How to Reduce the Risk of SIDS

SIDS (Sudden Infant Death Syndrome) is one of those things that no one wants to think about. After all, the thought of your baby suddenly dying is extremely scary. At the same time, SIDS is something all parents of new babies need to take seriously, and educate themselves about.

Thankfully, as scary as SIDS is, there are several simple things you can do to reduce the risk for your baby. Let’s take a look at the most effective measures you can take to protect your baby from SIDS.

What Is SIDS?

SIDS stands for “sudden infant death syndrome.” As Richard Brucker, MD, a pediatrician with Torrance Memorial Medical Center, explains, SIDS is defined as the unexpected death in an infant under the age of 1. Most of these deaths occur at night, usually between midnight and 6 a.m., while the baby is sleeping, says Dr. Brucker.

SIDS is diagnosed when no other cause of death is found after a thorough evaluation is performed, Dr. Brucker adds.

How Often Does SIDS Occur?

Tragically, about 3,400 babies under the age of 1 die unexpectedly each year, according to the CDC. Those deaths can be broken down into three main categories: SIDS, accidental suffocation/strangling, and death from an unknown cause.

In any given year, several thousand babies die of SIDS. In 2019, for example, there were 1,250 recorded deaths attributed to SIDS.

Although SIDS is defined as sudden and unexplained death in a baby younger than 1-year-old, most deaths occur between the ages of 1 month and 4 months. Ninety percent of SIDS deaths occur when the baby is under six months old.

What Are the Risk Factors?

The main risk factor for SIDS is putting your baby to sleep in an unsafe environment, says Danelle Fisher, MD, chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, CA. These practices include sleeping on soft bedding, sleeping with excessive pillows or blankets, and putting your baby face down to sleep before they are able to roll over, Dr. Fisher explains.

Other risk factors include overheating, such as dressing in too many warm layers of clothing or being in an overheated room. Exposure to cigarette smoke—either during pregnancy or after birth—also increases your baby’s risk of SIDS.

Some babies may be more prone to SIDS than others, says Dr. Brucker. “While the cause of death remains unknown, the most likely theory is that the child had an underlying vulnerability (e.g., genetic pattern or subtle brain anomaly) that was impossible to predict ahead of time,” Dr. Brucker says.

This vulnerable baby is then exposed to a trigger, such as an unsafe sleeping space or maternal smoking, and SIDS occurs. Because it’s often impossible to predict which babies may have health and developmental vulnerabilities, our best defense is to ensure that babies aren’t exposed to any triggers, says Dr. Brucker.

How to Reduce the Risks of SIDS

Current AAP recommendations to reduce SIDS focus on setting up a safe sleep environment for your child. The guidelines include information about where your baby should sleep, what type of conditions should be present for safest sleep, and what types of sleep position your baby should be in. Additionally, the guidelines discuss issues like maternal health, best feeding practices, and what items should and should not be present in your baby’s sleeping space.

Let’s take a look at these guidelines, along with expert advice from pediatricians.

Put Your Baby to Sleep on Their Back

One of the most important things you can do to reduce the risk of SIDS is put your baby to sleep on their back, says Marty Ellington, MD, a pediatrician at Lenox Hill Hospital in NYC. As Dr. Ellington points out, when the AAP began recommending that babies be put to sleep on their backs in the 1990s, SIDS rates started to decrease dramatically.

The AAP explains that you should place your baby to sleep on their back, but if they are able to roll on their own, and roll to their tummy or their side, you can leave them be. If your baby falls asleep in their car seat, a baby swing, a bouncy chair, or any other device, they should be moved to their crib, and placed on their back. Swaddling your baby is considered safe, but you should also take care to place your baby on their back once they are asleep.

Use a Firm, Uncluttered Sleep Space

You should place your baby to sleep on a firm mattress without any other objects present, says Christina Johns, MD, pediatrician and senior medical advisor at PM Pediatrics. “There should be no crib bumpers, pillows, loose sheets, or anything soft or plush, including stuffed animals in the crib,” says Dr. Johns.

You shouldn’t use blankets for your baby either, Dr. Johns says. If your baby is cold, you can use a “sleep sack” during sleep. You should also not include any sleep wedges or sleep positioners, she says.

Loose blankets and other bedding pose a strangulation risk, explains the AAP. In addition to sleep wedges and positioners, the AAP cautions against the use of nursing pillows or any type of lounging pads during sleep. If your baby rolls onto their stomach or side while sleeping on a pillow or nursing pillow, their airway may be blocked and they could suffocate. 

Keep Your Baby in Your Room, But Don’t Bedshare

It’s natural to want to keep your baby close to you during sleep. The AAP encourages parents to keep their babies close by, in their rooms. However, they discourage parents from taking their babies into bed with them.

The AAP recommends that babies sleep in the same room as their parents for the first six months of life at least, and up to a year, if possible. Sharing a room with your baby reduces their risk of SIDS by 50%, says the AAP. The AAP recommends that your baby’s crib or bassinet be within arms reach so that you can soothe your baby, and be aware of their movements and needs.

At the same time, bringing your baby into bed with you can increase their risk of SIDS and suffocation. This is particularly true if your baby is less than four months old, they were born prematurely, you or your partner is a smoker, you are under the influence of drugs or alcohol, or you are sleeping on a soft or cluttered surface, or a non-bed surface (such as a sofa or armchair). 

Breastfeed Your Baby

One of the best ways you can reduce the risk of SIDS is to breastfeed your baby. A study from 2017, published in Pediatrics, found that breastfeeding for at least two months lowered a baby’s risk of SIDS by almost 50%.

And you don’t have to breastfeed exclusively to reap these benefits. According to the study, even partial breastfeeding for at least two months offered the same protection against SIDS.

In addition to breastfeeding, the AAP says that giving your baby a pacifier while they sleep can cut down the risks of SIDS. If you are breastfeeding, it’s best to wait till breastfeeding is established before introducing a pacifier.

Never Sleep on a Couch, Sofa, Or Armchair With Your Baby

New parents are tired and it’s understandable that sometimes they would fall asleep while nursing, feeding, or comforting their babies. But falling asleep with your baby on an unsafe surface, such as a couch, sofa, armchair, or recliner, is a major risk factor for SIDS, says. Dr. Ellington.

“Infants sleeping in bed or on a couch or in other situations with parents is extremely dangerous and should be avoided,” Dr. Ellington explains. “As parents are often tired, it is very important for them to not fall asleep holding infants.”

Instead, says Dr. Ellington, if you feel like you are getting sleepy and might drift off, transfer your baby to their crib before falling asleep yourself.

Don’t Overheat Your Baby

It’s common to be concerned that your baby will be too cold while they are sleeping, and you might be tempted to dress them in warm clothing. But overheating is a risk factor for SIDS, and one that should be avoided, says Dr. Johns.

“Good general guidance is to dress an infant in no greater than one extra layer than what an adult would wear for a given season/temperature,” Dr. Johns recommends. You should also keep your baby’s room at a comfortable temperature and make sure it’s not too hot in the room, advises the AAP.

Don’t Use Breathing Monitors

It can be tempting to purchase a sleep monitor to use with your baby. After all, many are advertised to reduce your baby’s chances of SIDS. But the AAP advises against using these.

No device should replace parental monitoring of your baby, and the AAP explains that you shouldn’t rely on these devices to monitor your child. Not only that, but there is no proof that they work, says Dr. Johns. “Home cardiorespiratory monitors should not be used as a strategy to reduce the risk of SIDS as they have not been shown to decrease the incidence of SIDS,” she remarks.

A Word from Verywell

It may seem like there are a million rules when it comes to baby sleep, and you may feel overwhelmed reading and absorbing them. Dr. Johns has an excellent way to remember the most basic principles of safe sleep advice: You can reduce your risks of SIDS by following the ABCs: placing their baby ALONE, on their BACK, in a CRIB.

Remember, too, that if you have any questions about these sleep guidelines, or how to generally reduce your baby’s risk of SIDS, you shouldn’t hesitate to reach out to your pediatrician. Any concerns you may have are valid, and your pediatrician will be able to answer questions specific to your baby and your life situation.