SIDS - Risk Factors and Prevention

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Medical Author: Melissa Conrad Stoppler, MD
Medical Editor: Jay W. Marks, MD

Sudden infant death syndrome (SIDS) is the most common cause of death in babies aged one month to one year. Although many factors have been associated with SIDS, there is no single factor that can predict a SIDS death. Most commonly associated with sleeping, SIDS is also more common in boys than in girls, occurs more frequently in cold weather, and is most common in babies under six months of age. African Americans are more likely to be affected than Caucasians, and Native Americans have about a three-fold increased risk of SIDS when compared to Caucasian infants.

A number of risk factors have been identified that increase the likelihood of SIDS:

• Stomach sleeping - This is probably the most significant risk factor, and sleeping on the stomach is associated with a higher incidence of SIDS. It is unknown exactly why stomach sleeping increases the risk of SIDS, but doctors have hypothesized that either anatomical pressure on the airways or the phenomenon of "rebreathing" exhaled air with less oxygen might play a role. It is also possible that some babies' brains may not respond as well to internal cues and stimulate waking when lower levels of oxygen are present in inhaled air.
• Exposure to cigarette smoke
• Prenatal exposure to cigarette smoke, drugs, or alcohol
• Co-sleeping - Earlier studies showed an increased incidence of SIDS in babies whose parents smoked and when they shared a bed with parents. Newer research confirms bedsharing as a risk factor for SIDS independently of cigarette smoking. Sleeping in a room alone also confers an increased risk when compared to babies who sleep in a crib in a parent's room.
• Prematurity or low birth weight
• Poor prenatal care
• Mothers younger than 20 years of age

While SIDS isn't completely preventable, parents can take measures to reduce their infant's risk of SIDS:

• The American Academy of Pediatrics recommends that all healthy infants under one year of age be placed on their backs to sleep. Remember the slogan "back to sleep".
• If you smoke, stop smoking before pregnancy and do not allow your baby to be exposed to passive smoke.
• Sleeping in a crib in a parent's room is safer in terms of SIDS risk than sharing a bed with adults or sleeping in a room alone.

For more, please read the Sudden Infant Death Syndrome (SIDS) article.