Safe Infant Sleep Social Media Live Event

SIDS is one type of sudden unexpected infant death (SUID). SUID also includes accidental suffocation in a sleeping environment, and other deaths from unknown causes. The public health and medical communities recognize limitations of the term SIDS and its use to classify infant deaths. However, because many parents and caregivers are familiar with the term SIDS, it is important to continue educating families on the risk and protective factors that are common between SIDS and other sleep-related infant deaths.

Babies receive multiple vaccines when they are between 2 to 4 months old. This age range is also the peak age for sudden infant death syndrome (SIDS). The timing of the 2-month and 4-month shots and SIDS has led some people to question whether they might be related. Multiple research studies and safety reviews have looked at possible links between vaccines and SIDS. The evidence accumulated over many years do not show any links between childhood immunization and SIDS. See Sudden Infant Death Syndrome (SIDS) and Vaccines.

There is no evidence that there is a causal relationship between immunizations and SIDS. Though not well understood, evidence suggests that vaccination may even have a protective effect against SIDS. As such, a Task Force on SIDS by the American Academy of Pediatrics, or AAP, recommends that infants be immunized in accordance with recommendations of the AAP and Centers for Disease Control and Prevention. See SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment.

Per the American Academy of Pediatrics Updated 2016 Recommendations for a Safe Infant Sleeping Environment, soft objects like pillows, pillow-like toys, quilts, comforters, sheepskins and loose bedding, including non-fitted sheets, blankets and should be kept away from the infant’s sleep area to reduce the risk of SIDS, suffocation, entrapment, and strangulation. Infant sleep clothing, such as a wearable blanket, is preferable to blankets and other coverings to keep the infant warm while reducing the chance of head covering or entrapment that could result from blanket use.

The AAP has no evidence to recommend swaddling as a strategy to reduce SIDS. We do know the baby is at risk if the baby is swaddled and then placed on their stomach or rolls onto their stomach. The swaddle restricts their movement, and it is difficult for them to get out of the stomach position when they are swaddled. If caregivers swaddle their baby, they should make sure that the baby is always on his or her back when swaddled. The swaddle should not be too tight or make it hard for the baby to breathe or move his or her hips. When the baby looks like he or she is trying to roll over, caregivers should stop swaddling. Caregivers should also be careful to avoid baby becoming overheated. When swaddling, caregivers should watch for signs of overheating, such as baby sweating or the baby’s chest feeling hot to the touch.

Sitting devices, such as car seats, strollers, swings, infant carriers, and infant slings, are not recommended for routine sleep in the hospital or at home, particularly for young babies. Babies who are younger than 4 months are particularly at risk, because they may get into a position that can create a risk of suffocation or airway obstruction or may not be able to move out of a potentially dangerous situation. If a baby falls asleep in one of these locations, as soon as possible, he or she should be moved to a safe sleep surface such as a crib or bassinette.

Your baby’s safety is most important. Babies who are put to sleep on their tummies are twice as likely to die of SIDS. Parents and caregivers should place babies on their backs to sleep even if they seem less comfortable or sleep more lightly than when on their stomachs. There are other tools, such as swaddling or white noise that we can use to calm a fussy baby. Although swaddling is not a SIDS risk-reduction strategy, it is known to help calm fussy babies and promote back sleeping. Just a reminder, swaddling should be discontinued at the first sign of the baby trying to roll over. White noise, such as radio/tv static, rain, or small motors like a fan, can also help babies sleep better. You can discuss your questions or concerns about how your baby sleeps with your pediatrician and visit online resources such as Frequently Asked Questions (FAQs) About SIDS and Safe Infant Sleep .

Supervised ‘tummy time’ during baby’s waking hours is an important way to prevent flat spots on baby’s head. This practice promotes normal growth, such as making baby’s muscles stronger and improving motor skills. This is also a great way to use those baby blankets and comforters as a surface for baby to lie on for tummy time! Learn more at Baby’s Need Tummy Time! from NICHD.

AAP recommends that “infants sleep in the parents’ room, close to the parents’ bed, but on a separate surface designed for infants, ideally for the first year of life, but at least for the first 6 months. Placing the crib close to the parents’ bed so that the infant is within view and reach can facilitate feeding, comforting, and monitoring of the infant. Room-sharing reduces SIDS risk and removes the possibility of suffocation, strangulation, and entrapment that may occur when the infant is sleeping in the adult bed.”

According to AAP, pacifiers can reduce the risk of SIDS, which occurs most commonly between 2-4 months of age. It is not clear how pacifiers help reduce sleep related deaths, but increased wakefulness resulting from pacifier use may be one potential mechanism for the protective effect of pacifiers on SIDS. The protective effect is observed even if the pacifier falls out of the infant’s mouth.

The AAP’s policy statements (Breastfeeding and the Use of Human Milk and SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment) recommend that introduction of pacifiers for breastfed infants be delayed until breastfeeding is firmly established, which is generally within the first few weeks.