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JAMA Pediatrics Patient Page
February 2017

Reducing the Risk of Sudden Infant Death Syndrome

JAMA Pediatr. 2017;171(2):204. doi:10.1001/jamapediatrics.2016.3097

Sudden infant death syndrome (SIDS), also known as crib death, is the most common cause of death in the United States for infants 1 month to 1 year of age.

While the cause of SIDS is still unknown, experts believe that it occurs when an infant has 3 risk factors. The first risk factor is an infant who is vulnerable in 1 or more ways. These include being premature or having a low birth weight and having a mother who smoked during pregnancy. There are also likely unknown genetic factors that may predispose an infant to SIDS.

The second risk factor is age. The highest-risk period is 2 to 4 months of age, with 90% of cases occurring before 6 months of age. Deaths after 1 year are generally not classified as SIDS.

The third risk factor is some sort of stressor on the baby. This has been the area of most research because some of these are things that parents can change. The single most important risk factor is the sleep position of the infant. Studies performed in the 1970s found that infants sleeping on their bellies have a much greater risk of SIDS than infants sleeping on their backs. Other risk factors are soft bedding (such as blankets and crib bumpers), parents smoking, and recent infections.

There are a number of things parents can do to decrease the risk of SIDS:

  • Place the baby to sleep on his or her back, not side or belly. Do not use wedges or positioners to try to keep the baby on his or her side.

  • Do not use pillows or blankets in the crib. Sleep sacks work great, and avoid having blankets that can cover the baby’s face during the night. Avoid overheating the baby with too many clothes or covers.

  • Remove any stuffed animals or bumpers from the crib.

  • Breastfeeding of any duration is protective and decreases the risk of SIDS.

  • Pacifiers have been shown to reduce the risk of SIDS as well.

  • Avoid cigarette smoking during and after the pregnancy.

  • Do not use home monitors or other commercial devices marketed as preventing SIDS.

When SIDS does occur, it is a tragedy for the family. Most children’s hospitals have resources and support groups for families who had a child who died of SIDS. There are also national resources available online.

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Conflict of Interest Disclosures: None reported.