According to the NHS, SIDS, or cot death, is defined as “the sudden, unexpected and unexplained death of an apparently healthy baby.” Most SIDS cases are in infants below 6 months of age. SIDS is determined as the cause of death only when no other cause can be determined. Since 1991, when awareness campaigns and preventive measures were shared across the globe, SIDS has taken much fewer lives. In the UK today, however, there are still more than 200 babies taken by SIDS every year.
Doctors and researchers cannot as yet say for certain what causes SIDS, but the general consensus is that it is brought about by a combination of different factors. For instance, SIDS appears to occur at a certain stage of development. It also affects babies who are vulnerable to particular environmental stresses such as entanglement in bedding, co-sleeping, breathing obstructions, or a minor illness. This vulnerability is furthermore commonly the result of such circumstances as premature birth and low birth weight. Not all the reasons have been identified yet. Babies who are unable to properly respond to these stresses, such as regulating their breathing, heart rate and temperature, may become victims of SIDS.
Parents can greatly reduce the risk of SIDS by following these best practices:
Sleeping Position
Babies should be slept on their backs and not on their stomachs or sides, unless your pediatrician has advised otherwise due to a medical condition.
When your baby is able to roll over and seems to find sleeping on their stomachs more comfortable, it can be a challenge to maintain the supine sleeping position. To keep them safe from SIDS, you can gently roll them back onto their backs and observe whether this change of position was a coincidence or a preferred position. If the latter, try giving them more time on their stomachs during waking hours so they can enjoy it and then feel batter on their backs when they sleep. In any case, you should do so to help their development. Always supervise them while in this position. SIDS usually occurs during sleep, but can occur even while the baby is awake.
Sleeping Area
The safest place to sleep your baby for the first six months is in a separate cot or Moses basket, but in the same room as you, even for day naps. Your baby should not sleep with you, even if it’s just for a nap on the sofa or in an armchair. This puts your baby at higher risk for SIDS. One-sixth of infants in England and Wales who died of SIDS were found sleeping with an adult on a sofa. If you are breastfeeding, take steps to ensure that you do not fall asleep without first putting your baby in a safe place to sleep.
Print out this Back to Sleep Fact Sheet from Lullabye Trust as an easy reference for safe sleep comfort.
Sharing a bed with your baby can be very dangerous, especially if anyone in the bed is extremely tired or a heavy sleeper, a smoker, has drunk alcohol or taken medication that can cause drowsiness, or your baby was born at 37 weeks or less or had a birth weight of under 2.5kg. If you still choose to share a bed with your baby, make sure that the bed is clear of loose bedding or anything that can crowd your baby and obstruct their breathing or cause them to overheat. Use fitted beddings made of breathable material, such as bamboo sheets and pillowcases, to further reduce the risks of suffocation.
Your baby should sleep on a flat, firm mattress that will not allow their head to sink in and obstruct their breathing. The mattress should furthermore fit their cot perfectly to prevent folds or gaps that can cause suffocation or injury, or disrupt their sleep comfort. When your baby cannot achieve sleep comfort, they will likely become restless, which can cause them to seek a different position that can be dangerous.
Make sure that your baby’s bedding is flat and not bulky. This includes pillows and bumpers. Sleep comfort is important, but just like loose bedding, bedding that is too soft or fluffy can be a hazard. Firmly tuck in your baby’s bedding and sleep them at the bottom of the cot. This allows you to measure just enough bedding or a well-fitted baby sleeping bag to cover them up to their shoulders, and prevents them, from moving down to where the bedding can cover their faces. Don’t leave toys in the cot, either, as these can also obstruct breathing.
Download and print this Mattress and Bedding Fact Sheet to help you create a safe and comfortable sleeping area for your baby.
Sleeping Temperature
Temperature is important for sleep comfort, quality, and safety. The best room temperature for babies is around 16 -20°C – use a thermometer to measure the room’s temperature. Not all babies are alike, however, and some may sleep hotter than others. Check your baby’s tummy or the back of their neck to test whether it feels hot or sweaty, then adjust the room temperature or add or remove a layer of bedding as needed. This ensures that they are not too hot, which can increase the risk of SIDS.
Note that babies who are unwell should not be wrapped up too tightly or with thick swaddling, but allowed to feel cool. They should not wear hats or use thick bedding since these can be dangerous. If the room is too cold, adjust the temperature or sleep them in warmer clothing or a fitted sleeping bag for babies. The best bedding to keep them at a good temperature all the time is thermo-regulating bamboo material.
Download and print this Safer Sleep guide for quick reference. For more information, visit the Lullaby Trust.