occur in the colder months.

What Causes SIDS?

The cause(s) of SIDS is still unknown.   However, it is generally accepted that SIDS is a combination of factors or events.  A leading theory is that an infant who appears to be healthy has an underlying defect located in the brain stem.  This area in the brain controls heart and lung functions, including heart rate and breathing.  SIDS studies indicate some babies have a delay in the development of or an abnormality in the part of the brain which is involved in breathing and waking.  Babies born with this abnormality may be more vulnerable to sudden death. 

Other factors also could play a role in SIDS.   For example, if an infant with an underlying problem is exposed to other factors or stressors, such as secondhand smoke or sleeping on their stomach, the infant is at a higher risk of dying from SIDS. 

Because the exact cause of SIDS remains unknown and there is no way of predicting which infants are at a higher risk, it is important to eliminate the risk factors that can be controlled.  These factors include exposure to secondhand smoke, tummy sleeping and other unsafe sleep practices.

What are the SIDS Risk Factors?

1. Tummy (prone) or side sleeping, at bed time or nap time
2. Soft and/or loose bedding
3. Co-sleeping (both baby and adults or children sharing the same bed or couch)
4. Overheating
5. Maternal cigarette smoking during pregnancy
6. Infant’s exposure to secondhand smoke
7. No, or late prenatal care
8. Maternal age younger than 20 years
9. Premature or low birth weight

What can I do to Reduce the Risk of SIDS?

1. Always place your baby on his or her back to sleep for bed time and nap time.
2. Use a safety approved crib with a firm mattress.
3. Remove all loose bedding, such as pillows, quilts, stuffed toys and other soft items from the crib.
4. Don’t let your baby become too warm.
5. Make sure your baby’s head is uncovered.
6. Don’t smoke while pregnant.
7. Don’t smoke around your baby, and don’t let anyone else smoke around your baby.
8. Don’t allow bed sharing, or co-sleeping, even with siblings.  If bed sharing or co-sleeping is allowed, follow all safety precautions, including, placing the baby on its back, using a firm mattress, removing all loose bedding such as pillows, blankets and comforters and avoiding drugs and alcohol.
9. Don’t use bumper pads in cribs due to suffocation or strangulation hazards.
10. Take your baby for their well-child appointments, including vaccinations.

Back to Sleep Campaign

It is important to remember there is no way to prevent SIDS.  It is known that babies sleep safer when placed on a firm surface on their back. The Back to Sleep Campaign was launched in 1994 by the National Institute of Child Health and Human Development American Academy of Pediatrics, the SIDS Alliance (now First Candle/ SIDS Alliance), the Association of SIDS and Infant Mortality Programs, and the Maternal and Child Health Bureau of Health Resources and Services Administration to help inform parents and caregivers of the importance of back sleeping.  Since the introduction of the Back to Sleep Campaign, the number of SIDS deaths has dropped by more than 50 percent.  For more information on the Back to Sleep Campaign, visit the National Institute of Child Health and Human Development Web site at www.nichd.nih.gov/sids/sids.cfm. 

American Academy of Pediatrics 2005 SIDS Policy Recommendations

In 2005, the American Academy of Pediatrics (AAP) revised its policy statement regarding SIDS based on recent research studies.   AAP recommendations now include:

• Side sleeping is not a reasonable alternative to back sleeping.
• No bed sharing during sleep.
• The use of pacifiers at nap time and bed time throughout the first year of life.  Several studies have indicated a protective effect of pacifiers on the incidence of SIDS.  Pacifiers may help to keep the airways open and may discourage babies from turning over onto their stomachs.  Pacifiers also may stimulate airway muscles and saliva production which could enhance brain activity and the ability to awaken from sleep.  For breastfed infants, pacifier use can be delayed until the infant is 1 month old to assist in the establishment of breastfeeding. 

For more information on the American Academy of Pediatrics SIDS Policy Recommendations, visit www.aap.org/healthtopics/Sleep.cfm. 

SIDS and Co-sleeping

According to the American Academy of Pediatrics, co-sleeping is not recommended.   Co-sleeping has not been found to be protective against SIDS, and co-sleeping increases the risk of accidental suffocation and overlay.   However, room sharing may be protective against SIDS.  Placing the baby in a safety approved crib or bassinet near the adult bed will allow parents to remain close to the baby while providing a safe sleep environment. 

Can Vaccinations Cause SIDS?