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Sudden Infant Death Syndrome (SIDS): Other FAQs

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Basic information for topics, such as "What is it?" and "How many people are affected?" is available in the Condition Information section. In addition, Frequently Asked Questions (FAQs) that are specific to a certain topic are answered in this section.

What does a safe sleep environment look like?
Will my baby choke if placed on the back to sleep?
Why shouldn't I use bumpers in my baby's crib?
Does back sleeping cause flat spots on the back of the head?
Can certain breathing or heart monitors detect SIDS before it happens?
Can wedges and other products reduce the risk of SIDS?
What kind of support is available for parents who have lost an infant to SIDS?
What is a sudden unexpected infant death (SUID)?
What are sleep-related causes of infant death?

What does a safe sleep environment look like?

A safe sleep environment—one that is free of items and features that could be dangerous to infants—reduces the risk of SIDS and other sleep-related causes of infant death. Parents and caregivers can create a safe sleep environment in the following ways:

  • Always place your baby on his or her back to sleep, for naps and at night.
  • Use a firm sleep surface, such as a mattress in a safety-approved* crib, covered only by a fitted sheet.
  • Do not use pillows, blankets, sheepskins, or crib bumpers anywhere in your baby's sleep area.
  • Keep soft objects, toys, and loose bedding out of your baby's sleep area.
  • Make sure nothing covers the baby's head or face.
  • Dress your baby in light sleep clothing, such as a one-piece sleeper, and don't use a blanket.
  • Do not smoke or let anyone smoke around your baby.
  • Your baby should not sleep in an adult bed, on a couch, or on a chair alone, with you, or with anyone else.

To learn more about safe sleep environments, check out the NICHD publication Reduce the Risk of SIDS: What does a safe sleep environment look like? (PDF- 334 KB).

* For information on crib safety guidelines, contact the Consumer Product Safety Commission at 800-638-2772 or

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

No. Healthy infants naturally swallow or cough up fluids—it's a reflex all people have. Where the opening to the windpipe is located in the body makes it unlikely for fluids to cause choking. Babies may actually clear such fluids better when on their backs.

Cases of fatal choking are very rare except when related to a medical condition. The number of fatal choking deaths has not increased since back sleeping recommendations began. In most of the few reported cases of fatal choking, an infant was sleeping on his or her stomach.1

Why shouldn't I use bumpers in my child's crib?

Current research shows that crib bumper pads or padded bassinets can cause injury or death to infants.2

Before crib safety was regulated, the spacing between the slats of the crib sides could be any width, which posed a danger to infants if they were too wide. Parents and caregivers used padded crib bumpers to protect infants. Now that cribs must meet safety standards, the slats don't pose the same dangers. As a result, the bumpers are no longer needed.

Evidence does not support using crib bumpers to prevent injuries. In addition, evidence shows that crib bumpers can cause serious injuries and death. Keeping them out of an infant's sleep area is the best way to avoid these dangers.

Does back sleeping cause flat spots on the back of the head?

Infants' skulls are soft and are made up of several skull plates. These movable plates have spaces between them, called sutures, which allow the head to be flexible so that the brain can grow. If the head is left in the same position for long periods of time (such as lying on the back, or sitting in a car seat or carrier), the plates move in a way that may leave a flat spot.

Positional plagiocephaly (pronounced pley-jee-uh-SEF-uh-lee) is the term used to describe a flattened or misshapen head. Health care providers also use the term brachycephaly (pronounced bray-kee-SEFF-a-lee) to describe the flattening of the back of the skull. Positional plagiocephaly and brachycephaly often occur together.

Many cases of positional plagiocephaly can be prevented (and sometimes corrected) by repositioning the infant to remove the pressure from the back of his or her head. Repositioning includes the following:

  • Providing "Tummy Time" when the infant is awake and when someone is watching. Tummy time not only helps prevent flat spots, but it also helps the head, neck, and shoulder muscles get stronger as part of normal development.

    Parents and caregivers should try supervised tummy time several times a day, for short periods of time, until the infant gets used to being on the tummy. Once infants begin to enjoy the position, parents can try longer periods of time or increase frequency of tummy time.
  • Changing the direction that the infant lies in the crib from one week to the next. For example, have the infant's feet point toward one end of the crib for a few days, and then change the position so his or her feet point toward the other end of the crib. This change will encourage the infant to turn his or her head in different directions to avoid resting in the same position all the time.
  • Avoiding too much time in car seats, carriers, and bouncers while the infant is awake. Spend "cuddle time" with the child by holding him or her upright over one shoulder often during the day.
  • Changing the location of the infant's crib in the room so that he or she has to look in different directions to see the door or the window.

It is important to note that although back sleeping may increase the risk of flat spots on the head, flat spots are much less serious than SIDS and can often be prevented and treated. Parents should not stop placing infants on their backs to sleep, but rather should be sure to offer tummy time while they are awake and use repositioning techniques. If you have concerns about the shape of your infant's head, talk with your child's health care provider.

Can certain breathing or heart monitors detect SIDS before it happens?

Some breathing and heart monitors claim to be able to detect SIDS before it happens. These products might be prescribed by health care providers to manage certain medical conditions, but research shows that these monitors are not effective at detecting SIDS or reducing SIDS risk.

The NICHD-led Collaborative Home Infant Monitoring Evaluation (CHIME) study evaluated infants at high risk for SIDS to determine whether these monitors could identify situations that are dangerous to infants and perhaps reduce the risk for SIDS. The research findings led the American Academy of Pediatrics to recommend that these monitors not be used to prevent SIDS or identify infants at risk for SIDS.3

Keep in mind that breathing, heart, and other home monitors are different from baby monitors that allow caregivers to hear and/or see the infant from another room. These baby monitors often are useful for alerting caregivers that a child is awake, but they do not reduce or detect SIDS.

Can wedges and other products reduce the risk of SIDS?

Some products claim to prevent SIDS or safely position the infant for sleep. These products may include:

  • Wedges
  • Positioners
  • Special mattresses
  • Special sleep surfaces

The U.S. Consumer Product Safety Commission, the Food and Drug Administration, and the American Academy of Pediatrics warn against using these products because of the dangers they pose to infants and because there is no evidence that they reduce SIDS.2

What kind of support is available for parents who have lost an infant to SIDS?

One of the most important things to remember when an infant dies from SIDS is that the families themselves are not to blame. The causes of SIDS remain unknown. Even though there are ways to reduce the risk, there is no definitive way to prevent SIDS from occurring.

There are a variety of resources available to help families who have lost an infant to SIDS. Talking to other parents or caregivers who have lost an infant to SIDS may be helpful. A health care provider may also be able to recommend local resources and groups.

Parents can also find support at the community and state level through the SUID/SIDS Gateway External Web Site Policy. The center offers resources for parents and caregivers External Web Site Policy grieving for their loss, including The Death of a Child: The Grief of the Parents, A Lifetime Journey External Web Site Policy (PDF - 470 KB).

What is a sudden unexpected infant death (SUID)?

Each year in the United States, thousands of babies die suddenly and unexpectedly. These deaths are called SUID (pronounced SOO-idd) which stands for "sudden unexpected infant death."

SUID includes all unexpected deaths: those without a clear cause, such as SIDS, and those from a known cause, such as suffocation. About one-half of all SUID cases are SIDS. Many unexpected infant deaths are accidents, but a disease or something done on purpose can also cause a baby to die suddenly and unexpectedly.4

What are sleep-related causes of infant death?

Sleep-related causes of infant death are those linked to how a baby sleeps or slept. They are due to accidental causes, such as:

  • Suffocation
  • Entrapment, when a baby gets trapped between two objects, such as a mattress and a wall, and can't breathe
  • Strangulation, when something presses on or wraps around baby's neck, blocking a baby's airway

These deaths are not SIDS.2

  1. Hunt, C. E., Lesko, S. M., Vezina, R. M., McCoy, R., Corwin, M. J., Mandell, F., et al. (2003). Infant sleep position and associated health outcomes. Archives of Pediatric and Adolescent Medicine, 157, 469-74. Retrieved June 18, 2012, from External Web Site Policy [top]
  2. American Academy of Pediatrics. (2011). SIDS and other sleep-related infant deaths: Expansion of recommendations for a safe infant sleeping environment. Pediatrics, 128, 1030-1039. Retrieved June 6, 2012, from External Web Site Policy [top]
  3. American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. (2005). The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk. Pediatrics, 116, 1245-1255 [top]
  4. Centers for Disease Control and Prevention. (2012). Sudden Unexpected Infant Death (SUID). Retrieved June 15, 2012, from [top]