NICHD Alerts Parents to Winter SIDS Risk

The cold winter months bring an increase in the number of infants who die from Sudden Infant Death Syndrome, or SIDS, according to the National Institute of Child Health and Human Development, one of the National Institutes of Health. During colder months, parents often place extra blankets or night clothes on infants, hoping to provide them with extra warmth. In fact, the extra material may actually increase infants' risk for SIDS.

"Parents and caregivers should be careful not to put too many layers of clothing or blankets on infants, as overheating increases the risk of SIDS," said Duane Alexander, M.D., Director of the NICHD. "Of course, parents and caregivers should always place infants to sleep on their backs-at nighttime and at naptime."

For almost a decade, the NICHD has led the Back to Sleep campaign, which recommends that, unless there's a medical reason not to, infants should be placed on their backs to sleep, on a firm mattress with no blankets or fluffy bedding under or over them. If a blanket is used, it should be placed no higher than a baby's chest and be tucked in under the crib mattress. The baby's crib or sleep area should be free of pillows and stuffed toys, and the temperature in the baby's room should be kept at a level that feels comfortable for an adult. Since the NICHD campaign began, the overall rate of SIDS in the U.S. has declined by more than 50 percent.

Despite this progress, SIDS claims the lives of roughly 2,500 infants each year. SIDS is the sudden, unexplained death of an infant in the first year of life. The causes of SIDS are still unclear, and while it is not yet possible to predict which infants might fall victim to SIDS, it is possible to reduce factors known to increase SIDS risk:

  • Always place a baby to sleep on his or her back-even at naptime
  • Don't smoke around a baby
  • Don't smoke if you're pregnant
  • Place a baby on a firm mattress, such as in a safety-approved crib
  • Remove soft, fluffy bedding and stuffed toys from a baby's sleep areas
  • Keep blankets and other coverings away from a baby's nose and mouth
  • Don't put too many layers of clothing or blankets on a baby
  • Make sure everyone who cares for a baby knows that infants should be placed to sleep on their backs and the other ways to reduce SIDS risk

Among African Americans, the rate of SIDS has declined by almost 50 percent since the beginning of the Back to Sleep campaign. However, the SIDS rate among African American infants remains higher than that of white infants. In fact, African American infants are twice as likely to die of SIDS as are white infants. To help eliminate the racial disparity in SIDS rates, the NICHD has forged a strategic alliance with several African American organizations. This year, the NICHD has worked with the leadership and members of the National Coalition of 100 Black Women, the Women in the NAACP, and Alpha Kappa Alpha Sorority, Inc., to conduct SIDS risk reduction training and outreach activities in communities across the country.

"We have made great progress over the last decade in cutting the SIDS rate for African American infants by almost 50 percent. But we need an even greater effort," said Yvonne Maddox, Ph.D, Deputy Director of the NICHD, who is responsible for creating the alliance with the African American organizations. "The winter SIDS alert serves to remind all of us, mothers, fathers, and caregivers, that we can reduce the risk of SIDS by placing infants on their backs to sleep and by not placing too many blankets on infants."

Based on the extensive body of research that has shown that placing infants to sleep on their backs reduces their risk of SIDS, the NICHD formed a coalition of national organizations to launch a public awareness campaign called Back to Sleep in 1994. Along with the NICHD, the coalition consists of the Health Resources and Services Administration, the American Academy of Pediatrics, the Association of SIDS and Infant Mortality Programs, and First Candle/SIDS Alliance.

The NICHD distributes a variety of free Back to Sleep education materials for parents and health care providers, including brochures, crib reminder stickers, door hangers, and videos. Most of these materials are available in English and Spanish. To obtain these free materials, other NICHD publications, as well as information about the Institute, visit the NICHD Web site, or call the NICHD Information Resource Center, 1-800-370-2943; e-mail


The NICHD is part of the National Institutes of Health (NIH), the biomedical research arm of the federal government. NIH is an agency of the U.S. Department of Health and Human Services. The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation.

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