Isn’t snuggling a newborn just about the best thing in the world? So of course it makes sense that so many of us are drawn to the idea of napping with them. Having sleepovers in our bed while they purr happily all night. Not having to get out of bed to reach them for middle-of-the-night feedings. Ah, that sounds like heaven.
But you know where I’m going with this, don’t you? We hear it all the time, and for good reason. Falling asleep with our tiny little loves is just not safe. We’re unintentionally putting them in danger and dramatically increasing the risk of SIDS.
What is SIDS?
SIDS stands for Sudden Infant Death Syndrome. SIDS is an unexplained death in a healthy infant under the age of one year old. It typically occurs in their crib or sleep area and even after a thorough investigation is complete, a true cause cannot be determined.
What causes SIDS?
The overall cause of SIDS is unknown, but researchers have identified certain factors that increase the risk of SIDS. Not all of these factors are in our control, such as:
- Respiratory infections. It has been found that many babies who have died from SIDS had a recent cold or other respiratory infection, which may have affected their ability to breathe adequately.
- Premature birth or low birth weight. In premature babies, their brains have not matured fully to regulate heart rate and breathing.
- Brain defects. Similarly to premature babies, those born with brain defects do not have mature enough brains to regulate heart rate, breathing, and/or the ability to be woken from sleep if something is wrong.
- The sex of our newborn. Males are more likely to die from SIDS than females.
- Family history. Babies with siblings or cousins who have died from SIDS have a higher chance of dying from SIDS as well.
- The SIDS age risk is highest in infants between the age of two to four months. However, the SIDS risk is still there for anyone under 1 year old.
SIDS risk factors that ARE in our control:
- Sleeping on their side or stomach has been shown to decrease their ability to breathe as well. Sleeping on their back is safest.
- Overheating from being overdressed.
- Being exposed to secondhand smoke.
- Sleeping on a soft surface. Their airway can be blocked if they’re squished down too much on a soft mattress or blanket. The same thing applies to extra bedding or stuffed animals in the bed – they can block our little one’s airway.
SIDS risk factors in place during the pregnancy:
- A mother under the age of 20 years old.
- Poor prenatal care.
- A mother who smokes, uses drugs, or drinks alcohol.
How to prevent SIDS?
Since 1992, the American Academy of Pediatrics (AAP) and National Institutes of Health (NIH) have been recommending that babies be placed on their backs to sleep for SIDS prevention. In 1994, the Back to Sleep campaign rolled out and it has been instrumental in lowering the cases of SIDS throughout the world. Having your baby sleep on his or her back is the most important thing you can do for their safety. This is essential for their first year of life or until they can safely roll from back to stomach AND stomach to back on their own. This is often referred to as safe sleep.
Now, speaking from a NICU perspective, NICU babies are often positioned on their stomachs and sides while in the hospital. Positioning devices are used, they are constantly on a monitor, and they are being watched very closely by the NICU nurses. This is okay for hospitalized infants. The NICU nurses should be educating you – the parents – on the Back to Sleep campaign and what to do when you get home with your newborn. Also, as the baby gets closer to being discharged, the nurses will transition them to back sleeping as well.
Other very important things you can do to lower SIDS risk factors:
- Hold your baby skin-to-skin immediately after birth, if possible. Skin-to-skin contact in your baby’s early days is very important.
- Anytime you are getting sleepy, put your baby in their own bed. This is sad news, yes, but it’s SO important. Are you exhausted and the only time your baby sleeps is when you’re holding him or her? Give your partner a turn while you nap! Or grandma! Or your friend or neighbor! Then baby gets to snuggle and you get some sleep.
- Make sure babe’s bed is clear of everything. No pillows, blankets, stuffed animals, cute decorations on the railings, etc. No crib bumpers or mesh netting either. Just a plain ol’ bed with a very snug fitted sheet over the mattress.
- No blankets?! Let’s talk about that. No loose blankets. Your baby may be swaddled in a thin blanket. The nurses should teach you how to do this in the hospital before you go home! There are also cute little pajama + swaddle + blanket combos that are acceptable, such as sleep sacks. Swaddled babies must still be placed on their backs for sleep. Once your baby can roll back and forth from stomach to back on their own, you should stop swaddling them (this could be as early as 2 months of age).
- If you dress your baby in a long sleeved onesie and swaddle them, they will be okay and will not get too cold. Generally speaking, dress your baby in just one extra layer than you would wear – that is enough for them. Keep the temperature in the house consistent for how you would be comfortable – you don’t need to crank the heat way up. Remember one of our risks from the list above: an overheated baby is at a higher risk of SIDS.
- Use a firm mattress for baby’s bed. We don’t want something plush that tucks the baby into any indents – if they roll over at all, that just leaves a wall around them that will potentially block their airway. Never put baby down to sleep on the couch or snuggle them on the couch if you’re getting sleepy.
- If your little one falls asleep in a swing or car seat or anything beyond an awake person’s arms or a firm surface – move them to their bed. (It is inevitable that your baby will fall asleep everywhere you put them, such as in the car seat while you’re driving. This is okay. Just make sure once you get home, you move them to their bed instead of leaving them in the car seat to sleep.)
- Giving your babe a pacifier at bedtime has been shown to reduce the risk of SIDS. No need to stay up all night to make sure they keep the pacifier in their mouth (spoiler alert: they won’t). Just offer it when you put them down initially. (Breastfeeding mamas: most experts suggest waiting until your baby is breastfeeding well before offering a pacifier.) Pacifiers that are attached to stuffed animals should not be used.
- Even though you can’t share your bed, you do get to share your room! Yay! Bringing a bassinet, crib, or playpen into your room during the first year of life has been shown to reduce the risk of SIDS by 50%. Wow! You can more easily check on your love throughout the night and hear if they’re struggling for some reason. And not only that, but it makes those middle-of-the-night feedings much easier.
- Maintain a smoke-free home.
- Stay on track with all of baby’s well-check visits with the pediatrician and keep them up to date on immunizations.
- Exclusive breastfeeding for 6 months has been shown to reduce the risk of SIDS.
- Make sure your baby gets some tummy time each day, while they are awake. This will help develop strength and motor skills for your little one, eventually helping them learn to roll back and forth on their own. This also prevents flat spots from developing on the back of the head.
What about home breathing monitors?
There are special mattresses, monitors, and alarms available on the market that claim to reduce the risk of SIDS. There have not been enough studies on these so they should not be relied on to keep your baby safe.
What about babies who have reflux or spit up while they are sleeping?
This is a very common concern because of course we don’t want our babies spitting up and then choking on it. We have a tendency to want them on their sides or stomach so they don’t choke. Studies have shown that our babies will be able to protect their airway, even in events such as these. Sleeping on their back has still been proven to be the safest for them. And as an added protection, if your baby is sleeping in your room (not your bed!), you will likely hear them spit up and can assist them if needed.
Hopefully we see a day where SIDS is a thing of the past. We have already come so far and there are people diligently researching SIDS around the clock to find more answers. If you or anyone you know has experienced a loss due to SIDS, we at Kinsa are deeply sorry. Not all cases of SIDS can be prevented, but together, we can educate everyone in our circle to prevent someone else from going through the same hardship, and to keep more precious lives intact.
Blake Wageman, RN, BSN has over 11 years of nursing under her belt, primarily focused on NICU babies and, just as importantly, their worried parents. She also has two daughters who have kept her on her toes from birth all the way into their tween years. Blake’s passion is giving parents not only the information, but also the comfort and confidence they need to make good decisions for their kiddos.
This content is intended for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis or treatment from an appropriately qualified and licensed physician or other healthcare provider.