How can a caregiver create a safe infant sleep environment?

Parents and caregivers can create a safe infant sleep environment and reduce the risk of Sudden Infant Death Syndrome (SIDS). SIDS is the sudden, unexplained death of a baby younger than 1 year of age – in fact, it is the leading cause of death among babies between the ages of 1 month and 1 year. Since this sudden and silent disorder – which can occur anytime during a baby's first year, even if the baby seemed healthy – is more often than not associated with the periods during which the baby is asleep, it is also known as ‘crib death.’ Actually, the crib itself has nothing to do with SIDS, but the general sleep environment can certainly make a difference in what otherwise is a non-preventable occurrence.

Creating a safe sleep environment

Always place the baby on his/her back, for naps and at night

·         The back sleep position is the safest.

·         Sleeping on the stomach or on the side has the highest risk of SIDS.

·         Babies who sleep on their backs at night but are placed on their stomachs for naps – or vice versa – have a very high risk for SIDS.

·         Everyone who cares for a baby should place him or her on the back to sleep for all sleep times, including naps.

·         Babies who sleep on their backs are not more likely to choke.

Use a firm sleep surface

·         Such as a safety-approved crib, bassinet, or portable play area.

·         Use tight-fitting bedding to help prevent the baby from getting tangled up in the bedding.

·         Do not use a car seat, carrier, swing, or similar product as the baby's everyday sleep area.

·         Babies who sleep on soft surfaces, like an adult mattress, couch, or armchair, are at an increased risk for SIDS and suffocation.

·         Evidence does not support using crib bumpers to prevent injury; on the contrary, crib bumpers can cause serious injuries and even death.

Room sharing

·         Babies who sleep in an adult bed with one or more adults are at higher risk for SIDS.

·         Babies who sleep in an adult bed are at higher risk for SIDS if they:

-        Are younger than 3 months.

-        Share a bed with a current smoker or if the mother smoked during pregnancy.

-        Share a bed with someone who is very tired.

-        Share a bed with someone who has used or is using medications or substances.

-        Share a bed with someone who is not a parent, including other children.

-        Share a bed with more than one person.

-        Are placed on a waterbed, older mattress, sofa, couch, or armchair.

-        Are placed on a bed with soft bedding.

·         Babies who sleep on adult bed, sofa, couch, or armchair are at serious risk for accidental suffocation, entrapment, injury, and death—regardless of whether they are alone or if they share the sleep area with someone.

·         Give the baby his/her own sleep area in the same room as you or others.

·         If you feed a baby in bed, put him/her back in a separate sleep area, such as a safety-approved crib, bassinet, or portable play yard, in your room next to where you sleep when finished.

Keep soft objects, toys, crib bumpers, and loose bedding out of the baby’s sleep area

·         Loose bedding and other items under or over the baby or in the baby's sleep area could end up covering the baby's face, and in turn:

-         Put the baby at higher risk for suffocation or strangulation.

-         Put the baby at higher risk for re-breathing air low in oxygen.

-         Put the baby at higher risk of overheating.

·         Loose bedding and soft bedding, placed over or under the baby increase the risk of SIDS regardless of sleep position.

·         Most other sleep-related infant deaths are caused by accidental suffocation involving pillows, quilts, and extra blankets.

Get regular healthcare during pregnancy

·         Babies of mothers who get regular health care during pregnancy are at lower risk for SIDS.

·         Start getting healthcare early in the pregnancy, and continue to do so throughout the entire pregnancy.

Do not smoke, drink alcohol, or use illicit drugs during pregnancy or after the baby is born

·         Babies of mothers who don't smoke have the lowest risk of SIDS.

·         Babies of mothers who smoked during pregnancy are up to 3-4 times more likely to die of SIDS than babies whose mothers did not.

·         Babies whose caregivers smoke or who are exposed to secondhand smoke are at a higher risk for SIDS than babies not exposed to secondhand smoke.

·         Babies who share a bed with an adult smoker have a higher risk of SIDS.

·         Babies who died of SIDS had higher nicotine concentrations in their lungs than did babies who died from other causes.

·         Babies of mothers who do not drink alcohol or use illegal drugs during or after pregnancy have a lower risk for SIDS.

·         Babies who share a bed with a parent who uses alcohol or illegal drugs are at a particularly high risk for SIDS.

Breastfeed your baby

·         Babies who are breastfed or fed with breast-pumped milk for the first 6 months of life have a lower risk for SIDS.

Give the baby a dry pacifier not attached to a string

·         Babies who used pacifiers during their last sleep were at considerably lower risk for SIDS than were babies who did not.

·         Wait until your baby is used to breastfeeding before trying a pacifier.

·         Because of the risk of strangulation, do not hang the pacifier around your baby's neck or attach it to his or her clothing with a string or cord.

·         Do not coat the pacifier with anything sweet or sticky.

·         Clean the pacifier often and replace it regularly.

·         If the pacifier falls out of the baby’s mouth during sleep, you don’t have to put it back in the mouth during that sleep time.

Do not let the baby get too hot during sleep

·         Some babies are more likely to die from SIDS if they are dressed in two or more layers of clothes for sleep.

·         Babies who get too hot during sleep might slumber too deeply and be unable to wake themselves up, which could play a role in SIDS.

·         Blankets are not recommended. In most cases, sleep clothing alone is enough to keep the baby warm during sleep.

Follow the recommended schedule for the baby’s vaccines

·         Immunizations reduce the risk of SIDS by half.

·         There is no causal relationship between vaccines and SIDS.

Avoid products advertised as reducing the risk of SIDS

·         The FDA, the Consumer Product Safety Commission, and the American Academy of Pediatrics warn against using products that make such a claim because of the dangers they pose to babies.

·         Parents and caregivers should also avoid products made from foam rubber or Memory Foam™ because of the risk of suffocation.

Do not use home heart or breathing monitors

·         Home heart or breathing monitors that claim to detect SIDS are not effective.

·         Baby monitors can alert caregivers that a baby is awake, but they do not detect or prevent SIDS.

Give the baby enough tummy time when awake

·         Placing the baby on his/her tummy for short periods while awake and when someone is watching is important for healthy development.

·         Supervised Tummy Time strengthens the baby's neck, shoulder, and arm muscles.

·         When a baby is placed too often or for too long in the same position, pressure on the same part of the baby's head can cause flat spots.