Research has explored what causes SIDS (sudden infant death syndrome), but hasn’t shown that baby sleep positioners prevent SIDS. Here’s a summary of SIDS research, and how to prevent sudden infant death. Also, a health educator from Penn State University Children’s Hospital shares why baby sleep positioners aren’t necessary.
Sudden infant death syndrome (SIDS) is when an infant suddenly and unexpectedly dies before the first birthday. The death remains unexplained even after a comprehensive evaluation consisting of a complete autopsy, a death scene investigation and a review of medical history of the infant and the family. Here, I briefly share research about the causes of SIDS, and highlight what a children’s hospital health educator says about baby sleep positioners.
What Causes SIDS?
Many research studies suggest that one of the potential causes of SIDS may be an abnormality in the brainstem that would prevent an infant from responding to breathing challenges, such as those posed by prone (on the stomach) sleep in soft bedding. The number of infants who die each year from sudden infant death syndrome (SIDS) has decreased in recent decades as awareness of safe sleeping habits has increased. Yet each year, babies still die from sudden, unexplained causes.
Most parents know that it’s best for infants to sleep on their backs, rather than on their sides or bellies. But other caregivers may not know the best way to prevent SIDs – especially if they raised their children when there was less awareness about safe sleeping habits and preventing SIDS in babies.
SIDS is the third leading cause of infant death, according to the Centers for Disease Control (CDC). SIDS is decreasing because we’re learning about safe sleep practices for newborns and infants. Safe sleep practices for babies are the best way to prevent SIDS – and baby sleep positioners aren’t necessarily one of those practices.
Below, I share a list of tips for preventing SIDS and several safe sleep practices for babies.
New research points to accidental asphyxiation as a cause of SIDS
Research from the University of Adelaide’s School of Medical Sciences helped uncover the possible causes of sudden infant death syndrome (SIDS). Their study compared 176 children who died from head trauma, infection, drowning, asphyxia and SIDS. Researchers found telltale signs in the brains of babies that died of SIDS are remarkably similar to those of children who died of accidental asphyxiation.
“This is a very important result,” says Roger Byard, Professor of Pathology at the University of Adelaide and Senior Specialist Forensic Pathologist with Forensic Science. “It helps to show that asphyxia rather than infection or trauma is more likely to be involved in SIDS deaths.”
In one SIDS case studied by this professor, the presence of APP staining in a baby who had died of sudden infant death syndrome led to the identification of a significant sleep breathing problem – obstructed sleep apnea – in the deceased baby’s sibling. This raised the possibility of an inherited sleep apnea problem, which could help save the other child’s life.
Research still needs to determine with certainty if there an asphyxia or suffocation-based mechanism of death in SIDS.
Other causes of sudden infant death
Many SIDS deaths occur when parents practice bed sharing – sleeping with the baby between mom and dad in a regular bed. If you want your infant nearby when you sleep, it’s best to practice room sharing instead of co-sleeping. The best way to prevent SIDS is to place your baby in a separate crib or cradle, close to your bed but not in it.
Mothers who tend to drift off to sleep while breastfeeding their babies run the risk of having their babies wedge into the crevice of their arm and suffocate. Another possible cause of SIDS is exposure to second-hand smoke on an adult’s clothing or in the home environment.
Baby Sleep Positioners and SIDS
Leigh Brown, a health educator at Penn State Hershey Children’s Hospital’s Pediatric Trauma Injury Prevention Program, said a baby’s sleeping environment during the first year of life is one of the biggest factors in causing and preventing SIDS deaths.
Crib bumpers, extra blankets, stuffies shouldn’t be in a baby’s crib
Items such as crib bumpers, extra bedding, stuffed animals and loose sheets and blankets can cause suffocation for infants who aren’t yet able to roll or extract themselves from dangerous situations.
However, some parents notice their babies don’t stay on their backs when sleeping – and that’s when a swaddle may come in handy. In fact, I know a mother who tightly swaddles her three month old daughter every night, and the baby sleeps for ten hours!
Parent reviews on baby swaddles on Amazon are very positive. Moms have been making swaddles out of sheets, blankets, and even towels for centuries, but a baby swaddle may be easier to use.
For instance, the Safe T Sleep Classic Sleepwrap Baby Swaddle for bassinets, cribs and single beds isn’t a baby sleep positioner. It’s a swaddle that allows for natural movement while providing security for the baby.
To prevent SIDS, put a tight-fitting sheet on the crib mattress
“It’s confusing for parents because in the media you see these cribs that look all cute and soft and comfortable, when all you really need is a mattress with a tight-fitting sheet,” says Brown.
In terms of crib and baby bedding, the best way to prevent SIDS is with a simple crib mattress for infants. A sheet that fights tightly around the mattress won’t get tangled up, or accidentally smother the baby.
“People have the misconception that babies are freezing, but overheating them is a risk factor as well,” she says. “If you are comfortable in your house, babies probably are as well.” If you must use a blanket with an infant, she suggests tucking it in tightly along the sides and bottom of the crib and no higher than the infant’s armpit. To prevent SIDS, you want to avoid putting anything near your baby’s face.
Baby sleep positioners don’t prevent SIDS
Brown says parents shouldn’t spend their money on items such as baby sleep positioners, which claim to prevent or reduce the risk of SIDS and create a safe sleeping environment. She says baby sleep positioners haven’t proven to be safe.
“Nor do parents need to worry about the infant rolling from back to side or belly during sleep,” says Brown. “If your baby is able to roll, he or she is likely able to avoid suffocation.”
To prevent SIDS, avoid the following:
- Exposure to tobacco smoke
- Pillows, quilts and soft or loose bedding in the baby’s crib
- Any face covering
- A shared sleep surface during sleep (co-sleeping with parents)
- Bumper pads should not be used in cribs. There is no evidence that bumper pads prevent injuries, and there is a potential risk of suffocation, strangulation or entrapment.
- Wedges and baby sleep positioners should not be used.
- Do not use home monitors or commercial devices marketed to prevent SIDS.
Safe sleep practices include:
- Breastfeeding, because it is associated with a reduced risk of SIDS.
- Immunization for infants. Evidence suggests that immunization reduces the risk of SIDS by 50 percent.
- Place your baby on his or her back for every sleep time.
- Use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep.
- Room-sharing, but not bed-sharing).
- A pacifier at nap time and bedtime.
- Supervised, awake tummy time is recommended daily to facilitate development and minimize the occurrence of positional plagiocephaly (flat heads).
Researchers from the American Academy of Pediatrics add that SIDS and other sleep-related infant deaths risk factors are different for younger and older babies. They encourage parents to follow their recommendations for a safe sleep environment. And, don’t forget that different factors reflect risk for a baby’s death at different developmental stages.
Improving your baby’s sleep
In The Happiest Baby on the Block, Dr Harvey Karp blends modern science and ancient wisdom to prove that newborns are not fully ready for the world when they are born. Through his research and experience, he has developed basic principles that are crucial for understanding babies, as well as improving their sleep and soothing their senses.
For instance, he believes all babies have a “Missing Fourth Trimester.” As odd as it may sound, one of the main reasons babies cry is because they are born three months too soon. Dr Karp describes The Calming Reflex, which is an automatic reset switch to stop crying of any baby in the first few months of life.
And Dr Karp shares the 5 “S’s”: the simple steps (swaddling, side/stomach position, shushing, swinging and sucking) that trigger the calming reflex. For centuries, parents have tried these methods only to fail because, as with a knee reflex, the calming reflex only works when it is triggered in precisely the right way. He teaches parents exactly how to guide cranky infants to calm and easy babies to serenity in minutes…and help them sleep longer too.
Sources: 1) Simple steps can lead to safe sleep for infants via Penn State News; 2) Study Identifies that Multiple Risk Factors Existed in 78 Percent of Sudden Infant Death Syndrome Cases by Robert Wood Johnson Medical School at Rutgers; and 3) AAP Expands Guidelines for Infant Sleep Safety and SIDS Risk from the American Academy of Pediatrics.