Ways To Reduce the Risk of SIDS and Other Sleep-Related Causes of Infant Death


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Research shows that there are several ways to reduce the risk of SIDS and other sleep-related causes of infant death:

The actions listed here and in Safe to Sleep®materials and publications are based on recommendations from the American Academy of Pediatrics (AAP) Task Force on SIDS. You can read the latest Policy Statement from the AAP Task Force on SIDS External Web Site Policy.

* Visit the U.S. Consumer Product Safety Commission website for more information about crib safety: http://www.cpsc.gov/info/cribs/index.html.

Always Place Your Baby on His or Her Back To Sleep, for Naps and at Night, To Reduce the Risk of SIDS

Research shows that:

  • Sleeping on the back carries the lowest risk for SIDS.

  • Sleeping on the stomach or side carry the highest risk for SIDS.

  • Babies who usually sleep on their backs but are then placed to sleep on their stomachs, such as for a nap, are at very high risk for SIDS.

The back sleep position is the safest position for all babies, including those born preterm or early. You should always place your baby on his or her back to sleep, for all sleep times—for naps and at night—to reduce the risk of SIDS.

Remember that every sleep time counts. Babies who usually sleep on their backs but who are then placed to sleep on their stomachs, for a sleep time like a nap, are at very high risk for SIDS.

That's why it is important for everyone who cares for your baby to place him or her on the back to sleep for all sleep times, including naps.

Can my baby choke if placed on the back to sleep?

The short answer is no—babies are not more likely to choke when sleeping on their backs.

Learn more about why choking risk might actually be lower when sleeping on the back.

Use a Firm Sleep Surface, Such as a Mattress in a Safety-Approved* Crib, Covered by a Fitted Sheet, To Reduce the Risk of SIDS and Other Sleep-Related Causes of Infant Death

Research shows that:

  • Babies who sleep on soft surfaces, such as on an adult mattress, a couch, or an armchair, are at higher risk for SIDS and suffocation.

  • Babies who sleep under a soft covering, such as a soft blanket or quilt, are at higher risk for SIDS and suffocation.

For these reasons, you should always place your baby to sleep on a firm sleep surface, such as a safety-approved* crib, bassinet, or portable play area. Use tight-fitting bedding, such as a fitted sheet, to help prevent your baby from getting tangled up in the bedding.

Do not use a car seat, carrier, swing, or similar product as your baby's everyday sleep area.

Never place your baby to sleep on soft surfaces, such as on a couch or sofa, or on pillows, comforters, quilts, or sheepskins. Do not place your baby to sleep on a waterbed, sofa, or soft mattress that allows the baby's head to sink into the surface.

Why shouldn't I use crib bumpers in my baby's sleep area?

Bumper pads and similar products that attach to crib slats or sides are frequently used with the intent of protecting infants from injury. However, evidence does not support using crib bumpers to prevent injury. In fact, crib bumpers can cause serious injuries and even death. Keeping them out of your baby's sleep area is the best way to avoid these dangers.

* Visit the U.S. Consumer Product Safety Commission website for more information about crib safety: http://www.cpsc.gov/info/cribs/index.html.

Your Baby Should Not Sleep in an Adult Bed, On a Couch, or On a Chair Alone, With You, or With Anyone Else

Room sharing—keeping baby's sleep area in the same room where you sleep—reduces the risk of SIDS and other sleep-related causes of infant death.

Research also shows that:

  • Babies who sleep in an adult bed with one or more adults are at higher risk for SIDS.

  • Babies who sleep in an adult bed are at significantly higher risk for SIDS when they:

    • Are younger than 3 months of age

    • Share a bed with a current smoker (even if he or she does not smoke in bed) or if the mother smoked during pregnancy

    • Share a bed with someone who is very tired

    • Share a bed with someone who has used or is using medications or substances, such as alcohol or illicit drugs

    • Share a bed with someone who is not a parent, including other children

    • Share a bed with more than one person

    • Are placed on a waterbed, older mattress, sofa, couch, or armchair

    • Are placed on a bed with soft bedding, including pillows, heavy blankets, quilts, and comforters

  • Babies who are placed for sleep on adult bed, sofa, couch, or armchair are at serious risk for accidental suffocation, entrapment, injury, and death—regardless of whether they are alone or if they share the sleep area with someone

Mother and baby sharing a room - baby has his own sleep area in the same roomFor these reasons, room share: give your baby his or her own sleep area in the same room as you or others.

If you bring your baby into bed with you to breastfeed, put him or her back in a separate sleep area, such as a safety-approved* crib, in your room when finished.

* Visit the U.S. Consumer Product Safety Commission website for more information about crib safety: http://www.cpsc.gov/info/cribs/index.html.

 

Keep Soft Objects, Toys, Crib Bumpers, and Loose Bedding Out of Your Baby's Sleep Area To Reduce the Risk of SIDS and Other Sleep-Related Causes of Infant Death

Research shows that:

  • Loose bedding and other items placed under or over the baby or in the baby's sleep area could end up covering the baby's face, which could:
    • Put the baby at higher risk for suffocation or strangulation

    • Put the baby at higher risk for rebreathing air that is low in oxygen

    • Put the baby at higher risk of overheating

  • Loose bedding and soft bedding, placed over or under the baby, such as quilts, comforters, and pillows increase the risk of SIDS regardless of sleep position.

It is reported that the majority of other sleep-related infant deaths are due to accidental suffocation involving pillows, quilts, and extra blankets. For these reasons, do not use pillows, blankets, quilts, sheepskins, stuffed animals, or crib bumpers anywhere in your baby's sleep area.

Why shouldn't I use crib bumpers in my baby's sleep area?

Bumper pads and similar products that attach to crib slats or sides are frequently used with the intent of protecting infants from injury. However, evidence does not support using crib bumpers to prevent injury. In fact, crib bumpers can cause serious injuries and even death. Keeping them out of your baby's sleep area is the best way to avoid these dangers.

To Reduce the Risk of SIDS, Women Should:

Get Regular Health Care During Pregnancy

Research shows that:

  • Babies of mothers who get regular health care during pregnancy are at lower risk for SIDS.

For this reason, start getting health care early in your pregnancy, and continue to get regular care throughout the entire pregnancy. Visit the Preconception Care and Prenatal Care Overview topic for more information.

To Reduce the Risk of SIDS, Women Should:

Not Smoke, Drink Alcohol, or Use Illegal Drugs During Pregnancy or After the Baby Is Born

Research shows that:

  • Babies of mothers who do not drink alcohol or use illegal drugs during or after pregnancy are at lower risk of SIDS.

  • Babies who share a bed with a parent who uses alcohol or illegal drugs are at particularly high risk of SIDS.

For these reasons, you should not use alcohol and illegal drugs during pregnancy or after your baby is born.

More information about smoking and SIDS risk is provided below.

To Reduce the Risk of SIDS, Do Not Smoke During Pregnancy, and Do Not Smoke or Allow Smoking Around Your Baby

Research shows that:

  • Babies of mothers who don't smoke have the lowest risk of SIDS.

  • Babies of mothers who smoked during pregnancy are up to 3 to 4 times more likely to die of SIDS than babies whose mothers did not smoke during pregnancy.

  • Babies whose caregivers smoke or who are exposed to second-hand smoke in their environment are at higher risk for SIDS than babies not exposed to secondhand smoke.

  • Babies who share a bed with an adult smoker are at higher risk of SIDS.

  • Babies who died of SIDS had higher nicotine concentrations in their lungs than did babies who died from other causes.

For these reasons, do not smoke during pregnancy or after the birth of your baby, and don't let others smoke around your baby.

Breastfeed Your Baby To Reduce the Risk of SIDS

Research shows that:

  • Babies who are breastfed or fed with breast milk for the first 6 months of life are at lower risk of SIDS.

  • Breastfeeding has many health benefits for mothers and babies. Visit the Breastfeeding and Breast Milk Overview topic for more information.

For this reason, breastfeed your baby as much and for as long as you can.

If you bring your baby into your bed to breastfeed, make sure to put him or her back in a separate sleep area, such as a safety-approved* crib, in your room when finished.

Give Your Baby a Dry Pacifier That Is Not Attached To a String for Naps and at Night To Reduce the Risk of SIDS

Research shows that babies who used pacifiers during their last sleep were at significantly lower risk for SIDS than were babies who did not.

For this reason, think about giving your baby a dry pacifier for sleep, but don't force the baby to use it.

Consider the following when using a pacifier:

  • If you are breastfeeding, wait until your baby is used to breastfeeding before trying a pacifier.

  • Because of the risk of strangulation, do not hang the pacifier around your baby's neck or attach it to his or her clothing with a string or cord.

  • Do not coat the pacifier with anything sweet or sticky.

  • Clean the pacifier often and replace the pacifier regularly.

  • If the pacifier falls out of the baby's mouth during sleep, you don't have to put it back in the mouth during that sleep time.

Do Not Let Your Baby Get Too Hot During Sleep

Research shows that:

  • Some babies are more likely to die from SIDS if they are dressed in two or more layers of clothes for sleep.

  • Babies who get too warm during sleep might sleep too deeply and be unable to wake themselves up, which could play a role in SIDS.

For these reasons, you should dress your baby in no more than one layer more of clothing than an adult would wear to be comfortable. Keep the room at a temperature that is comfortable for an adult.

Babies who are too warm might sweat, have damp hair, have flushed or red cheeks, have a heat rash, or breathe rapidly (as if they are panting).

What if I want to use a blanket when putting my baby to bed?

Using a blanket is not recommended. In most cases, light sleep clothing without a blanket is enough to keep baby warm during sleep. If you are concerned the room is not warm enough, consider an infant blanket sleeper.

If you choose to use a blanket, use it safely in the following way (sometimes called the "feet to foot" method):

  • Place the baby with his or her feet at the end of the crib or sleep area.

  • Tuck the ends of the blanket under the mattress.

  • Keep the blanket away from the baby's face. The blanket should come no higher than the baby's chest or armpits to help ensure safety.

  • Use only light sleep clothing—a diaper, onesie, T-shirt, or sleeper—under the blanket so the baby stays warm but doesn't get too warm during sleep.

Follow Health Care Provider Guidance on Your Baby's Vaccines and Regular Health Checkups

Following the recommended schedule for your baby's vaccines has a protective effect against SIDS. Research shows that immunizations reduce the risk of SIDS by 50%.1

There is no evidence of a causal relationship between vaccines and SIDS.

For this reason, follow your health care provider's recommendations for vaccines and for regular health checkups for your baby.

The American Academy of Pediatrics maintains a recommended vaccine schedule External Web Site Policy that your health care provider will follow for your baby's immunizations.

Avoid Products That Claim To Reduce the Risk of SIDS and Other Sleep-Related Causes of Infant Death

Wedges, positioners, and other products that claim to reduce the risk of infant death have not been tested for safety or effectiveness. The U.S. Food and Drug Administration, the Consumer Product Safety Commission, and the American Academy of Pediatrics warn against using these products because of the dangers they pose to babies.

Parents and caregivers should also avoid using products made from foam rubber or Memory Foam™ because of the risk of suffocation.

Do Not Use Home Heart or Breathing Monitors To Reduce the Risk of SIDS

Research shows that home heart or breathing monitors that claim to be able to detect SIDS and other life-threatening events are not effective at detecting or reducing SIDS. For this reason, you should avoid using home monitor devices to detect and prevent SIDS.

Keep in mind that these heart and breathing monitors are different from "baby monitors," which allow caregivers to hear or see the baby from another room. Baby monitors are often useful for alerting caregivers that a baby is awake, but they do not detect or prevent SIDS.

In some cases, health care providers prescribe a home heart or breathing monitor for babies with certain medical conditions. These babies are under medical care for conditions not related to SIDS, and the monitors are not used to detect or reduce SIDS risk. If you have questions about using home heart or breathing monitors for medical conditions, talk to your baby's health care provider.

Give Your Baby Plenty of Tummy Time When He or She Is Awake and When Someone Is Watching

Research shows that:

  • Placing your baby on his or her tummy for short periods while the baby is awake and when someone is watching is an important part of healthy development.

  • Supervised Tummy Time helps your baby's neck, shoulder, and arm muscles get stronger.

  • When a baby is placed too often or for too long in the same position, pressure on the same part of the baby's head can cause flat spots. These flat spots are usually not dangerous, are not associated with long-term problems with head shape, and typically go away on their own once the baby starts sitting up. Tummy Time can help prevent those flat spots.

For these reasons, you should make sure your baby gets plenty of Tummy Time and use other ways to reduce the chance that flat spots will form on the back of your baby's head.

Visit Babies Need Tummy Time! for more information.

 

* Visit the U.S. Consumer Product Safety Commission website for more information about crib safety: http://www.cpsc.gov/en/Safety-Education/Safety-Guides/Kids-and-Babies/Cribs/


  1. Vennemann, M. M., Höffgen, M., Bajanowski, T., Hense, H. W., & Mitchell, E. A. (2007). Do immunisations reduce the risk for SIDS? A meta-analysis. Vaccine, 25(26): 4875-4879. Retrieved March 11, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/17400342.

 

Safe to Sleep® is a registered trademark of the U.S. Department of Health and Human Services.

Last Updated Date: 09/23/2013
Last Reviewed Date: 09/23/2013