SIDS Reduction :: Nationwide Children's Hospital

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SIDS Reduction

Sudden Infant Death Syndrome (SIDS) is the sudden death of a baby under one year of age where no other cause can be found. It was once called "crib death." SIDS is the most common cause of death for babies between one month and one year old. The highest risk is between 2 and 4 months. The cause of SIDS is not known, but it is more likely to happen to babies who sleep on their stomachs than to those who sleep on their backs. Since 1994, doctors in the United States have been telling parents to have their babies sleep on their backs. Because of this change, the number of babies in the US who die from SIDS is much lower now.

Why Sleep Positioning is Important

Much research has been done to find out the cause of SIDS, but doctors have not been able to find a cause. There’s no way to predict or prevent SIDS, but doctors have found that babies who sleep on their bellies, have soft bedding, are kept too warm, or are ill are more likely to die of SIDS. Many parents worry that their baby will spit up and choke if he sleeps on his back.  Doctors have not found this to be true, even in babies with reflux. Babies who sleep on their backs do not have a greater chance of choking or other problems.

How to Position Your Baby

Babies should sleep on their backs until they are 12 months of age (Picture 1). To keep babies on their backs, follow these steps:

Picture 1 - Babies should sleep on their backs until they are 12 months of age.
Image of baby sleeping

You Will Need

  • Firm crib mattress
  • Sleep sack (a special sleeping blanket that has arm holes to prevent fabric from going over the baby’s head/face).


Put your baby in the sleep sack, then place the baby on his back in a safe crib.

How to Position Your Baby 

  • Always put your baby on his back for sleep. This includes night time sleep and all naps.
  • If your baby has just been fed, make sure to burp him well before laying him down to sleep.
  • Never restrain your baby to keep him in the back position. Once an infant can roll from back to tummy and from tummy to back, the infant can be allowed to remain in the sleep position that he or she assumes.

Other Sleep Safety Tips

Along with using the back position for sleep, other things that help prevent SIDS include:

  • Cribs should meet the safety standards of the Consumer Product Safety Commission.
  • Use a firm surface for your baby's bed. DO NOT let your baby sleep on a sofa, waterbed, beanbag chair, sheepskin, stuffed toys, cushion, comforter, pillow, or other soft material. Some infants have smothered while using these. No quilts, comforters, bumper pads or other fluffy, loose bedding should be in the crib.  Bumper pads should not be used in cribs. There is no evidence that bumper pads prevent injuries, and there is a potential risk of suffocation, strangulation or entrapment.
  • Take pillows, blankets, and all soft toys out of your baby's crib.  Wedges and positioners should not be used.
  • Don’t put baby to bed wearing a hat or decorative headband.
  • Babies who get too warm are more likely to die of SIDS. They may get too warm if they are overdressed or bundled. Keep your baby's room at a temperature that is comfortable for you (68 to 72 degrees).  Your baby will be warm enough with just a thin layer of clothing and a sleep sack.
  • Do not let your baby sleep with older children or any adults. This increases the risk of the infant being smothered. The baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing).
 
Image of parents and baby

Keeping Your Baby Healthy

  • Keep your baby in a smoke-free environment. Do not smoke or allow others to smoke in your home.  Keep baby away from people whose clothes smell of smoke. Do not smoke during pregnancy or after birth.
  • Breastfeed your baby if possible. This has been shown to decrease the risk of SIDS.
  • You may offer a pacifier at naptime and at bedtime.
  • Make sure your baby gets all immunizations (shots) on time. Evidence suggests that immunizations reduce the risk of SIDS by 50%.
  • If your baby seems sick, call the doctor or clinic for advice or an appointment.
  • Get good prenatal care during pregnancy.
  • Place your baby on his stomach while he is awake and you can watch him. This helps to develop neck muscles and good head control.

If you have any questions about sleeping positions for your baby, be sure to ask his doctor or nurse.

SIDS Reduction (PDF)

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