A safe sleep environment—one that is free of items and features that could be dangerous to infants—reduces the risk of SIDS and other sleep-related causes of infant death. Parents and caregivers can create a safe sleep environment in the following ways:
- Always place your baby on his or her back to sleep, for naps and at night.
- Use a firm sleep surface, such as a mattress in a safety-approved* crib, covered only by a fitted sheet.
- Do not use pillows, blankets, sheepskins, or crib bumpers anywhere in your baby's sleep area.
- Keep soft objects, toys, and loose bedding out of your baby's sleep area.
- Make sure nothing covers the baby's head or face.
- Dress your baby in sleep clothing, such as a one-piece sleeper, and don't use a blanket.
- Do not smoke or let anyone smoke around your baby.
- Room-sharing—keeping your baby's sleep surface separate from your sleep surface but in the same room where you sleep—reduces the risk of SIDS and other sleep-related causes of infant death.
To learn more about safe sleep environments, check out the Safe to Sleep® publication Reduce the Risk of SIDS: What does a safe sleep environment look like? (PDF 1.7 MB).
* For information on crib safety guidelines, contact the Consumer Product Safety Commission at 800-638-2772 or http://www.cpsc.gov/en/Safety-Education/Safety-Guides/Kids-and-Babies/Cribs/.
No. Healthy infants naturally swallow or cough up fluids—it's a reflex all people have. The location of the opening to the windpipe in the body makes it unlikely for fluids to cause choking. In fact, babies may actually clear such fluids better when on their backs.
When the baby is in the back sleep position, the windpipe lies on top of the esophagus, which leads to the stomach. Anything regurgitated or refluxed from the stomach through the esophagus has to work against gravity to enter the trachea and cause choking. When the baby is sleeping on its stomach, such fluids will exit the esophagus and pool at the opening for the trachea, making choking much more likely.
Cases of fatal choking are very rare except when related to a medical condition. The number of fatal choking deaths has not increased since back sleeping recommendations began. In most of the few reported cases of fatal choking, an infant was sleeping on his or her stomach.1
Research shows that crib bumper pads or padded bassinets can cause injury or death to infants.2
Before crib safety was regulated, the spacing between the slats of the crib sides could be any width, which posed a danger to infants if they were too wide. Parents and caregivers used padded crib bumpers to protect infants. Now that cribs must meet safety standards, the slats don't pose the same dangers. As a result, the bumpers are no longer needed.
Evidence does not support using crib bumpers to prevent injuries. In addition, evidence shows that crib bumpers can cause serious injuries and death. Keeping them out of an infant's sleep area is the best way to avoid these dangers.
Infants' skulls are soft and are made up of several skull plates. These movable plates have spaces between them, called sutures, which allow the head to be flexible so that the brain can grow. If the head is left in the same position for long periods of time (such as lying on the back, or sitting in a car seat or carrier), the plates move in a way that may leave a flat spot.
Positional plagiocephaly (pronounced pley-jee-uh-SEF-uh-lee) is the term used to describe a flattened or misshapen head. Health care providers also use the term brachycephaly (pronounced bray-kee-SEFF-a-lee) to describe the flattening of the back of the skull. Positional plagiocephaly and brachycephaly often occur together.
Many cases of positional plagiocephaly can be prevented (and sometimes corrected) by repositioning the infant to remove the pressure from the back of his or her head.
It is important to note that although back sleeping may increase the risk of flat spots on the head, flat spots are much less serious than SIDS and can often be prevented and treated. Parents should not stop placing infants on their backs to sleep, but rather should be sure to offer tummy time while they are awake and use repositioning techniques. If you have concerns about the shape of your infant's head, talk with your child's health care provider.
Some breathing and heart monitors claim to be able to detect SIDS before it happens. These products might be prescribed by health care providers to manage certain medical conditions, but research shows that these monitors are not effective at detecting SIDS or reducing SIDS risk.
The NICHD-led Collaborative Home Infant Monitoring Evaluation (CHIME) study evaluated infants at high risk for SIDS to determine whether these monitors could identify situations that are dangerous to infants and perhaps reduce the risk for SIDS. The research findings led the American Academy of Pediatrics to recommend that these monitors not be used to prevent SIDS or identify infants at risk for SIDS.3
Keep in mind that breathing, heart, and other home monitors are different from baby monitors that allow caregivers to hear and/or see the infant from another room. These baby monitors often are useful for alerting caregivers that a child is awake, but they do not reduce or detect SIDS.
One of the most important things to remember when an infant dies from SIDS is that the families themselves are not to blame. The causes of SIDS remain unknown. Even though there are ways to reduce the risk, there is no definitive way to prevent SIDS from occurring.
There are a variety of resources available to help families who have lost an infant to SIDS. Talking to other parents or caregivers who have lost an infant to SIDS may be helpful. A health care provider may also be able to recommend local resources and groups.
Parents can also find support at the community and state level through the National SUID/SIDS Resource Center . The center offers resources for parents and caregivers grieving for their loss, including The Death of a Child: The Grief of the Parents, A Lifetime Journey (PDF 470 KB).
Each year in the United States, thousands of babies die suddenly and unexpectedly. These deaths are called SUID (pronounced SOO-idd) which stands for "sudden unexpected infant death."
SUID includes all unexpected deaths: those without a clear cause, such as SIDS, and those from a known cause, such as suffocation. About one-half of all SUID cases are SIDS. Many unexpected infant deaths are accidents, but a disease or something done on purpose can also cause a baby to die suddenly and unexpectedly.4
Sleep-related causes of infant death are those linked to how a baby sleeps or slept. They are due to accidental causes, such as:
- Suffocation
- Entrapment, when a baby gets trapped between two objects, such as a mattress and a wall, and can't breathe
- Strangulation, when something presses on or wraps around baby's neck, blocking a baby's airway
These deaths are not SIDS.2
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