According to the American Academy of Pediatrics,

"Place babies to sleep on their backs to reduce the risk of SIDS. Side sleeping is not as safe as back sleeping and is not advised." 

Safe sleeping practices not only make for a happy, healthy baby, but also help develop routines that improve sleep quality for both the baby and the caregivers!  A well-rested baby is a happy baby.  And a happy baby means happy parents!

What is SIDS?

SIDS stands for sudden infant death syndrome.  SIDS involves the unexplained death of an infant during sleep.  The exact cause of SIDS is unknown, but several risk factors have been identified.  One leading idea about the cause of SIDS states that some infants are born with abnormal or immature brain function in the area that controls breathing and wakefulness. 

SIDS is the leading cause of death in infants between 1 month and 1 year of age.  In the United States, about 2200 deaths occur each year due to SIDS.

The best way to prevent SIDS is to place an infant on her back during sleep.  This and the other "safe sleeping" strategies below should be followed.

Safe sleeping for infants includes:

• Sleeping infants should be placed on their backs, not on the side or stomach
• Safety-approved cribs and mattresses only
• Cribs should be free of toys, stuffed animals, pillows, and extra bed linens
• Sleep clothing is safer than blankets
• A single blanket can be used if tight fitting, tucked into the sides of the bed, reaches the infant's chest, and the infant's feet reach the end of the bed
• Only one baby per crib
• A comfortable room temperature that does not require heavy clothing (an adult should feel comfortable in a T-shirt)
• Do not use wedges or sleep positioners
• No smoking near the infant at any time
• Avoid jewelry on the infant (necklaces, bracelets, earrings, etc.)
• "Tummy time" is encouraged when the infant is awake and being watched by an adult
• Avoid cosleeping
• Make sure all caretakers know the above

Should my infant sleep in bed with me?

No.  Medical research has determined that infants that sleep outside of a safe crib and specifically those infants who sleep with the parent on a bed or sofa (called "cosleeping") are at an increased risk for sudden infant death syndrome (SIDS).

Other risk factors for SIDS include:

• The mother consumed more than 2 alcoholic drinks in past 24 hours
• The mother smoked during pregnancy
• The infant was swaddled during the last sleep
• The infant was found lying on the stomach
• The infant was premature (born before 37 weeks gestation)
• The infant was placed on a pillow
• The infant was ill or sick in the past 24 hours

Should my baby go to bed with a bottle or pacifier?

Bottle - no.  Pacifier - yes.

Infants that go to bed with a bottle (especially when it is propped up with a pillow or blanket) are at an increased risk of choking and aspiration.  Older children who are allowed to fall asleep with a bottle in their mouths are at increased risk for dental cavities.

Pacifiers are safe and there is some evidence that use of a pacifier actually reduces the risk of SIDS.  Infants older than about 1 month of age may use a pacifier unsupervised.  Pacifiers should not be secured in place, coated with sugar, or inserted in the mouth of a sleeping infant.

References

1. BMJ. 2010;340:b3666.
2. CDC.gov.  http://www.healthychildcare.org/pdf/SIDSparentsafesleep.pdf, accessed Sept. 24, 2010
3. Hagan JF, Shaw JS, Duncan PM, eds. 2008. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, Third Edition. Elk Grove Village, IL: American Academy of Pediatrics.
4. McInerny TK, Adam HM, Campbell DE, Kamat DM, Kelleher KJ, eds. American Academy of Pediatrics Textbook of Pediatric Care. Elk Grove Village, IL: American Academy of Pediatrics; 2009.

Photo by Jacqueline Godany, Pacifier. WikiMedia Commons, 2005.

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