Sudden Unexplained Infant Death/Sudden Infant Death Syndrome
PRESENTED BY THE HEALTHY START COALITION OF SARASOTA COUNTY
Includes infant deaths due to the following causes:
• accidental suffocation and strangulation in bed
• other accidental suffocation and strangulation
• sudden infant death syndrome
• unknown causes
• A sub-group of SUID
• Sudden death of an infant under one year of age
that remains unexplained after a complete
investigation, which includes an autopsy,
examination of the death scene, and review of the
symptoms or illnesses the infant had prior to dying
and any other pertinent medical and family history.
Some SIDS babies are born with brain abnormalities
that make them vulnerable to sudden death during
infancy. Studies of SIDS victims reveal that many SIDS
infants have abnormalities in a portion of the brain
that is involved in control of breathing and waking
during sleep. These abnormalities may stem from
prenatal exposure to a toxic substance, or lack of a vital
compound in the prenatal environment, such as
• Mothers who smoke during or after pregnancy
• Mothers who are <20 years old at the time of first
• Mothers who had no or late prenatal care
• Mothers with too short an interval between pregnancies
• Premature or low birth weight babies and multiples
• African American infants are nearly two-and-a-half
times more likely to die of SIDS than white infants, and
Native American babies are approximately three times
as likely to die from SIDS.
• Male gender
• Fall/winter season
• Higher parity
SIDS is the leading cause of death in infants between
1 to 12 months old.
Most SIDS deaths occur when a baby is between
2 and 4 months old.
Ninety percent of SIDS victims die before
6 months old.
The diagnosis of SIDS is not commonly
used after 1 year old.
• Placing babies on their backs to sleep is the single
most important step that parents and other
caregivers can take.
• Infants who fall asleep on their stomachs should be
gently turned onto their backs.
• Studies show that placing babies on their backs have
reduced their total SIDS deaths by more than 50%.
• Side sleeping position is not a safe alternative. Babies
that roll from their side to their tummy are 18 times
more likely to die of SIDS.
When a baby is on his/her back, the trachea (airway) lies on top of the esophagus
(food path). Anything (spit-up, food) that is in the esophagus will have to go
AGAINST GRAVITY to be inhaled into the trachea (airway).
Picture courtesy of Dr. Fern Hauck
• Sleep is lighter.
• They awaken more easily.
• Parents should make sure their baby sleeps on a firm,
flat mattress in a crib that meets current safety
• Avoid using soft, fluffy or loose bedding or other
objects in the crib, and should not use pillows,
sheepskins or comforters under the baby.
• Bumpers are not necessary, and soft or pillow-like
bumpers should be avoided.
• Consider using a sleeper or other sleep clothing as an
alternative to blankets, with no other covering. Infants
under 1 year of age should not be placed to sleep on
an adult bed, waterbed, sofa or with stuffed toys or
• Do not share a sleep surface.
• Bring baby into bed to feed and cuddle, put place
them in a separate, safe sleep area alongside your
bed when its time to go to sleep.
• Infants should not sleep with parents whose
instincts are impaired by exhaustion, drug or
alcohol abuse, or who are smokers.
• There are also dangers connected with infants
sharing a bed with brothers, sisters, or relatives
other than the baby’s mother.
• Sofas and chairs are particularly dangerous
environments for shared sleep.
Among Black and White women, frequent bed sharing was
more likely among those who-» <25 years of age or >34 years of age
» U.S. born
» Experienced partner-associated stress
» Breastfed for > 4 weeks
Among Black women, frequent bed sharing was also more
likely among those who-» Started PNC after the 1st trimester or had no prenatal care
» Breastfed for ≤ 4 weeks
» Experienced depression during or after pregnancy
» Black mothers who experienced depression were 7.5
times more likely to bed share than Black mothers
who did not experience depression.
• Breastfeeding has been shown to be good for babies
by building their immunity against illness and
infections, in addition to other benefits. Mothers
should be encouraged to breastfeed exclusively for
at least the first six months if at all possible.
• Breastfeeding can reduce the risk of death for
infants in their first year of life. (Up to 720 postneonatal deaths in the U.S. each year. )
• Mothers who smoke during pregnancy are three
times more likely to have a SIDS baby, and exposure
to passive smoke from smoking by mothers, fathers,
and others around the baby after its born doubles
their risk of SIDS. Parents should be sure to keep
their babies in a smoke-free environment.
• Studies have found that the risk of SIDS rises with
each additional smoker in the home, the numbers of
cigarettes smoked a day, and the length of the infant’s
exposure to cigarette smoke.
• Components of smoke are believed to interfere with
an infant’s developing lungs and nervous system, and
to disrupt a baby’s ability to wake from sleep.
• Recent research has shown that pacifiers can
significantly reduce a baby’s risk for SIDS. Experts
recommend providing the baby with a pacifier
EVERY time they are placed down to sleep.
• One theory suggests that pacifier use might help to
keep the tongue positioned forward, keeping the
• On the other hand, pacifiers may stimulate the
upper airway muscles and saliva production,
possibly triggering brain activity and ability to
arouse from sleep. Increased arousability is seen in
infants who usually sleep with a pacifier, even if the
pacifier is not being used.
• Babies should be kept
warm, but they should not be
allowed to get too warm. An
overheated baby is more likely
to go into a deep sleep from
which it may be hard to wake
up. Keep the temperature in
the baby's room at a level that
feels comfortable to a lightly
clothed adult and avoid
overdressing the baby.
• Babies who routinely sleep on
their backs and are unaccustomed to
sleeping on their stomachs are at a
significantly increased risk of SIDS
when placed prone by a well intentioned
but ill-informed relative or caregiver. Be sure to
communicate Back to Sleep information to baby
sitters, daycare providers, grandparents and
everyone else who cares for your infant.
• As much "tummy time" as possible while the infant
is awake and being observed is recommended for
motor development of the upper body muscles. In
addition, tummy time may also help prevent flat
spots from developing on the back of the baby's
head. Never leave your baby unattended during
tummy-time. If the baby tires or is sleepy, place
them on their back in a safe sleep area.
• Many parents do not believe that the supine position
reduces the risk of SIDS
• Infant safety and infant comfort are competing reasons for
how a parent places an infant for sleep
• Many parents place infants prone for safety reasons
• Many African-American parents roomshare for economic
reasons (no other place for the baby to sleep)
• An important reason that African-American parents
roomshare and bedshare is their belief that this is the best
way to keep their infant safe
• Efforts to encourage roomsharing without bedsharing must
address parental concerns about safety
Task Force on Sudden Infant Death Syndrome. "The
Changing Concept of Sudden Infant Death Syndrome:
Diagnostic." Pediatrics 115.5 (2005): 1245-255. Print.
"SIDS Q & A." Web.