Sudden Infant Death Syndrome, or SIDS, is the sudden and unexplained death of an infant under 12 months old. SIDS is the most common cause of death between the ages of 1 month and 12 months and it most commonly occurs between 2 to 4 months.
SIDS is more common in African American and Native American infants and it is also more common in boys. The risk of SIDS is linked to sleeping position, which is why it is sometimes called crib death. An infant who is sleeping on their belly is believed to be at greater risk of obstructed breathing or rebreathing used air. There may also be an impairment where the infant’s own nervous system does not properly monitor their oxygen and carbon dioxide and, therefore, they are not prompted to wake up and cry when they are not getting sufficient air.
Dr. Jenny Brault, MD of Sheboygan Pediatric Associates says, “There has been a lot of success over the past 20 years in lowering the incidence of SIDS. One of the keys has been educating parents about safe sleeping habits for their infant.” Through programs, such as the American Academy of Pediatrics’ Back to Sleep campaign, which was started in 1994, the incidence of SIDS has been reduced by more than half. For every 100,000 infants born in 1990, there were 130 cases of SIDS, whereas in 2015 there were 39. The Back to Sleep program taught parents to lay their infants on their backs to sleep, rather than their stomachs or their sides. Side sleeping is discouraged because a sleeping infant may easily roll and end up on their belly.
“The Back to Sleep program was successful because infants sleeping on their backs have much less risk of a mattress, blanket, or toy obstructing their breathing,” said Dr. Brault.
Back sleeping can lead to positional skull deformities or “flat spots”. This is one of the reasons tummy time is encouraged. Tummy time refers to play and interaction while the infant is lying on their stomach. The National Institutes of Health recommends 2 to 3 sessions of tummy time per day, each lasting a few minutes. These sessions may get longer as the infant gets stronger. Dr. Brault explains that, “Tummy time can reduce flat spots and help develop the infant’s strength and coordination. Tummy time should be done when the infant is awake and constantly supervised by an adult.”
In 2012, the Safe to Sleep program was launched. Safe to Sleep is an extension of the Back to Sleep program and its goal is to reduce the rate of SIDS even more than the Back to Sleep program. Besides always positioning infants on their backs for sleep, the Safe to Sleep program emphasizes educating parents on other factors that impact the incidence of SIDS. Some of those factors include:
• Placing the infant on a firm, flat sleeping surface without other soft objects such as loose blankets and stuffed toys that can obstruct breathing.
• Breastfeeding reduces the risk of SIDS.
• Overheating increases the risk of SIDS.
• Maternal smoking, alcohol consumption and drug use during and after pregnancy is associated with SIDS.
Educating parents has significantly reduced the incidences of SIDS cases over the last 20 years and education will continue to be the key in lowering the incidence of SIDS even more. “Any number of SIDS cases is too many, and educating parents on the risk factors that extend beyond sleeping position will help us continue to reduce the incidence of SIDS,” said Dr. Brault.
Hauck F, Tanabe K. Beyond “Back to Sleep”: Ways to Further Reduce the Risk of Sudden Infant Death Syndrome. Pediatr Ann. 2017; 46: e284-e290
. ScienceDaily, 13 February 2008.