Reducing your baby's risk of SIDS

Babies should sleep on their backs on a firm, sheet-covered mattress to reduce the risk of SIDS.

The nurse shook her head as she wheeled the newborn's bassinette back into the hospital nursery. "Look," she said, "the parents are already trying to put a pillow under his head!"

The infant was lying on his back -- a good thing -- but had layers of receiving blankets bunched under his head -- a big no-no. The nurse knew she had a lot of parental teaching to accomplish before the baby was discharged to his new home.

Her concern was SIDS, or Sudden Infant Death Syndrome. SIDS is defined as the unexplained sudden death of an infant under age 1. The U.S. Department of Health and Human Services notes that SIDS is the leading cause of death among babies 1 to 12 months of age, with most deaths occurring with infants between 2 and 4 months old.

Government statistics reveal a drop in recent SIDS deaths, from 6,000 infants per year in the 1980s to 2,300 in the year 2002. While we still have a lot to learn about SIDS, changes in a number of baby-care techniques appear to have contributed to this marked reduction in SIDS mortality.

The American Academy of Pediatrics revised its official SIDS policy statement in 2005. This statement outlines helpful infant sleep time practices for parents and other caregivers.

The academy's first recommendation, placing infants to sleep on their backs instead of their stomachs, has been clearly linked to a dramatic decline in SIDS deaths. In 1992, 70 percent of U.S. infants were being put to bed on their stomachs, while by 1998, use of the stomach sleep position had dropped to 20 percent. With this change, SIDS deaths fell by more than 40 percent during that same time period.

Types of infant bedding are also discussed in the AAP document. Before buying or borrowing an infant bed, parents must make sure it meets the standards of the Consumer Product Safety Commission and ASTM International.

In addition, be aware that a firm, sheet-covered crib mattress is the recommended sleep surface for infants. Pillows, quilts and stuffed toys should never be placed under a sleeping baby. These items, like all soft objects, are best kept out of the crib altogether.

Many parents also ask about the advisability of bumper pads. The AAP recommends that, if such pads are used, they should be thin, firm, well-anchored to the crib rails, and not at all fluffy or pillow-like.

A good number of first-time parents (and grandparents!) feel the need to crank up the heat with the arrival of their new little one. This practice is not only unnecessary but should, in fact, be avoided. Remember the germ theory of disease -- it's not cold air that will make your infant sick, but viruses and bacteria spread by other people in close contact with the baby.

The AAP makes the very simple recommendation that parents not over-bundle or overheat their infants. Lightweight sleep outfits are preferred, with room temperature kept at a level that is "comfortable for a lightly clothed adult."

If parents wish to use a thin blanket in the crib, tuck the blanket around the mattress so that it reaches only to chest level, not near the infant's face or head.

Other potential SIDS-reducing suggestions from the academy -- each an interesting topic in its own right -- include parents sleeping in the same room, but not in the same bed as the infant; offering the baby a pacifier as he or she is put in the crib for naps or overnight sleep; and avoiding infant exposure to tobacco smoke during pregnancy as well as after the birth.