It's every parent's nightmare: you lay your baby down to sleep, and she never wakes up. But sudden infant death syndrome (SIDS) is rare, and there are ways you can reduce your child's risk.
About half of the 4,000 babies who die suddenly and unexpectedly each year pass away from SIDS.
Though that number sounds high, it's only a tiny percentage of the nearly 4 million babies born in the US every year. In fact, it's about 0.05 percent, or five out of every 10,000 babies.
Still, it is important that parents are aware of risk factors for SIDS and ways to help reduce their child's risk of it.
Understanding Suffocation/Strangulation Risks
One important thing to realize is that SIDS is often hard to distinguish from accidental suffocation or strangulation in beds or cribs.
Therefore, some of the guidelines offered to reduce the risk of SIDS are actually designed to reduce the risk of suffocation or strangulation as well.
Suffocation can occur in a variety of ways, such as a person rolling onto or against an infant or an infant suffocating from soft bedding, such as with pillows or in waterbeds.
Babies may also become trapped or wedged between objects, such as a mattress and a wall or within a bed frame.
Or babies sleeping in a crib may accidentally strangle themselves if their neck or head becomes caught between crib railings or if there are any objects in the crib that can lead to strangulation.
Another way to reduce SIDS risk is to ensure that mothers receive regular prenatal care during pregnancy and that children attend all regular well-child visits. According to the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), parents should follow their healthcare provider's advice on their infant's vaccines and regular health checkups.
Importantly, the NICHD recommends that parents should actually avoid products such as wedges, positioners, special pillows or other objects that claim to reduce the risk of SIDS. These products may actually increase the risk.
The only type of product that appears to be safe to use in reducing SIDS risk are sleeping outfits such as "wearable blankets" in which a child's head is still free and clear.
NICHD also recommends that babies get plenty of "tummy time" each day while awake and supervised. This means putting babies on their tummies for fun activities so that the infant develops strong abdominal and neck muscles.
Reducing SIDS and Suffocation Risks
The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) offer a number of recommendations parents can follow to reduce their babies' risk of SIDS, suffocation and strangulation.
First, according to AAP, parents should always place their infants to sleep on their backs. When the "Back to Sleep" campaign, now called the "Safe to Sleep" campaign, kicked off in the early 1990s, SIDS deaths dropped by more than half.
Once babies learn to roll over on their own, it is okay if they roll onto their tummies after being placed down on their backs. However, they should always be set down on their backs first.
According to NICHD, parents should ensure their infants have a firm sleeping surface covered with a fitted sheet only, without additional sheets or blankets.
In addition, parents can consult the Consumer Product Safety Commission website to learn about crib safety information.
NICHD says that babies should not sleep on couches or on a chair alone. It is also not recommended for them to sleep with adults, other children or in an adult bed.
All toys, loose bedding, pillows, stuffed animals and any other soft objects should be removed from the crib or the baby's other sleeping surface, according to NICHD.
Women should not smoke during pregnancy or allow smoking around their babies. Exposure to smoking in the womb or to secondhand smoke in the home are both significant risk factors for SIDS.
In addition, parents should not drink alcohol or use illegal drugs during pregnancy or after the baby is born. Both are SIDS risk factors.
Breastfed babies have a lower risk of SIDS than babies fed formula, so the AAP recommends breastfeeding your baby for at least the first six months.
The use of a pacifier also may slightly reduce the risk of SIDS, so babies can be put to sleep with a pacifier as long as it is by itself and not attached to a string or rope.
Keep your baby's room at typical room temperature and not too warm. Babies who become too hot while asleep are also at a higher risk for SIDS.
William Kohler, MD, the medical director of the Florida Sleep Institute in Spring Hill, Florida, said these guidelines are important for parents to be aware of.
"I think the important messages here is that SIDS can be reduced," Dr. Kohler said. "It's very tragic when a child dies needlessly."
The more risk factors that parents can reduce, the less likely it is that their child will die from SIDS.
"Once the Back to Sleep program was initiated by the American Academy of Pediatrics, there was a significant decline in the number of SIDS patients," Dr. Kohler said.
"Putting the patient on their back, not having loose bedding in the crib, avoiding cosleeping, avoiding cigarette smoking during pregnancy and after the child is born are all important things to consider as far as a way to prevent SIDS," he said.
What's Being Done about SIDS?
Even though this condition affects a tiny percentage of babies, a great deal of time and funding go into research to better understand SIDS.
Much of what is understood today has resulted from research done in the US, Australia, New Zealand, South Africa, Canada, Asia and Europe.
It is through research studies that public health officials have learned about the value of pacifiers and breastfeeding, as well as the importance of placing babies on their back and away from secondhand smoke.
The CDC also maintains a database of SIDS and suffocation deaths gained when people fill out the Sudden Unexplained Infant Death Investigation Reporting Form.
The CDC has also invested in regional training to teach state teams how to effectively conduct investigations of babies' deaths.
Meanwhile, because black, Native American and Alaskan Native babies have been found to have twice the risk of SIDS than white babies, the CDC has sought ways to convey the message about safe sleep guidelines to underserved communities.
The CDC also has begun working with the Navajo Nation to improve death investigations of infants.