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How Do You Reduce the Risk of Sudden Infant Death Syndrome (SIDS)?

Posted Date: 6/10/2015
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SI Parent June 2015
Ask the Doctor

Dr. Santosh Parab


How Do You Reduce the Risk of Sudden Infant Death Syndrome (SIDS)?


As the name implies, Sudden Infant Death Syndrome (SIDS) is the sudden and unexplained death of an infant who is younger than 1 year old. It's a frightening prospect because it can strike without warning, usually in seemingly healthy babies. Most SIDS deaths are associated with sleep (which is why it is commonly referred to as "crib death") and infants who die of SIDS show no signs of suffering. A lack of answers is part of what makes SIDS so frightening. SIDS is the leading cause of death among infants 1 month to 1 year old, and claims the lives of about 2,500 each year in the United States.

Most diseases are usually diagnosed by the presence of specific symptoms; most SIDS diagnoses come only after all other possible causes of death have been ruled out through a review of the infant's medical history, sleeping environment, and autopsy.

There is not a single factor which leads to SIDS, but usually a combination of physical and sleep environmental factors which make an infant more vulnerable to SIDS. These factors may vary from child to child.

Most deaths due to SIDS occur between 2 and 4 months of age, and incidence increases during cold weather. African-American infants are twice as likely and Native American infants are about three times more likely to die of SIDS than Caucasian infants. More boys than girls fall victim to SIDS. Babies who've had siblings or cousins die of SIDS are at higher risk.

There's no guaranteed way to prevent SIDS, but you can help your baby sleep more safely by following these tips:

  • Back to sleep. Place your baby to sleep resting on his or her back, rather than on the stomach or side. This isn't necessary when your baby's awake or able to roll over both ways without help. Don't assume that others will place your baby to sleep in the correct position — insist on it. Advise sitters and child caregivers not to use the stomach position to calm an upset baby. Because babies sleeping on their sides are more likely to accidentally roll onto their stomach, the side position is just as dangerous as the stomach position.
  • Keep the crib as bare as possible. Use a firm mattress and avoid placing your baby on thick, fluffy padding or a thick quilt. Don't leave pillows, fluffy toys or stuffed animals in the crib. These may interfere with breathing if your baby's face presses against them. Place your baby on a firm mattress, covered by a fitted sheet that meets current safety standards.
  • Don't overheat baby. Avoid letting the baby get too hot. The baby could be too hot if you notice sweating, damp hair, flushed cheeks, heat rash, and rapid breathing. Dress your baby lightly for sleep. Set the room temperature in a range that is comfortable for a lightly clothed adult. To keep your baby warm, try a sleep sack, swaddling or other sleep clothing that doesn't require additional covers. Don't cover your baby's head.
  • Baby should sleep alone. Your baby's sleeping in the same room with you is a great idea, but adult beds aren't safe for infants. A baby can become trapped and suffocate between the headboard slats, the space between the mattress and the bed frame, or the space between the mattress and the wall. A baby can also suffocate if a sleeping parent accidentally rolls over and covers the baby's nose and mouth. Baby can sleep in your room but she has to sleep in their own bed.
  • Offer a pacifier. Put your baby to sleep with a pacifier during the first year of life. If your baby rejects the pacifier, don't force it. Pacifiers have been linked with lower risk of SIDS. If you're breastfeeding, try to wait until after the baby is 1 month old so that breastfeeding can be established.
  • Avoid heart rate and breathing baby monitors, as well as other commercial devices that claim to reduce the risk of SIDS. The American Academy of Pediatrics discourages the use of monitors and other devices because of ineffectiveness and safety issues.

Mothers should not smoke, drink, or use drugs while pregnant. Infants of mothers who smoked during pregnancy are three times more likely to die of SIDS than those whose mothers were smoke-free; exposure to secondhand smoke doubles a baby's risk of SIDS. Researchers speculate that smoking might affect the central nervous system, starting prenatally and continuing after birth, which could place the baby at increased risk.

Mothers are recommended to receive early and regular prenatal care and babies should have regular well-baby checkups. Breastfeeding is also recommended. There is some evidence that breastfeeding may help decrease the incidence of SIDS. The reason for this is not clear, though researchers think that breast milk may help protect babies from infections that increase the risk of SIDS.

Your baby's health care provider is always available to answer any questions you have about SIDS, prevention, and keeping your baby safe.


Santosh Parab, M.D., practices Neonatal-Perinatal Medicine and maintains a practice affiliated with Richmond University Medical Center on Bard Avenue in Staten Island. For more information visit the health library, which offers articles, quizzes, videos and more at