All about SIDS

The spectre of Sudden Infant Death Syndrome (SIDS) strikes fear into the heart of all parents with new babies.

SIDS is the diagnosis given when a baby under 1 year dies suddenly and an exact cause of death can’t be found after a complete legal and medical investigation. It is devastating, not least because it generally happens without warning in a seemingly healthy infant.

SIDS most commonly affects babies between the ages of 2 to 4 months, with 90% of cases occurring in infants under 6 months. It occurs most frequently during winter months.

The exact cause of SIDS is not known, but there are guidelines for lowering the risk.

Guidelines for lowering the risk of SIDS

Babies younger than 1 year should sleep on their backs

• One thing most experts agree on is that the Back to Sleep Campaign has significantly lowered the incidence of SIDS. All healthy infants younger than 1 year should be put to sleep on their backs, because of strong evidence that stomach sleeping contributes to the incidence of SIDS.

Avoid smoking, drinking or using drugs during pregnancy

• Another area of agreement is that parents should avoid smoking, drinking or using drugs while pregnant or caring for a small baby, and should avoid exposing a baby to secondhand smoke.
• Infants of mothers who smoked during their pregnancy are three times more likely to die of SIDS than mothers who were smoke-free. Exposure to secondhand smoke after your baby is born is believed to double his risk of succumbing to SIDS.

Don't let baby overheat

Some researchers also suggest that overheating contributes to the SIDS risk as it puts babies into a deeper sleep, making it more difficult for them to wake up if they stop breathing.

What studies say

Put your baby to sleep on his back

It is also important that daytime caregivers know to put your baby to sleep on his back, as 20% of SIDS deaths happen in daycare settings. Several studies have also shown that if a child is used to sleeping on his back and is then put down on his tummy, his risk of SIDS rises significantly.

Co-sleeping with your baby

The jury is out on co-sleeping with your baby. Some people believe you shouldn’t take your baby to bed with you during his first few months as your bed has lots of soft bedding, which ups the risk factors for SIDS. It’s also easy for your baby to become overheated while sharing your bed.

Then again, others believe that co-sleeping allows a mother to be in tune to changes in her baby’s breathing and movements and that bed sharing could lower the risk of SIDS as long as it done safely.

Flat head syndrome

Some parents are concerned about positional plagiocephaly, a condition in which babies develop a flat spot on the back of their heads from spending too much time lying on their backs. This condition – otherwise known as “flat head syndrome” – has become more common worldwide since the introduction of the Back to Sleep campaign.

It’s usually treatable fairly easily by changing your baby’s position frequently and allowing for more “tummy time” while he’s awake. When you put your baby on his back to sleep, put his head at one end of the cot one night and alternate the next night or weekly. This will make him turn his head to a different side regularly, and can help avoid developing a flat spot.

How can I reduce the risk of SIDS?

• Put your baby to sleep on his back, on a firm, flat mattress, with large ventilation holes
• Don’t let your baby sleep on a soft surface, such as a duvet, sofa or waterbed, or surrounded by bedding
• Don’t put soft toys in his cot and ensure that bedding doesn’t creep up over his head. Position your baby so he is lying with his feet touching the end of the cot, so he doesn’t move down the bed and get trapped under the covers
• Either avoid using a blanket and keep your baby in a warm room, or swaddle your baby under his arms or use a “wearable blanket” – a sleeveless garment that’s closed at the bottom like a bag
• Avoid overheating your baby. Signs that he might be overheating include sweating, damp hair, heat rash, rapid breathing, restlessness and fever. Keep the room temperature around 20ºC. Watch humidity levels and strike a happy balance between air that isn’t too dry or too humid
• Don’t use cot bumpers while your baby is tiny, and buy a new mattress for each new baby, as mattress-sharing is thought to contribute to SIDS by passing on infectious organisms
• Limit your baby’s exposure to illness and infection in other people
• Dummies and thumb-sucking are now recommended to reduce the risk of SIDS. Put your baby to sleep with a dummy if he wants one, but don’t put it back in his mouth if it falls out when he’s asleep. Don’t coat the dummy in anything sweet and sterilise it regularly
• Don’t let your newborn sleep for too long without checking on him, as prolonged deep sleep could induce SIDS
• Don’t cover your baby’s head while he is sleeping as this can cause overheating
• If your baby has gastric reflux or certain upper airway malformations, sleeping on the stomach may be the better option. In this case consult your doctor to determine the best sleeping position for your baby