Spring 2009

Reducing Your Baby’s Risks for SIDS

Back to Sleep guidelines help prevent sudden infant death syndrome

An interview with Jennifer Daru, M.D., chief, pediatric hospital medicine

Nothing is more tragic than the death of an infant—especially if it could have been prevented. That’s why the National Institute of Child Health and Human Development (NICHD) launched its Back to Sleep campaign in 1994 to help reduce the risk for sudden infant death syndrome (SIDS).

“Since the Back to Sleep campaign started, the number of SIDS deaths has been cut in half,” says Jennifer Daru, M.D., a pediatric hospitalist and chief of pediatric hospital medicine at California Pacific Medical Center. “Yet SIDS is still one of the leading causes of death for infants up to age 1, claiming approximately 2,300 infants in the U.S. every year. That’s about one out of every 2,000 births. Most SIDS deaths occur between ages 2 months and 4 months.”

No Known Cause

The American Academy of Pediatrics defines SIDS as “the sudden death of an infant younger than 1 year of age that remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and review of the clinical history.”

Jennifer Daru, M.D., Chief, Pediatric Hospital Medicine

“We don’t know what causes SIDS, although there are various theories about it being related to an immature respiratory system or to problems in the part of the brain stem that helps regulate functions such as heart rate, breathing and body temperature. There also may be associations with infants who have prolonged QT syndrome,” Daru says. “We also don’t know why African-American babies are twice as likely to die of SIDS as Caucasian babies or why American Indian babies are three times as likely to die of SIDS. What we do know is that babies who sleep on their back are less likely to die of SIDS.” Other risk factors include being male, being born prematurely or during the winter months, and tobacco exposure.

Here are guidelines to follow:

Place your baby on a firm sleeping surface—never on a pillow or other soft surface.
Keep soft objects, toys and loose bedding out of the baby’s sleep area.
Avoid letting your baby overheat during sleep.
Consider using a pacifier when putting the baby to sleep. If you’re breastfeeding, wait until the baby is 1 month old or is used to breastfeeding.
Don’t use sleep positioners to prop your baby up on his or her side. Although they are marketed as anti-SIDS devices, there is no evidence they are effective or safe.
Electronic breathing monitors do not decrease SIDS risk and should be avoided.

Will a Fan Help?

Daru notes that a study published in the October 2008 Archives of Pediatric Adolescent Medicine indicated that using a fan in the room where a baby sleeps might help reduce the incidence of SIDS. “The researchers found that infants who slept in rooms with fans had a 72 percent lower risk of SIDS,” she says. “That finding may or may not coincide with the recommendation to avoid letting your baby overheat during sleep. It’s important to note that this was just one small study, and using a fan is not a hard-and-fast recommendation. I use a fan in my son’s room to block noise, but I am happy that there might be other benefits as well.”

To Learn More

For more information about the NICHD’s Back to Sleep campaign, please visit www.nichd.nih.gov/sids/sids.cfm.