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November 8, 2009
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Sudden Infant Death Syndrome

Reduce the Risk of Sudden Infant Death Syndrome: Babies Sleep Safest on Their Backs

What is SIDS?

SIDS, a word that stands for Sudden Infant Death Syndrome, is the sudden and unexplained death of a baby under one year of age.

Because many SIDS babies are found in their cribs, some people call SIDS "crib death." But cribs do not cause SIDS.

Facts About SIDS

  • Doctors and nurses don't know what causes SIDS, but they do know:


  • SIDS is the leading cause of death in babies after one month of age.


  • Most SIDS deaths occur in babies who are between 2 and 4 months old.


  • More SIDS deaths occur in colder months.


  • Babies placed to sleep on their stomachs are much more likely to die of SIDS than babies placed on their backs to sleep.


  • African American babies are twice as likely to die of SIDS as white babies. American Indian babies are nearly three times more likely to die of SIDS than white babies.
Even though there is no way to know which babies might die of SIDS, there are some things that you can do to make your baby safer.

Babies Should Sleep on Their Backs

One of the best ways to lower the risk of SIDS is to put your baby on his or her back to sleep, even for naps.

This is new advice. Until a few years ago, doctors told mothers to place babies on their stomachs to sleep. If you have older children, your doctor may have told you that babies should sleep on their stomachs. But research now shows that fewer babies die of SIDS when they sleep on their backs. In fact, before the "Back to Sleep" campaign began to recommend back sleeping as the best way to reduce SIDS, more than 5,000 babies in the U.S. died from SIDS every year. But now, as the "Back to Sleep" message spreads and more babies sleep on their backs, the number of babies who die of SIDS is under 3,000 each year. The "Back to Sleep" campaign is  by the National Institute of Child Health and Human Development, Maternal and Child Health Bureau, American Academy of Pediatrics, SIDS Alliance, and Association of SIDS and Infant Mortality Programs.

Back sleeping is the best sleep position for your baby and provides the best protection against SIDS. The American Academy of Pediatrics says that back sleeping is the preferred sleep position.

Make sure everyone knows to place babies on their backs to sleep. Tell your baby's grandparents, aunts, uncles, child care providers, friends, babysitters, and anyone who cares for your baby. Some babies don't like sleeping on their backs at first, but most get used to it quickly. Babies who are on their backs can move their arms and legs and look around more easily.

Is there a risk of choking when my baby sleeps on his or her back?

Many mothers worry that babies sleeping on their backs will choke if they spit up or vomit while sleeping. Because babies automatically swallow or cough up such fluid, doctors have found no increase in choking or other problems in babies sleeping on their backs.

What about side sleeping?

To keep your baby safest when he or she is sleeping, use the back sleep position rather than the side position. Even though the side position is safer than sleeping on the stomach, babies who sleep on their sides can roll onto their stomachs. A baby sleeping on his or her stomach is at greater risk of SIDS. If you choose to place your baby on his or her side to sleep, make sure the lower arm is in front of the baby to help stop him or her from rolling onto the stomach.

Some products are designed to keep the baby in a certain position during sleep. But there is no proof that using any such product lowers the risk of SIDS.

Some babies have health problems that call for them to sleep on their stomachs. If your baby was born with a birth defect, spits up often after eating, or has a breathing, lung, or heart problem, you should talk to your doctor about the best sleep position for your baby.

Are there times when my baby can be on his or her stomach?

You can place your baby on his or her stomach for "tummy time," when he or she is awake and someone is watching. When the baby is awake, tummy time is good because it helps make your baby's neck and shoulder muscles stronger.

Will my baby get "flat spots" on his or her head from back sleeping?

For the most part, flat spots on the back of the baby's head are a passing condition that goes away a few months after the baby learns to sit up. Tummy time when your baby is awake is one way to reduce flat spots.

One other way to reduce flat spots is to change the direction that your baby lies in the crib (head toward one end of the crib for a few nights and then toward the other). Doing this means the baby is not always sleeping on the same side of his or her head. If you think your baby has a more serious problem, talk to your doctor or nurse.




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