How to Reduce the Risk of SIDS

For more than a decade, pediatricians have urged parents to put babies to sleep on their backs. The goal: Reducing sudden infant death syndrome (SIDS).

That strategy seems to be working -- but millions of parents still haven't gotten the message, according to the American Academy of Pediatrics (AAP).

The AAP first recommended that infants sleep on their backs in 1992. That year, seven out of 10 parents were letting babies sleep on their stomachs, according to the National Institute of Child Health and Human Development (NICHD). The National Center for Health Statistics says 120 out of every 100,000 babies were falling victim to SIDS -- the unforeseen death of an otherwise healthy infant, usually while sleeping.

By 1997, those agencies reported a dramatic shift. Fewer than two out of 10 parents were putting infants to sleep on their stomachs -- and the death rate from SIDS had fallen 36 percent, to 77 out of 100,000 births.

Why don't all parents heed the advice that the AAP considers so sound? Pediatrician William J. Cashore, M.D., a Brown University medical professor, offers these reasons:

• Some parents fear children will choke on their vomit. In reality, says Dr. Cashore, normal infants have a very strong reflex that helps them protect their airways (through coughing, for instance).

• Some workers at child-care centers aren't getting the message.

• Grandparents who care for an infant believe the old way is best.

• Parents believe SIDS is very rare.

Reduce the Risk of SIDS

The cause of SIDS remains a mystery. But the following is known about SIDS, according to the NICHD:

• Babies who sleep on their stomachs are much more likely to die of SIDS than babies who sleep on their backs.

• Babies who sleep on or under soft bedding are more likely to die of SIDS.

• Babies who usually sleep on their backs but who are then placed on their stomachs, like for a nap, are at very high risk for SIDS. So it's important for everyone who cares for your baby to use the back sleep position for naps and at night.

The AAP says SIDS occurs most often during a baby's first 6 months of life, particularly between 2 and 4 months of age.

African American babies are more than two times as likely to die of SIDS as white babies, and American Indian/Alaskan Native babies are nearly three times as likely, according to NICHD.

What can you do to help prevent SIDS?

• Place infants on their backs to sleep.

• Never let a child sleep on a waterbed or other very soft surface.

• Avoid soft pillows sheepskins and pillow-like crib bumpers in the sleep area.

• Never place stuffed animals, soft toys or soft blankets in the crib.

• Don't smoke during pregnancy or expose an infant to smoke.

• Don't let an infant share a bed with other family members.

To reduce the chance that flat spots will develop on the back of your baby's skull:  

• Put your baby on his or her tummy when he or she is awake and someone is watching.

• Change the direction that your baby lies in the crib from one week to the next.

• Avoid too much time in car seats, carriers and bouncers.