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Part 2: Reducing the risk of SIDS and Other Sleep-Related Infant Deaths Oct 14, 2014 5:52:00 PM | by Nadine Goldberg
Reducing the risk of SIDS and Other Sleep-Related Infant Deaths

Our team at Just Born is dedicated to reduce the risk of SIDS through education, awareness and funding. ‘Reducing the risk of SIDS and other sleep-related infant deaths’ is the second post in a blog series about SIDS by Executive Director of Wellness Services, Dr. Nadine Goldberg. Visit the Just Born blog throughout the month of October for more in-depth stories.

Although we do not know what exactly causes Sudden Infant Death Syndrome (SIDS), we do have information on how to reduce the risk of SIDS and other sleep-related causes of infant death. It’s important to note that other sleep-related causes of infant death can occur in the sleep environment or during sleep time that are not related to SIDS. They include accidental suffocation, entrapment or strangulation.

SIDS Risk Reduction Recommendations

Back is Best! Babies should always be placed on their backs for every sleep.  This includes naptime and at night.  Research shows that the back (supine) sleep position is the safest position for full and preterm babies[1].  The stomach (prone) or side position for sleep increases the risk of hypercapinia (increased amount of carbon dioxide) and hypoxia (insufficient concentration of oxygen in blood).  In addition, the stomach sleeping position increases the risk of overheating which is also a SIDS risk factor.  The back sleeping position carries the lowest risk of SIDS for babies.

Safe Surface.  At naptime and nighttime, babies should always be placed in a safety approved crib, portable style crib, or play yard style crib, covered by a fitted sheet to reduce the risk of SIDS and other sleep-related infant deaths.  Babies who are placed to sleep on soft surfaces such as adult and toddler beds, waterbeds, pillows, cushions, sheepskins, sofas and comforters, are at a higher risk for SIDS and suffocation.

Clear Sleep Space.  Never place anything soft, loose or fluffy in a baby’s sleep area.  This includes pillows, blankets, comforters, pillow-like bumpers, stuffed animals, toys and other soft items.  Studies show 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 increase the risk of suffocation or strangulation, rebreathing carbon dioxide or air that is low in oxygen and overheating. It is reported that the majority of other sleep-related infant deaths are due to accidental suffocation involving pillows, quilts and loose blankets.

Practice Room Sharing.  Falling asleep with a baby on a bed, couch or armchair is extremely dangerous; these babies are at serious risk for accidental suffocation, entrapment, injury and death.  Room share instead by placing your baby in a portable crib or play yard style crib next to your bed.  Research shows that babies who sleep in an adult bed with one or more adults are at a higher risk of SIDS.  Please remember that babies should never sleep in an adult or toddler bed, on a couch, or an armchair alone or with anyone else. 

Avoid overdressing babies. Studies have shown that there is an increased risk of SIDS with overheating.  Researchers postulate that 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.

Use a Wear-a Blanket® or other type sleeper instead of blankets to keep your baby warm and safe at naptime and nighttime.  Keep the room temperature at a level that feels comfortable to a lightly clothed adult.  

Breastfeeding. Studies have shown that breastfeeding is associated with a reduced risk of SIDS.  The American Academy of Pediatrics (AAP) recommends that mothers should exclusively breastfeed or feed with expressed human milk (i.e., not offer any formula or other non-human milk-based supplements) for 6 months[2].

Consider offering your baby a pacifier at naptime and nighttime. Research shows that babies who used pacifiers during their last sleep were at significantly lower risk for SIDS than were babies who did not.  Pacifiers should only be offered to breastfed babies when nursing has been well established (which is usually around 3-4 weeks).  When using a pacifier it is important to remember the following:

  • Do not hang the pacifier around your baby's neck or attach it to his or her clothing with a string or cord because this is a strangulation hazard.
  • 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.

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.  Due to the dangers these products pose to babies, the U.S. Food and Drug Administration, the Consumer Product Safety Commission, and the American Academy of Pediatrics do not support their usage.

Do not use home cardiorespiratory (heart and breathing) monitors to reduce the risk of SIDS and other sleep-related causes of infant death. Some babies are prescribed these monitors due to medical conditions, but they are not effective in detecting or reducing the risk of SIDS.

Infants have significantly higher risk of SIDS if 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 illicit drugs or alcohol
  • 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

Parents and caregivers can take the following additional steps to reduce the risk of SIDS:

  • Women should get regular health care during pregnancy
  • Women should not smoke during pregnancy
  • Parents and caregivers should not smoke or allow smoking around their baby
  • Follow your health care provider's recommendations for vaccines and for regular health checkups for your baby

Educate everyone who cares for your baby with these safe sleep tips and provide them with our Safe Sleep tips sheet and notecards.

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[1] Moon, Rachel Y. "SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment." Pediatrics 128.5 (2011): e1341-e1367.

 

[2] Moon, Rachel Y. "SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment." Pediatrics 128.5 (2011): e1341-e1367.

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