OpEdSudden Infant Death

Sudden infant death syndrome (SIDS) is diagnosed when a seemingly healthy baby dies suddenly for unexplained reasons. SIDS mostly occurs during sleep, and remains the leading cause of death for babies one to 12 months of age. Roughly 1500 infants in the United States die of SIDS each year.

Notably, Black babies are at two to three times greater risk of SIDS than White babies. At this point, the research is still unclear as to why some babies are at greater risk of SIDS than others. Some of it is likely due to biological differences—such as differences in a baby’s ability to arouse and shift when there is not enough air around her mouth and nose.

Nonetheless, much of the risk has been linked to the sleep environment. In other words, some of the ways people put babies down for sleep can be more dangerous than others. Unfortunately, some of these dangerous sleeping arrangements are common in the United States, particularly among the Black community. The good news is that by changing how we put babies down to sleep, we can dramatically lower their chances of dying from SIDS.

The top 3 ways to help protect against SIDS are:

  • Always put your baby on her back (not side or stomach) to sleep—make sure this happens night and day even when others are watching her for you.
  • Always place your baby on a firm sleep surface made for babies such as a crib, bassinet or portable infant playpen/bed. Do not put crib bumpers, stuffed animals, rolled towels or other “sleep positioners” or heavy blankets in the crib with her.
  • Have your baby’s crib (or bassinet or playpen) in the same room as where you sleep, so you can check up on her easily.

Often, parents feel like having their infants in bed with them (bed sharing) or using bumper pads in the crib will keep their babies safe, or that placing pillows and thick blankets in babies’ cribs will keep them comfortable and help them sleep better. However, SIDS experts know that these well-meaning decisions put infants at an increased risk of SIDS and accidental suffocation as babies don’t always have the brain development or physical strength to awaken themselves and move out of a position when they can’t breathe.

Seventy-five percent of babies who die of SIDS do so while sleeping together with another person on a couch, bed, or armchair. A 2010 national survey found that Blacks were 3.5 times more likely to bed share than White parents. The take home message is to make sure your baby always has her own crib or bassinet whenever she is sleeping.

Linda Fu, MD

On TV, in ads, and online, safe sleep environments often aren’t accurately portrayed. For example, babies’ rooms often are shown with crib bumpers or with babies sleeping on their stomachs. This can make unsafe sleep environments seem acceptable or even recommended. Misinformation around what constitutes a safe sleep environment for babies often then gets passed on by trusted friends and family members who may be unaware of the facts. To help babies develop into healthy children, it’s important for parents, grandparents, healthcare providers, daycare providers—pretty much anyone who cares for children or is a source of information for new parents—to be informed about what sleeping arrangements are risky for SIDS. For more information about safe sleeping arrangements for babies, check out the recommendations from American Academy of Pediatrics (AAP) at healthchildren.org.

Linda Fu, MD, is a general pediatrician at Children’s National Health System and an Associate Professor of Pediatrics at the George Washington University School of Medicine.