If you mention Sudden Infant Death Syndrome (SIDS) to a new mom or dad, you will see that parent cringe. Putting a baby down to sleep and later finding him unarousable is a scenario that terrifies every mom, dad and pediatrician.

Over the last decade, the number of SIDS cases has decreased, thanks to a campaign encouraging parents to put their infants to sleep on their backs. Unfortunately, SIDS is still a leading cause of infant deaths. The American Academy of Pediatrics (AAP) recently updated their SIDS policy recommendations in an effort to further reduce the number of SIDS related fatalities.

Known risk factors

To date, no one has determined the exact cause(s) of SIDS, but certain risk factors have been identified: sleeping in the prone (stomach) position, sleeping on a soft surface (with pillows, quilts, comforters, sheepskins or stuffed toys), the mother smoking during pregnancy, the infant being overheated or over-bundled, the mother receiving little or no prenatal care, a very young mother, a premature or low birth weight baby or the infant being male.

Side versus back sleeping

The AAP no longer considers side sleeping to be as safe as sleeping on the back. Studies have shown that a baby sleeping on her side is more likely to roll over to her stomach. The AAP encourages caregivers to use the back sleeping position for all naps and bedtime.

Co-sleeping versus the crib

The AAP does not recommend that infants sleep in the same beds as their parents. Moms and dads are encouraged to bring their infant into bed for comforting or nursing, but then return their baby to the crib when the parent is ready to go to sleep. Having an infant sleep in a crib inside or near a parent’s bedroom has been shown to reduce SIDS.

The role of a pacifier

A recent study suggests that pacifier use during naps and bedtime may further decrease the risk of SIDS. The AAP has revised its policy to encourage pacifier use during naps and bedtime for infants during their first year of life. Some pediatricians believe that prolonged pacifier use may be related to an increased number of ear infections; however, the anticipated reduction in SIDS deaths is more significant. Nursing moms are still encouraged to hold off on pacifier use for the first month or until breastfeeding is well established. If an infant refuses to take a pacifier, it should not be forced.

In conclusion (for now)

A SIDS death is a truly tragic event. Over time, pediatricians hope to implement new strategies to help parents reduce the risks. One day, we may discover that SIDS has an entirely different cause, but until then pediatricians feel that it is important to continuously revise and update their recommendations based on the most current research. I encourage you to discuss these issues with your own pediatrician and then share your thoughts with anyone who helps care for your baby.
As of today, it appears that the safest sleeping infant is the one who sleeps on his back, in a crib or bassinet, on a firm surface, without soft bedding, lightly clothed, close to but not in the same bed as his non-smoking parents and possibly with a pacifier in his mouth.