Safe Sleeping and Sudden Infant Death Syndrome (SIDS)

The causes of Sudden Infant Death Syndrome (SIDS) are not known, but are thought to be a combination of genetic predisposition, neurologic immaturity and environmental factors. The main known environmental risk factor is prone (stomach) sleeping position. Side sleeping has also been found to be dangerous for infants because of the risk of rolling onto the stomach. The Back To Sleep campaign was launched nationally in 1994 and by 2001, the rate of SIDS had dropped by 53%.

• Exposure to tobacco smoke, both in utero and during the first year of life;
• Use of soft bedding (e.g. pillows, blankets, foam padding) and sleep surfaces (including adult mattresses and sofas);
• Bed sharing with another person (adult or child);
• Overheating due to high room temperatures or multiple layers of clothing and blankets;
• Prematurity and low birth weight.

SIDS is the third leading cause of death among infants (0 to 12 months) in Maryland and Anne Arundel County behind prematurity/low birth weight and birth defects. Between 2003 and 2007, 28 infants died of SIDS in the county. African American infants are three times more likely to die of SIDS than white infants. Infants that live in the northern and western areas have a higher rate of SIDS compared with infants living in other areas of the county.

There are important steps that anyone who cares for babies, including parents, family and daycare providers, should follow. The 2005 American Academy of Pediatrics recommendations include:

• Place babies on their backs to sleep and nap.
• Avoid smoking during and after pregnancy. Don't let anyone smoke around the baby.
• Use a crib with a firm mattress covered by a well-fitting crib sheet.
• Keep all soft objects and loose bedding out of the baby's sleep area. Blankets should be tucked under the baby's arms and then under the mattress. Bumper pads are not needed but if used, should be thin, firm and securely attached.
• Put the baby to sleep alone. Parents can share a room with the baby, but not a bed.
• Don't let the baby get too hot. Avoid overbundling-try a one-piece sleeper or sleep sack. Keep the room at a comfortable temperature.
• Consider giving a pacifier when the baby is put down to sleep or nap. It can be introduced after breastfeeding is established, about one month of age.
• Don't use any special equipment or sleep positioners to lower the risk of SIDS. They have not been proven to help.

More details can be found in the full AAP Policy Statement on reducing the risk of SIDS.

The Anne Arundel County Healthy Babies Coalition has produced patient information cards about safe sleeping and other topics that are available for providers' offices and community organizations. They can be downloaded. They can also be ordered for free online or by calling 410-222-7203.

The Anne Arundel County Infant Health Report contains additional information about other infant health indicators.