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What are ways to prevent Sudden Infant Death Syndrome (SIDS)?

We are expecting our first child soon. There was a case of SIDS (sudden infant death syndrome) several years ago, in a close family member. Are there any tests that can be done to see if our baby is at increased risk? I have seen ads for monitors that alarm if the baby stops breathing. Any suggestions?

Robert Woodford | Pediatrician

Robert Woodford

There are many causes of unexpected infant death that are sleep-related. First, in healthy, newborn infants, there is no evidence that monitoring the infant’s heart rate and rhythm, blood oxygen levels or respirations before hospital discharge can predict which infants are at increased risk of SIDS.

Also, there is no evidence that an infant’s risk of SIDS can be reduced by the use of home monitoring devices. One commercial company advertises that their monitor will give parents “peace of mind,” but  there is no evidence to substantiate that claim. 

The emphasis now, in terms of prevention, is promoting a safe sleep environment. New AAP (American Academy of Pediatrics) recommendations were published in November, 2011. New recommendations include:

  • Avoiding commercial devices marketed to reduce the risk of SIDS, including wedges, positioning devices, home cardiorespiratory monitors and special mattresses.
  • A firm, crib mattress, covered by a fitted sheet is suggested to reduce the risk of SIDS and suffocation. No more bumper pads in the crib.
  • Do not position baby for routine sleep in a swing, car seat, infant carrier, sling and no more elevating the head of the crib. These practices do not help with gas, spitting-up, or fussiness and these may actually increase the risk of suffocation or airway obstruction.
  • After an infant falls asleep in a sitting device, the baby should be placed in the crib on his or her back. There is no evidence to suggest that sleeping on the back is dangerous for those babies who spit-up.
  • Avoid smoke exposure, overheating and keep soft objects (stuffed animals, comforters, pillows and loose blankets) out of the crib.
  • Room sharing, but not bed sharing is suggested. Once a baby is fed, the baby should immediately be returned to the bassinet or crib and placed on the back for sleeping.

Unfortunately, while the risk of SIDS has dropped by approximately 50% over the past several years, unidentified causes still comprise 20-30% of infant deaths.

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