SIDS Recommendations

It’s perhaps the worst thing parents could experience: finding their newborn baby has quietly died while sleeping overnight.

Sadly, this happens too often as a result of SIDS--sudden infant death syndrome. Although some specific cases have been understood, the cause of many cases of SIDS is still unknown. SIDS is the most common cause of infant deaths beyond the first month of life in the U.S.

“Every day is something new, the smiles, the giggles…his personality is developing now. It’s so much fun,” says Cori Attali, clearly enjoying every aspect of being a new mom to five-and-a-half month old Jack.

To understand SIDS, imagine for a moment a scenario that is deeply disturbing, but important to consider. A baby is alive and happy in the crib one moment, and dead the next moment, with little indication as to why it happened.

That is exactly what occurs with SIDS- healthy babies, suddenly, inexplicably, dying.

Dr. Peter Tesler, the Chief of Ambulatory Pediatrics at St. Luke’s Roosevelt Medical Center, says, “There are some theories that the child may suffocate, may get caught underneath something like a soft object, and be unable to move out of a position once they get into trouble. But the absolute physiology behind SIDS cases is still unclear.”

Since the public education campaign called Back To Sleep was started in 1994, the death rate from SIDS has been reduced by more than 50%. Measures against SIDS advocated by Back To Sleep included not putting children to sleep on their stomachs, keeping stuffed soft toys out of the crib, not using heavy blankets, and not smoking while pregnant.

Now the American Academy of Pediatrics has issued an updated policy statement, advising that parents not put their children to sleep on their sides either. The experts believe that putting the child to sleep on the back is the only way to go to prevent SIDS.

“He rolls onto to his side by himself. If he’s on his side I’ll put him back on his back,” says Cori.

Bed sharing is certainly not recommended, since it puts the baby at great risk of SIDS. But there is a growing body of research which says that putting the baby’s crib in the parent’s bedroom is associated with a reduced risk for SIDS.

And perhaps the biggest revelation involves the use of pacifiers. A review of the medical literature has found they can prevent SIDS deaths. “What the American Academy of Pediatrics is suggesting is that babies use pacifiers when first going to sleep, either night sleep or a nap, that if they don’t take the pacifier it should not be forced on them. If it falls out you don’t need to put it back in,” says Dr. Tesler.

Each approach is a baby step, but combined, they are making a difference at achieving the ultimate goal of eliminating this frustrating cause of death in healthy infants.

You should not start pacifier use until the baby is one month old, after breast feeding is well established. Again, it should be stopped at 1 year of age, when the risk of SIDS markedly diminishes.

Some are concerned about teeth formation and ear infections with pacifier use, but under a year, and certainly before the baby is six months old, these are not significant issues.

For more information, go to our website at www.aap.org.