Back To Sleep

Contents

• What is SIDS?
• Facts About SIDS
• Babies Should Sleep on Their Backs
• What Can I Do to Help Lower the Risk of SIDS?
• What Other Things Can I Do to Keep My Baby Healthy?

What is SIDS?

SIDS, a word that stands for Sudden Infant Death Syndrome, is the sudden and unexplained death of a baby under one year of age.

Because many SIDS babies are found in their cribs, some people call SIDS "crib death." But cribs do not cause SIDS.

Facts About SIDS

Doctors and nurses don’t know what causes SIDS, but they do know:

• SIDS is the leading cause of death in babies after one month of age.
      
• Most SIDS deaths occur in babies who are between 2 and 4 months old.
      
• More SIDS deaths occur in colder months.
      
• Babies placed to sleep on their stomachs are much more likely to die of SIDS than babies placed on their backs to sleep.

• African American babies are twice as likely to die of SIDS as white babies. American Indian babies are nearly three times more likely to die of SIDS than white babies.

Even though there is no way to know which babies might die of SIDS, there are some things that you can do to make your baby safer.

Babies Should Sleep on Their Backs.

One of the best ways to lower the risk of SIDS is to put your baby on his or her back to sleep, even for naps.

This is new advice. Until a few years ago, doctors told mothers to place babies on their stomachs to sleep. If you have older children, your doctor may have told you that babies should sleep on their stomachs. But research now shows that fewer babies die of SIDS when they sleep on their backs. In fact, before the Back to Sleep campaign began to recommend back sleeping as the best way to reduce SIDS, more than 5,000 babies in the U.S. died from SIDS every year. But now, as the Back to Sleep message spreads and more babies sleep on their backs, the number of babies who die of SIDS is under 3,000 each year.

Back sleeping is the best sleep position for your baby and provides the best protection against SIDS. The American Academy of Pediatrics says that back sleeping is the preferred sleep position.

Make sure everyone knows to place babies on their backs to sleep. Tell your baby's grandparents, aunts, uncles, child care providers, friends, babysitters, and anyone who cares for your baby. Some babies don't like sleeping on their backs at first, but most get used to it quickly. Babies who are on their backs can move their arms and legs and look around more easily.

Is there a risk of choking when my baby sleeps on his or her back?

Many mothers worry that babies sleeping on their backs will choke if they spit up or vomit while sleeping. Because babies automatically swallow or cough up such fluid, doctors have found no increase in choking or other problems in babies sleeping on their backs.

What about side sleeping?

To keep your baby safest when he or she is sleeping, use the back sleep position rather than the side position. Even though the side position is safer than sleeping on the stomach, babies who sleep on their sides can roll onto their stomachs. A baby sleeping on his or her stomach is at greater risk of SIDS. If you choose to place your baby on his or her side to sleep, make sure the lower arm is in front of the baby to help stop him or her from rolling onto the stomach.

Some products are designed to keep the baby in a certain position during sleep. But there is no proof that using any such product lowers the risk of SIDS.

Some babies have health problems that call for them to sleep on their stomachs. If your baby was born with a birth defect, spits up often after eating, or has a breathing, lung, or heart problem, you should talk to your doctor about the best sleep position for your baby.

Are there times when my baby can be on his or her stomach?

You can place your baby on his or her stomach for "tummy time," when he or she is awake and someone is watching. When the baby is awake, tummy time is good because it helps make your baby’s neck and shoulder muscles stronger.

Will my baby get "flat spots" on his or her head from back sleeping?

For the most part, flat spots on the back of the baby’s head (plagiocephaly) are a passing condition that goes away a few months after the baby learns to sit up. Tummy time when your baby is awake is one way to reduce flat spots.

One other way to reduce flat spots is to change the direction that your baby lies in the crib (head toward one end of the crib for a few nights and then toward the other). Doing this means the baby is not always sleeping on the same side of his or her head. If you think your baby has a more serious problem, talk to your doctor or nurse.

What Can I Do to Help Lower the Risk of SIDS?

• Place your baby on his or her back to sleep, at nighttime and naptime.
  This is the best way to reduce the risk of SIDS.

• Place your baby on a firm mattress, such as in a safety-approved crib.
  Don’t put babies to sleep on soft mattresses, sofas, sofa cushions, waterbeds, sheepskins, or other soft surfaces.

• Remove all fluffy and loose bedding from the sleep area.
  Make sure you take all pillows, quilts, stuffed toys, and other soft items out of the crib.

• Make sure your baby’s face and head stay uncovered during sleep.
  Keep your baby’s mouth and nose clear of blankets and other coverings during sleep. Use sleep clothing with no other covering over the baby. If you do use a blanket or another covering, make sure your baby is "feet-to-foot" in the crib. Feet-to-foot means that the baby’s feet are at the bottom of the crib, the blanket is no higher than the baby’s chest, and the blanket is tucked in around the crib mattress.

• Don’t smoke before or after the birth of your baby.
  Create a smoke-free zone around your baby. Make sure no one smokes around your baby.

• Don’t let your baby overheat during sleep.
  Keep your baby warm during sleep, but not too warm. Your baby’s room should be at a temperature that is comfortable for an adult. Too many layers of clothing or blankets can overheat your baby.

What Other Things Can I Do to Keep My Baby Healthy?

Get good health care. Good care starts early in pregnancy and includes eating the right foods and not smoking, taking drugs, or drinking alcohol while pregnant. You should also have frequent check-ups with your doctor or nurse. This kind of care helps keep your baby from having problems that could put him or her at risk for SIDS.

Breastfeed your baby, if possible. Studies show that breastfeeding is good for your baby. Breast milk helps to protect the baby from some infections and keeps your baby healthy.

There is no scientific proof that bed-sharing between baby and an adult reduces SIDS. In fact, in some cases, bed-sharing can be unsafe. If you choose to have your baby sleep in the bed with you in order to breastfeed, make sure your baby sleeps on his or her back. Avoid soft surfaces, pillows, and loose covers. Make sure the baby can’t get trapped between the mattress and the framework of the bed (headboard, footboard), a wall, or other furniture.

Take your baby for scheduled well-baby check-ups. Also, make sure your baby receives his or her shots on time.

Most babies are born healthy and most stay that way as they grow.

Enjoy your baby!

If you have any questions about your baby’s sleep position or health, ask your doctor or nurse.

For more information about the Back to Sleep campaign, call toll-free, 1-800-505-2742. Or write to: Back to Sleep/NICHD, 31 Center Drive, Room 2A32, Bethesda, MD, 20892-2425.

Back to Sleep campaign sponsors: