What Is SIDS?
Sudden infant death syndrome (SIDS) is a term that was first used in 1969 to describe a sudden and unexpected death of a baby under 1 year of age, while asleep.
Another term, ‘Sudden Unexpected Death in Infancy’ (SUDI), is also quite commonly used. SUDI is a research classification which includes both SIDS and fatal sleeping accidents.
There is nothing more terrifying than the thought of losing a child. Although we do not know what causes SIDS, we do know there are things which can reduce the risk. There are also guidelines to reduce the risk of SUDI caused by fatal sleeping accidents.
Thankfully, the risk is much lower than it was 25 years ago. SIDS has at least halved in many countries like Australia, the US, New Zealand and in the UK. In Australia, the incidence of SIDS is now approximately 1 in 1,000. However, for the family of that one child in 1000, the loss is devastating.
Something that is important to keep in mind is that 999 babies in 1000 do NOT die of SIDS.
Here are 6 things mothers, fathers, partners, carers and families need to know about SIDS:
#1: All Babies Should Sleep In A Safe Sleeping Environment
Room-sharing has been shown to reduce the risk of SIDS. Dr James McKenna says:
“Room-sharing, where the infant is simply in the room of a supervising caregiver (mother or father) is safe for all families and would be, in my mind, the preferred and default sleeping arrangement, especially for non-breastfed infants.”
Bed-sharing is something most parents do, even if they didn’t plan to. One Australian study found that 80% of babies spent some time bed-sharing in the first 6 months of life.
For babies who are breastfed, whose parents are non-smokers and not affected by drugs or alcohol, the risk of SIDS is greatly reduced, even if bed-sharing.
A breastfeeding bed-sharing mother usually adopts a position that facilitates close physical contact and observation of her baby. She tends to keep her baby at the level of her breast with an arm between her baby’s head and the pillow. She also instinctively bends her legs completing the protective space around the baby, making it impossible for another person to roll onto the baby without first coming into contact with her legs.
Find out more: Bed-Sharing: The Facts from the Australian Breastfeeding Association.
The Breastfed Baby Bed-Sharing With His Mother:
- Electric blankets should not be used.
- The bed should be arranged so that the baby is not near a pillow and nor is the head covered by a doona, blanket, sheet or pillow.
- Babies should always be placed on their back to sleep, never face down. They should not be swaddled or wrapped, but be free to move.
- The mattress should be firm and flat and there should be no chance for the baby to be trapped against a wall or another bed or between the sides of the bed and the mattress.
- The bed should not be accessible by pets and not shared by other children.
Research has shown, among parents who do not smoke or infants older than 14 weeks, there was no association between infants being found in the parental bed and an increased risk of sudden infant death syndrome. The same study showed the risk linked with bed sharing among younger infants seems to be associated with recent parental consumption of alcohol, overcrowded housing conditions, extreme parental tiredness, and the infant being under a doona/duvet.
Formula Fed and Breastfed Babies In A Bassinette Or Cot/Crib:
- Have a firm, snug fitting mattress.
- Make sure your cot or bassinette meets the Australian Standard (AS/NZS 2172).
- Don’t use bumpers.
- Have a breathable mattress, blankets and covers.
- Don’t use plastics.
- Don’t have toys.
- Make sure there are no cords or drawstrings (e.g. from curtains) within reach.
- Sleep your baby on his or her back.
- Have baby’s feet at the bottom of the cot.
- Make sure the blankets are tucked in firmly.
Find out more: Making Up Your Baby’s Cot from SIDS and Kids Australia.
#2: Never Risk Falling Asleep With A Young Infant On A Sofa
The sofa is the only sleep environment in which SIDS deaths have increased in recent years, up from 6% in 1993-6 to 16% in 2003-6. This represents an increase from 24 to 42 deaths per year.
Many fatal sleeping accidents occur when a parent sits up to feed on a couch or armchair and falls asleep. Peter Blair, infant sleep researcher, is concerned that an increase in sudden unexplained deaths in infants (SUDI) associated with sofa-sharing may be linked to parents trying to avoid bed-sharing.
The study found that 16% of SIDS babies had died while sleeping with an adult on a sofa.
Sleeping with a baby on a sofa or an armchair can be very dangerous for babies because the risk of suffocation, or becoming trapped, is much greater on a sofa or arm-chair than in a bed.
Babies can become wedged between a parent's body and the back of a couch or the arm of a chair and the weight of the adult's body can prevent them from breathing.
If you fear you are too tired to stay awake while your baby breastfeeds, it is safer to lie down on your bed to feed. You can learn how to do this safely here.
#3: Babies Who Are Formula Fed Are More At Risk Of SIDS
Research has shown that breast-fed babies are more easily aroused from sleep than formula-fed babies at 2–3 months of age, which is within the 2–4 month peak age during which SIDS occurs.
Breastfeeding provides babies with important immune factors (e.g. antibodies and white blood cells). These immunological properties of breastmilk may help to protect babies from SIDS.
If you are no longer breastfeeding your baby, it is important to follow all the other recommendations to reduce the other risks. If you have recently stopped breastfeeding, you might like to consider re-lactation – your IBCLC Internationally Board-Certified Lactation Consultant or breastfeeding counsellor can tell you more about this. You can also read 3 Inspirational Stories Of Relactation to learn more.
Most breastfeeding problems can be overcome with the right support and information. If you are struggling to maintain breastfeeding, do seek help.
#4: Sleep Baby On The Back From Birth, Not On The Tummy Or Side
The single most effective action to lower a baby’s risk of SIDS is to place the baby to sleep on his or her back for naps and at night.
But what do you do if your baby is one of many who won't settle on their backs?
Parents worry that their baby's sleep preference for their tummy or side puts them at higher risk of SIDS, yet lack of sleep is stressing the whole family. This frustrating situation can be resolved – here are 6 tips for when your baby wont sleep on his back.
#5: Sleep Baby With Head And Face Uncovered
Babies are safest when there is minimal bedding in their cot. Reduce the risk even more by NEVER using a pillow with any baby. Remove bibs, hats and excess garments from your baby whenever you lay them to sleep. . Swaddling wraps can also pose an additional risk – look for swaddlers which cannot unwrap and move to an infant sleeping bag as soon as possible. Find out how to safely swaddle here.
When bed-sharing, make sure your bed is a safe sleeping space by removing potential hazards like excess pillows or doonas. If you have long hair, plait or braid it to lie down or sleep with your baby.
#6: Keep Baby Smoke-Free Before Birth And After
Here some facts about babies and smoking that you need to know:
- If both parents smoke, baby’s SIDS risk is 3½ times greater than if neither parent smokes.
- If mother smokes, but father doesn’t, baby’s risk is 2 times greater.
- If father smokes, but mother doesn’t, baby’s risk is 1½ times greater.
If you, or your partner, are smokers – these statistics can be hard to read. You have probably tried – and failed – to quit in the past and in the stressful environment of having a new baby in the family, now might not be the right time to do so – despite the facts.
Smokers – even if they are breastfeeding – must not bed-share with their baby. They should, however, room-share with their baby as long as that room is kept smoke-free.
If you have not yet had your baby, quitting will lower the risk factor but not remove it entirely. Bed-sharing is not considered safe when the mother smoked in pregnancy. BellyBelly recommends the Allen Carr method to stop smoking – find out more here (located in a pregnancy and smoking article, but the information is very helpful). Else you can get help to quit here.
Life is full of risks, right from conception. By informing ourselves about risks and making informed choices in all aspects of raising our children, we can reduce risk where possible – like using approved child restraints – but we cannot prevent what is outside our control.