Sudden Infant Death Syndrome (SIDS) is a medical disorder which claims the lives of thousands of young children one week to one year of age.

What is SIDS?
Once known as crib death, these infant deaths remain unexplained after all known causes have been ruled out through autopsy, death scene investigation, and medical history.  SIDS can affect families of all races, religions, and income levels.  It usually occurs during sleep, and strikes without warning.  Its victims appear to be healthy.  Neither parents nor doctors can tell which babies will die.

What Causes SIDS?
We do not know how or why SIDS happens.  The first year of life is a time of rapid growth and development when any baby may be vulnerable to SIDS.   It is likely that SIDS may be caused by a subtle developmental delay, an anatomical defect, or a functional failure.  Challenges a normal baby can overcome - such as passive smoke exposure, stomach sleeping, or overheating - may pose an added, if not fatal risk to an infant who is already vulnerable, and may contribute to a SIDS death.

Researchers ask questions about how babies who die from SIDS might be different from babies who do not.   These differences are often referred to as risk factors.  Risk factors are not causes of SIDS, but they may be clues about what causes SIDS.  Statistics tell us that more babies die of SIDS during the cold weather months.  Babies who sleep on their stomachs have an increased risk of SIDS.  We also know that more babies die of SIDS whose mothers smoked during and after pregnancy. The younger the mother, the greater baby's risk for SIDS.  Boys are at slightly higher risk than girls.  And SIDS occurs most often in infants two to four months of age.  In fact, 90% of all SIDS babies are under six months of age. There is also a higher likelihood of SIDS among premature and low-birthweight infants, twins and triplets.

Can SIDS Be Prevented?
Despite some recent claims, there is no product that can stop SIDS from happening.  Scientists are exploring the development and function of the nervous system, the brain, the heart, breathing and sleep patterns, body chemical balances, autopsy findings, and environmental factors.  SIDS, like other medical disorders, may eventually have more than one explanation and more than one means of prevention.  This may explain why the characteristics of SIDS babies seem so varied.

The real headway is being made in identifying factors that may be associated with SIDS.   Studies from around the world have now identified risk factors which, though not causes of SIDS in and of themselves, seem to play a role in some cases.

The SIDS Alliance shares the following recommendations with you in the interest of providing parents with the latest medical evidence from the U.S. and other countries - in the hope of giving your baby the best possible chance to thrive.

Place your baby on the back to sleep.
The American Academy of Pediatrics recommends that healthy infants sleep on their backs to reduce the risk for SIDS.  Since nearly one-third of all SIDS deaths occur in daycare settings, the Academy urges parents to extend this advisory to grandparents, babysitters, daycare providers and everyone who cares for the infant. Babies are not more likely to choke while sleeping on their backs.   Delays in rolling over, however, are normal among babies who sleep on their backs.   Some infants may experience head-flattening from too much time on their backs or in carseats, a condition which can usually be resolved by simply allowing more tummy-down time when the baby is awake and being watched.  Infants unexpectedly falling asleep on their tummies should be gently turned onto their backs.  While the side sleep position is preferable to tummy-down, research continues to demonstrate that back is best.   The SIDS Alliance does not endorse the use of wedges or other purchased items intended to prop a baby on its side.  Parents should discuss sleep positioning of infants with breathing problems or excessive spitting up with the baby's doctor.

Stop smoking around your baby.
Findings from the National Center for Health Statistics demonstrate that women who smoke cigarettes during or after pregnancy put their babies at increased risk for SIDS.  Babies exposed to smoke only after birth were twice as likely to die from SIDS as those whose mothers did not smoke at all.  And, mothers who smoked both during and after pregnancy tripled their babies' risk for SIDS.  Recent studies have found that the risk of SIDS rises with each additional smoker in the household, the numbers of cigarettes smoked a day, and the length of the infant's exposure to cigarette smoke.  Components of smoke are believed to have a negative impact on the infant's developing lungs and nervous system and to cause abnormalities in the developing brain.  Smoke exposure may also disrupt the arousal mechanism in infants, interfering with a baby's ability to wake from sleep.  Parents are advised not to smoke during pregnancy and the critical first year of life, and not allow anyone else to smoke around the baby either!

Use firm, flat bedding.
The U.S. Consumer Product Safety Commission has issued advisories for parents regarding hazards to infants sleeping on top of beanbag cushions, sheepskins, sofa cushions, pillows or other soft bedding, such as blankets or comforters.  Blankets and bumpers should be thin, flat and fastened securely to minimize the risk of covering the baby's head or face.  Your baby's sleep safety may also be enhanced by positioning your baby for sleep on the back, "feet to foot," with feet at the foot of the bed (not centered in the crib) and blankets fastened under the sides of the mattress at armpit level to reduce the likelihood of an infant crawling under the bedcovers. Waterbeds have been identified as unsafe for infant's sleep.   And now a new study indicates that sleeping on a cloth or foam-covered mattress previously used by another child or adult may increase the risk of SIDS.  Parents are advised to use a firm, flat mattress in a safety-approved crib, without a pillow, for their baby's sleep.  Be sure to discuss the safety of any second-hand, hand-me-down, or family heirloom cribs, cradles or other bedding items with your baby's doctor before using them for your baby.

Avoid overheating your baby.
SIDS is associated with the presence of colds and infections; although colds are not more common among babies who die of SIDS than babies in general.  Now, research findings indicate that overheating - too much clothing, too heavy bedding, and too warm a room - may increase the risk of SIDS for a baby who sleeps on the stomach, particularly if the baby is ill.  Signs that your baby may be overheated include sweating, damp hair, heat rash, rapid breathing, restlessness, and fever.  To help your baby regulate his or her temperature, some pediatricians recommend consistent indoor temperatures of 68 to 70 degrees Fahrenheit; and dressing your baby in as much or as little as you would wear.  Parents are also advised to avoid using a blanket or other covering directly over your baby's head or face as a sun or weather screen, particularly when the baby is sleeping in a stroller or carseat.

Take good care of yourself and your baby.
Maintaining good prenatal care and communication with your health care professional about changes in your baby's behavior and health are of the utmost importance.  Breastfeeding has been shown to be good for your baby. The benefits gained from breastfeeding your baby include building up baby's immunity against illness and infections.   Parents are also advised to follow proper immunization schedules for their baby.  The risk of leaving a child unprotected against such dangerous diseases as tetanus or whooping cough is 1,000 times greater than any risk posed by using the vaccines.  While there is a coincidence of time frame, studies by the National Institutes of Health have turned up no connection between immunizations and SIDS.  In fact, SIDS occurs among infants who never received their shots, as well as in countries with different immunization schedules.

Some new concerns about bedsharing.
Bedsharing has not been proven to be protective against SIDS and, according to the American Academy of Pediatrics, may under some conditions be hazardous.   The same recommendations for safest sleep conditions apply whether your baby sleeps alone in a crib or shares a bed with you: provide a smoke-free environment for your baby and make sure that your baby sleeps on his or her back on a firm, flat mattress without a pillow, comforter or other soft item under the baby or covering the baby's head or face.  While bedsharing boosts breastfeeding and promotes the bond between a mother and infant, bedsharing with brothers or sisters or relatives other than the baby's mother and father is not recommended.  Parents may wish to discuss bedsharing with your baby's doctor.