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SIDS is scary! It affects over 3,500 babies in our country every year, who die unexpectedly in their sleep. These babies can be healthy, without any previous signs of illness. The highest risk for SIDS is in premature and low birth weight babies less than a year of age, especially those younger than 4 months. SIDS can also happen later, though. The American Academy of Pediatrics regularly releases updated guidelines for parents, to promote safe sleep for babies and prevent Sudden Infant Death Syndrome (SIDS).

Over the past 7 years that I’ve been a Pediatrician, I’ve cared for too many families devastated by SIDS. The death of an infant probably stings the most. It’s a terribly long healing process for families. Regret is the common theme. What could they have done differently to keep their baby healthy and alive? Please, take these recommendations to heart and follow them closely for your baby, and pass along to family members, and friends.

Positioning Your Baby

You should always put your baby to sleep on his back, no matter how old he is. Sleeping on the back is safer than sleeping on the tummy or side. A baby sleeping on his side can easily roll over to his tummy, which is unsafe. This includes naptime and bedtime. Your baby should be place on his back even if you’re awake and “watching” him. It’s hard to sit and stare at your baby the entire time he’s sleeping, and to never look away. SIDS happens very quickly, and any moment on the tummy can be life-threatening.

I have had many parents bring to me the concern that their baby has reflux. They’re concerned that the baby will choke and/or spit up when on his back. A baby with a normal gag reflex will keep his airway protected. This is the case even if he spits up while sleeping on his back. Sleeping on the tummy creates a much higher risk of death than spitting up while sleeping on the back.

Once your baby can roll both ways on his own, it’s OK for him to stay on his tummy for sleep. By this time, he’s proven that he’s strong enough to move and to control his head to prevent suffocation. It’s still recommended that all babies start out on their backs for sleep no matter the age.

Sleep Space

Babies should sleep on a flat, firm surface with a tight-fitting sheet over the mattress. Cribs, bassinets, and playpens usually fit this criteria. A firm surface is one that doesn’t leave your baby’s outline in the mattress when you pick him up.

What happens if your baby falls asleep in the car seat? It’s best to move a sleeping baby from a car seat, swing or bouncer seat as soon as you can. I know most moms don’t want to move a sleeping baby. But remind yourself that you’re doing the right thing, to keep him alive!

Nothing should be in the crib with your baby when he’s sleeping. – no bumpers, toys, blankets, pillows, etc. If your baby’s face comes in contact with any of these things while sleeping, it can increase his risk of suffocation. This is even more important for those babies that have started to roll over.

Don’t share a bed with your baby. This drastically increases the risk of SIDS. If you’re feeding in the middle of the night, be sure that there are no blankets or pillows nearby that could cause harm to your little one, in case you fall asleep. Put him back down in a safe spot as soon as possible after feeding.

Room

The American Academy of Pediatrics now recommends that your baby sleep in the same room with you (near your bed, but not in your bed) at least until he’s 6 months old, and ideally until age 1. I know this is a stretch for many parents, but you can’t argue with research. The newest research has shown that the risk of SIDS is decreased by 50% when babies share a room with their parents.

Comfort

Blankets and toys should not be in your baby’s crib. So what can you do to keep your baby comfortable? Most babies love to be swaddled for the first few weeks to months. Just be sure your baby is flat on his back when swaddled. Also, be sure not to cover his face. Once your baby starts to roll even to his side, you should stop swaddling.

Dress your baby in clothing that is comfortable enough for sleep. Depending on the temperature in your home, dress him warm enough for comfort, but not to the point of overheating (since this can increase the risk of SIDS, too). A general rule of thumb is to have your baby wear one more layer than you’re wearing.

Pacifiers have been proven to reduce the risk of SIDS. This is true, even if your baby doesn’t keep it in the entire time he’s asleep. If your baby doesn’t take a pacifier well, though, don’t feel like you have to force the issue!

Your role as mom

Stay away from alcohol, drugs and cigarette smoke during pregnancy and afterwards. These increase the risk of SIDS, especially since alcohol and drugs can make parents much less aware, and unable to appropriately care for your baby.

Breastfeed your baby. At least give it a try! There’s a long list of health benefits for breastfeeding moms and babies. Breastfeeding reduces the risk of SIDS.

Bring your baby to all of his well visits and be sure his shots stay up to date. Your doctor can diagnose and treat problems during regular exams. Your baby can also be referred for therapy if there is any physical delay. Vaccines have also been shown to protect against SIDS.

Tummy time is so important. Even if your baby hates it, I recommend that you push him daily. I usually recommend starting tummy time from the time your baby’s umbilical cord stump (belly button) falls off and heals, and his circumcision (if done) heals. This is usually by 2 weeks of age. Tummy time is so important for your baby to gain head and neck strength, to lift his head, to learn to protect his face from suffocation, and to learn to roll over. It also prevents the back of your baby’s head from getting flat – which is an unfortunate side effect of the “Back to Sleep” campaign. It seems like such a small, simple thing to do, but it can make a huge difference for your little one.

Don’t be fooled into buying products that are marketed to “prevent SIDS”. Companies now sell clothing, wedges, positioners, etc. The American Academy of Pediatrics doesn’t officially endorse any of these products, so I don’t recommend spending the extra money. A simple firm, flat crib mattress and safe sleep practices are all that you need to keep your baby safe.

The AAP also recommends against using at-home heart rate and breathing monitors for your baby. I’m not talking about apnea monitors here. If your baby is sent home from the NICU with an apnea monitor, be sure to use it. But, I’m talking about other products that you can easily buy from the store. I recommend staying away from those. They aren’t always reliable, and can increase your anxiety as a parent with false alarms. There’s no doubt that these products may have saved lives, but there isn’t enough information out there to say that you can rely on any one of these to keep your baby safe.

Takeaway

The best way to keep your baby safe and to prevent sudden infant death syndrome (SIDS) is to follow the recommendations above. There’s no special product that you can use to guarantee safety. Just practice safe sleep at all times.

Believe me, I know that a lot of babies tend to sleep better on their tummies. A lot of grandmothers will stand by the fact that their babies slept on their tummies and lived. My youngest was (and still is at times) a terrible sleeper. He wouldn’t sleep for long periods on his back or alone. He slept better in his car seat. I’ve fallen asleep while breastfeeding all of my kids at night. They have sometimes ended up in my bed. I’ve been there!

But, I can never, with any good conscience, tell another parent that it’s OK to bend the recommendations when it comes to SIDS prevention for your baby. We know so much more now than we did years ago. I want you to do everything that you can to keep your little one safe. It can be hard to survive the first few months with a new baby, but I want you both to do just that – SURVIVE!

For a free printable with Do’s and Don’ts for SIDS Prevention and access to my resource library, just fill out the box below!

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