What to know about SIDS

Sudden infant death syndrome (SIDS) occurs when a baby dies suddenly, with no known cause. Sometimes called crib death, SIDS claims lives of more than 1,300 babies under age 1 each year, according the Centers for Disease Control and Prevention (CDC).

“There really are [no symptoms], because the infant shows to us in the emergency room pretty much already deceased,” says Kate Hewett, MD, a pediatric emergency medicine specialist in Summerville, South Carolina. “That's why we have to be very, very vigilant about it,” she adds.

Some risk factors for SIDS can’t be changed, like whether an infant was born preterm. But there are steps parents and caregivers can take to lower the risk of SIDS.

Sleep area recommendations

Experts recommend the following for maintaining a safe sleep space.

Place babies on their backs

It significantly lowers the chances of SIDS. If another caregiver is putting your child to bed, show them exactly what you want them to do.

You can start practicing tummy time during the day once you arrive home from the hospital. This will help develop your baby's ability to move around. Just make sure they’re awake and being supervised.

Choose a level sleeping surface

Babies should sleep on a firm, flat mattress. They shouldn’t sleep at an angle over 10 degrees. If they doze off in a car seat, swing, or other device, lay them flat as soon as you can.

Keep the sleep area free of soft objects

If they’re placed in a crib, pack-and-play, or bassinet, it’s important that it’s free of soft items or other things that could constrict their breathing. These include:

• Blankets and loose bedding
• Pillows
• Bumpers
• Stuffed animals and other toys
• Sleep positioners

Avoid co-sleeping

Babies shouldn’t sleep in the same bed as parents, caregivers, or other adults. It greatly increases the risk of suffocation. Co-sleeping on chairs, sofas, or cushions is also dangerous. Instead, consider sleeping with your baby in the same room, for at least six months—and ideally longer. Taking this step may slash SIDS risk in half.

Think about the temperature

Overheating is another risk factor for SIDS; signs include sweating or the baby’s chest feeling hot to the touch. Hewett advises setting the room to a comfortable temperature—not too cold or too hot.

While parents may worry their child will be cold without a blanket, one well-chosen layer of clothing is usually enough. When selecting clothes for an infant, remember that they will run cooler than adults. Avoid hats indoors, as well, especially during sleep time.

Swaddling may help babies sleep but it isn’t shown to prevent SIDS. Once a baby is about to start rolling over, swaddling should stop.

Consider a pacifier

Giving your baby a pacifier to sleep with is shown to protect against SIDS. It’s okay if it falls out of their mouth. You don’t have to put it back in. Note that some babies don’t take to pacifiers, and that’s okay. There’s no need to force them.

Smart parenting practices

In addition to adjusting your baby’s sleep space, there are steps parents can take themselves to reduce the risk of SIDS.

Try breast milk

If possible, breastfeeding or feeding your baby expressed milk can help prevent SIDS. The longer you can do this, the longer they’ll be protected. This can continue after the baby starts on solid foods.

Avoid substance use

Smoking is a major risk factor for SIDS. Don’t smoke or vape during pregnancy or after your baby is born, especially in your home or car. If you’re around people who smoke, make sure there’s ventilation or try to relocate.

The same goes for alcohol, marijuana, opioids, or illicit drugs. Avoid them while pregnant and after birth. Never, ever sleep with a baby if you’ve been using drugs or alcohol. Speak to a healthcare provider if you need support quitting during this time.

Attend well visits

Get regular checkups during pregnancy and then take your baby for recommended well visits once they’re born. In addition to regular care, a healthcare provider can give you tips on how to help prevent SIDS. “You're not born knowing how to take care of a baby,” Hewett says.

Can technology help?

Even when taking every precaution, parents and caregivers may still worry their child will stop breathing unexpectedly. Some people may consider using a monitor that can be placed on a child’s foot to measure oxygen levels and heart rate, or under their mattress to check for a lack of movement.

This may be warranted for some babies, including premature infants and those with a history of apnea. In other situations, Hewett recommends having a conversation with your pediatrician before using these monitors.

“There's no evidence to support the role of home cardiorespiratory monitors,” Hewett says. They don’t protect against SIDS and can cause parents to needlessly worry, according to the American Academy of Pediatrics.

“You could be panicking that your baby stops breathing, when actually it was a malfunction in the app or the device. Conversely, you can be falsely reassured that everything is fine because everything that you're seeing from afar is registering as normal, but it truly is not,” Hewett says.

Instead, “talking to your pediatrician, making sure that you’re vigilant every night—not just some nights—and throughout the night,” can all help prevent SIDS, Hewett says.