Sudden Infant Death Syndrome (SIDS)

Prevention

Remember, sudden infant death syndrome (SIDS) is rare. Don't let your fear of SIDS keep you from enjoying your baby.

Studies have found that some risk factors are associated with SIDS, although the relationships are not entirely clear. You can take the following precautions that may help reduce your baby's risk of SIDS:³

• Do not smoke, and take care of yourself when you are pregnant.During pregnancy, you can lower your baby's risk for SIDS by getting prenatal health care and taking general precautions. Also, do not allow anyone to smoke around your baby after he or she is born. Second-hand smoke also increases your baby's risk of SIDS.
• Always place your baby down to sleep on his or her back. This is the safest sleep position for a baby. The rate of SIDS deaths has greatly decreased in most countries that have encouraged parents to place babies who are less than 1 year old on their backs to sleep.⁵ It is important to follow these guidelines every time your baby sleeps. Children who are unaccustomed to sleeping on their stomachs and are then placed on their stomachs for sleep may be at an even higher risk for SIDS.² Unless your health professional advises otherwise, do not place your baby to sleep on his or her side or stomach.
• For the first 6 months, place your baby to sleep in a crib in the same room you sleep in. (You can use a cradle or bassinet.) The Canadian Paediatric Society (CPS) now recommends that you do not sleep with your baby in the same bed for the first year.⁶ If you do sleep together, take precautions to make bed sharing safer. Do not ever share a bed with your baby if you smoke, have had alcohol, used medicine that makes you sleep very soundly (sedatives), or used illegal drugs. Never sleep with a baby on a couch or armchair.
• Use firm bedding materials, including a firm mattress. Make sure the baby sleeps directly on a firm mattress with a fitted sheet.
  • Choose a crib, cradle, or bassinet that meets all the safety standards set by the Canadian government. (Baby beds that attach to the side of the parents' bed have not yet been tested enough to have set safety standards.)
  • Don't put anything in the crib with your baby. A baby may pull items like blankets, bumper pads, comforters, stuffed toys, or pillows over his or her head and increase the chance for SIDS.
  • If a sheet or blanket is needed for warmth, tuck it into the bottom of the crib. Place your baby so his or her feet touch the end of the crib where the sheet is tucked in. Make sure the sheet or blanket does not reach higher than the baby's chest.
• Avoid overheating your baby or the bedroom where the baby sleeps. Keep the room where your baby sleeps warm enough [around 18.5°C (65°F)] so that he or she can sleep with light clothing without needing covers. Usually, the temperature is about right if an adult can wear a long-sleeved T-shirt and pants without feeling cold. But make sure your baby does not get too warm. Putting extra blankets or clothes on your baby in winter can increase the chance that he or she gets too warm. Your baby is likely too warm if he or she sweats or tosses and turns a lot.
• Consider offering your baby a pacifier at nap time and bedtime.⁷ This may help prevent SIDS for reasons that experts do not yet fully understand. The Canadian Paediatric Society (CPS) has not made a recommendation for or against using pacifers to help prevent SIDS. But the CPS does not discourage pacifier use because there is proof they may help.⁸
  • If you breast-feed, wait until your baby is about 1 month old before you offer a pacifier. Pacifiers sometimes confuse a newborn baby and can make breast-feeding more difficult.
  • Don't worry about putting the pacifier back into your baby's mouth after he or she has fallen asleep.
  • Don't force your baby to use a pacifier is he or she does not want it.
• Talk with your child care providers and babysitters about these precautions. Explain in detail on the first day of child care (or before) what you expect the staff to do. Do not assume that your child care providers or babysitters know these new guidelines to prevent SIDS. About 20% of SIDS deaths occur in child care settings.⁹

Don't rely on home monitors or other devices marketed as a way to reduce your baby's risk of SIDS. These items have not been tested enough to prove they work.

Help your baby develop a normal head shape

The back of your baby's head may get a little flat from always placing him or her to sleep on the back. Usually, the flat area is not very noticeable. Your baby's head shape will return to normal after he or she can sit and crawl. But sometimes the head can become very noticeably flat. You can help prevent this by helping your baby get stronger and by changing his or head position regularly.

• Make sure your baby gets "tummy time" every day. Place your baby on his or her tummy for playtime while you are watching closely. Let your baby "squirm" around, making sure that he or she can breathe easily. Tummy time helps your baby build strength and develop motor skills. These are important for helping your baby learn to move and hold his or her head up.
• Cuddle your baby while holding his or her head up as much as you can. Don't place your baby in car seat carriers or bouncers for long periods each day. Holding your baby is better for all areas of development.
• At least every week, change your baby's head position during sleep. (Remember to always keep your baby on his or her back during naps and at bedtime.) A good way to make sure your baby's head rests in different positions is to switch which end of the bed you place him or her each week. One week, place your baby so his or her feet are at the end of one end of the crib; the next week, place the feet at the other end. Babies usually turn their heads away from the wall, toward the inside of a room. If your baby's crib is not against a wall, you can try moving your baby's head position more to one side while he or she is sleeping.

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Author:	Amy Fackler, MA Debby Golonka, MPH Carrie Henley	Last Updated: November 30, 2006
Medical Review:	Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics Julien I. E. Hoffman, MD - Pediatrics
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