There currently is no way of predicting which newborns will succumb to SIDS; however, there are a few measures parents can take to lower the risk of their child dying from SIDS.
Good prenatal care, which includes proper nutrition, no smoking or drug or alcohol use by the mother, and frequent medical check-ups beginning early in pregnancy, might help prevent a baby from developing an abnormality that could put him or her at risk for sudden death. These measures may also reduce the chance of having a premature or low birth weight baby, which also increases the risk for SIDS. Once the baby is born, parents should keep the baby in a smoke-free environment.
Parents and other caregivers should put babies to sleep on their backs as opposed to on their stomachs. Studies have shown that placing babies on their backs to sleep has reduced the number of SIDS cases by as much as a half in countries where infants had traditionally slept on their stomachs. Although babies placed on their sides to sleep have a lower risk of SIDS than those placed on their stomachs, the back sleep position is the best position for infants from 1 month to 1 year. Babies positioned on their sides to sleep should be placed with their lower arm forward to help prevent them from rolling onto their stomachs.
Many parents place babies on their stomachs to sleep because they think it prevents them from choking on spit-up or vomit during sleep. But studies in countries where there has been a switch from babies sleeping predominantly on their stomachs to sleeping mainly on their backs have not found any evidence of increased risk of choking or other problems.
In some instances, doctors may recommend that babies be placed on their stomachs to sleep if they have disorders such as gastroesophageal reflux or certain upper airway disorders which predispose them to choking or breathing problems while lying on their backs. If a parent is unsure about the best sleep position for their baby, it is always a good idea to talk to the baby's doctor or other health care provider.
A certain amount of tummy time while the infant is awake and being observed is recommended for motor development of the shoulder. In addition, awake time on the stomach may help prevent flat spots from developing on the back of the baby's head. Such physical signs are almost always temporary and will disappear soon after the baby begins to sit up.
Parents should make sure their baby sleeps on a firm mattress or other firm surface. They should avoid using fluffy blankets or covering as well as pillows, sheepskins, blankets, or comforters under the baby. Infants should not be placed to sleep on a waterbed or with soft stuffed toys.
Recently, scientific studies have demonstrated that bed-sharing, between mother and baby, can alter sleep patterns of the mother and baby. These studies have led to speculation that bed-sharing, sometimes referred to as co-sleeping, may also reduce the risk of SIDS. While bed-sharing may have certain benefits (such as encouraging breast feeding), there are not scientific studies demonstrating that bed-sharing reduces SIDS. Some studies actually suggest that bed-sharing, under certain conditions, may increase the risk of SIDS. If mothers choose to sleep in the same beds with their babies, care should be taken to avoid using soft sleep surfaces. Quilts, blankets, pillows, comforters, or other similar soft materials should not be placed under the baby. The bed-sharer should not smoke or use substances such as alcohol or drugs which may impair arousal. It is also important to be aware that unlike cribs, which are designed to meet safety standards for infants, adult beds are not so designed and may carry a risk of accidental entrapment and suffocation.
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Babies should be kept warm, but they should not be allowed to get too warm because an overheated baby is more likely to go into a deep sleep from which it is difficult to arouse. The temperature in the baby's room should feel comfortable to an adult and overdressing the baby should be avoided.
There is some evidence to suggest that breast feeding might reduce the risk of SIDS. A few studies have found SIDS to be less common in infants who have been breast fed. This may be because breast milk can provide protection from some infections that can trigger sudden death in infants.
Parents should take their babies to their health care provider for regular well baby check-ups and routine immunizations. Claims that immunizations increase the risk of SIDS are not supported by data, and babies who receive their scheduled immunizations are less likely to die of SIDS. If an infant ever has an incident where he or she stops breathing and turns blue or limp, the baby should be medically evaluated for the cause of such an incident.
Although some electronic home monitors can detect and sound an alarm when a baby stops breathing, there is no evidence that such monitors can prevent SIDS. A panel of experts convened by the National Institutes of Health in 1986 recommended that home monitors not be used for babies who do not have an increased risk of sudden unexpected death. The monitors are recommended, however, for infants who have experienced one or more severe episodes during which they stopped breathing and required resuscitation or stimulation, premature infants with apnea, and siblings of two or more SIDS infants. If an incident has occurred or if an infant is on a monitor, parents need to know how to properly use and maintain the device, as well as how to resuscitate their baby if the alarm sounds.
