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NICHD Highlights Research and Outreach Activities During Sudden Infant Death Syndrome (SIDS) Awareness Month

baby with stethescope SIDS is defined as the sudden, unexplained death of an infant younger than 1 year old that doesn’t have a known cause even after a complete investigation, including an autopsy, a review of the death scene, and complete family and medical histories. It is currently the leading cause of death in babies between 1 month and 1 year of age.

The cause of SIDS is not known, but we do know different ways to reduce the risk, such as placing babies on their backs to sleep for all sleep times and not letting them overheat during sleep. These ways to reduce the risk of SIDS formed the foundation of the NICHD-led Back to Sleep campaign, which began in 1994.

As SIDS rates have declined1 during the last 2 decades by more than 50% both overall and within specific racial and ethnic groups, rates of other sleep-related causes of infant death, such as accidental suffocation, have increased. Even though these deaths are not SIDS or related to SIDS, they contribute to overall infant mortality rates for the United States and can devastate families and communities.

In 2012, the NICHD, with support from its collaborators, created the Safe to Sleep® campaign as an expansion of the Back to Sleep campaign to address not only ways to reduce the risk of SIDS, but also ways to reduce other sleep-related causes of infant death. You can learn more about the expanded campaign in the previous NICHD Spotlight: Beyond Back Sleeping.

Like its predecessor campaign, the Safe to Sleep® campaign relies on research evidence to form the basis of its safe sleep messages. During this SIDS Awareness Month, the Institute highlights some of its more recent research findings and activities. Select a link below to learn more.

Health Care Provider Advice Matters
Other SIDS Research and Activities
More Information

Health Care Provider Advice Matters

New findings from an NICHD-funded study reinforce why reducing risk can be so challenging. The study, a survey of 19,000 nighttime caregivers, found that the number of parents and nighttime caregivers who bed share with infants has nearly doubled between 1993 and 2010.2 In 2010, nearly 14% of caregivers reported having shared a bed with an infant.

Infants who share a bed with another person are nearly three times more likely to die from SIDS than are infants who sleep alone.3 The risk is even greater for infants who are younger than 12 weeks and for infants whose mothers smoked during pregnancy.

Bed sharing carries more than just risk for SIDS, it also greatly increases the risk of accidental suffocation, one of several sleep-related causes of infant death that has been on the rise during the last decade. Infants can suffocate when an adult, child, or pet sharing the bed rolls over onto them during sleep. Or they can suffocate by becoming covered by pillows or blankets. Entrapment, such as when a baby becomes trapped between the bed and the wall, and strangulation, such as when loose bedding wraps around the baby’s neck, are also much more common when bed sharing.

Studies indicate that sharing a room with an infant—but not a bed—decreases the risk of SIDS by up to 50%.4 Room sharing also reduces the risk of other sleep-related causes of infant death, such as suffocation from roll over.

The study also reported some promising findings: parents were significantly less likely to bed share if their health care provider advised against it, or if they perceived their health care provider was against it. This finding suggests that, by renewing efforts to reach out to pediatricians, family physicians, and other health care providers, the Safe to Sleep® campaign may be able to further reduce the risk for SIDS and other sleep-related causes of infant death from bed sharing.

Campaign leadership is working with representatives from the American Academy of Pediatrics (AAP) and other health care provider organizations to capitalize on this finding as quickly as possible.

The Researchers discuss increase in percentage of infants who share bed with adult or child podcast provides additional information about this study.

Other SIDS Research and Activities

The NICHD also continues to fund research exploring the possible causes of SIDS and the effectiveness of SIDS interventions:

  • Extreme cardiorespiratory events—such as an abnormally long pause in breathing (apnea) or a heartbeat that is too slow (bradycardia)—were thought to be a cause SIDS. This theory formed the basis for the Collaborative Home Infant Monitoring Evaluation (CHIME) Study, which aimed to determine whether using home monitors to detect these types of extreme events could help to predict or prevent SIDS. In 2005, based on evidence from the CHIME study, the AAP began recommending against the use of monitors to predict or prevent SIDS. A more recent analysis found that infants who were on their stomachs or sides when sleeping were no more likely to experience an extreme cardiorespiratory event than were infants who slept on their backs.5 The findings also refute the idea that extreme cardiorespiratory events are a cause of SIDS.

  • Understanding how abnormalities in certain brain areas may cause or contribute to SIDS is also an active area of research. An NICHD-funded study found lower levels of serotonin in the brain stem of infants who died from SIDS compared to those who died from other causes.6 The finding also reinforces the concept that the serotonin system is also involved in the mechanisms of SIDS.  

  • Other ongoing efforts include:

Through the Safe to Sleep® campaign and other channels, the NICHD is also initiating several activities during SIDS Awareness Month that will continue into the coming months:

  • The campaign recently launched its redesigned website—http://safetosleep.nichd.nih.gov—to provide comprehensive information about reducing the risk of SIDS and other sleep-related causes of infant death. The site includes a Safe Sleep Environment Tool that allows users to “move” through a virtual room and learn about how to create a safe sleep environment, among other resources.

  • “SIDS Sunday” is being promoted at churches throughout the state of Arkansas as part of the Arkansas SIDS Outreach Project. Pastors are encouraged to share information about ways to reduce the risk of SIDS and other sleep-related causes of infant death with their congregation and safe infant sleep materials are distributed to church members.

  • Other efforts include:
    • Showing of the campaign’s 60-second video External Web Site Policy in health care office waiting rooms in states with the highest SIDS and other sleep-related infant death rates
    • Translating the NICHD A to Z Topic on SIDS into Spanish to reach a broader audience with important risk-reduction strategies

    More Information

    The NICHD remains committed to understanding SIDS and to raising awareness about the ways to reduce the risk of SIDS and other sleep-related infant deaths.

    For more information, select a link below:

    Originally posted: October 30, 2013

    All NICHD Spotlights


    1. http://www.nichd.nih.gov/sts/about/SIDS/Pages/progress.aspx
    2. Colson, E. R., Willinger, M., Tybin, D., Heeren, T., Smith, L. A., Lister, G., & Corwin M. J. (2013). Trends and factors associated with infant bed sharing, 1993–2010: The National Infant Sleep Position Study. JAMA Pediatrics. Advance online publication. PMID: 24080961
    3. Vennemann, M. M., Hense, H. W., Bajanowski, T., Blair, P. S, Complojer, C., Moon, R. Y., & Kiechl-Kohlendorfer, U. (2012). Bed sharing and the risk of sudden infant death syndrome: can we resolve the debate? Journal of Pediatrics, 160(1), 44–48. PMID: 21868032
    4. Task Force on Sudden Infant Death Syndrome, & Moon, R. Y. (2011). SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment. Pediatrics, 128(5), 1030–1039. PMID: 22007004
    5. Lister, G., Rybin, D. V., Colton, T., Heeren, T. C., Hunt, C. E., Colson, E. R., . . . Collaborative Home Infant Monitoring Evaluation Study Group. (2012). Relationship between sleep position and risk of extreme cardiorespiratory events. The Journal of Pediatrics, 161(1), 22–25.e1. PMID: 22364822
    6. Duncan, J. R., Paterson, D. S., Hoffman, J. M., Mokler, D. J., Borenstein, N. S., Belliveau, R. A., . . . Kinney, H. C. (2010). Brainstem serotonergic deficiency in sudden infant death syndrome. JAMA, 303(5), 430–437. PMID: 20124538
    Last Updated Date: 10/30/2013
    Last Reviewed Date: 10/30/2013
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