SIDS (Safe Sleep)
What is Sudden Infant Death Syndrome (SIDS)?
Sudden Infant Death Syndrome is the sudden death of a baby from unknown causes before the baby is one year old. Most SIDS deaths occur when babies are between one and four months old. 
- For more facts about SIDS, see the SIDS Fact Sheet from the National Institute for Child Health and Human Development. It also contains a list of SIDS support organizations.
How do I reduce the risk of SIDS?
Healthy babies should sleep on their backs. Putting your baby to sleep on his or her back is one of the most important things you can do to reduce the risk of SIDS.
To reduce the risk of SIDS and keep your sleeping baby safe:
- Put your healthy baby to sleep on his or her back for naps and at night.
- You can let your baby have awake “tummy time” during the day, when an adult is there to watch the baby. “Tummy time” is important for your baby’s development and also will help prevent positional plagiocephaly or flattened head.
- Babies who are put down on their sides, and then roll onto their bellies are especially at risk.[1]
- Make sure your baby sleeps on a firm surface.
- Do not put soft materials like pillows, comforters, sheepskins or stuffed animals in bed with your baby.
- Make sure your baby’s crib is safe. Here is a crib safety checklist from the American Academy of Pediatrics.
- When traveling, beware of hotel and motel cribs—many are not safe.
- Don’t let your baby share a bed with sibling [2]
- Don’t use soft or loose bedding [2]. Blankets should come to baby’s chest and be securely tucked on both sides under the mattress. You can also skip the blankets altogether, and simply dress your baby in warm sleep clothing. Just make sure your baby is not overheated.
- Keep the room temperature comfortable—not too warm, and don’t over-bundle your baby. [3]
- Don’t let anyone smoke around your baby. A recent study showed that nicotine interferes with a brain protein key in breathing.[4]
- If you are pregnant, get early and regular prenatal care, and don’t smoke.[4]
- Breastfeed your baby. Research is inconclusive (some studies say “yes,” and some say “no”) on whether breastfeeding is a protective factor [3]; however, even if it does not reduce the risk of SIDS, breastfeeding will benefit you and your child in many other ways! (See Your Child: Feeding Your Child.)
- Be sure to talk to anyone caring for your baby, such as childcare providers, friends, sitters, or grandparents about the safe sleep practices above. Research has shown that a large proportion of SIDS deaths occur in childcare settings [5]. When a baby is used to sleeping on their back, and then is put tummy-down to sleep, their risk of SIDS is greater [2]. Consistency is key, and goes for naps as well as nighttime sleep. Because of the higher risk in childcare, the American Academy of Pediatrics has started the Healthy Child Care America Back to Sleep Campaign.
Do not use infant sleep positioners.
CPSC and the FDA are warning parents and child care providers to:
- STOP using sleep positioners. Using a positioner to hold an infant on his or her back or side for sleep is dangerous and unnecessary.
- NEVER put pillows, infant sleep positioners, comforters, or quilts under a baby or in a crib.
- ALWAYS place an infant on his or her back at night and during nap time. To reduce the risk of SIDS, the American Academy of Pediatrics recommends placing infants to sleep on their backs and not their sides.
Find out more about the warning and see what sleep positioners look like: Deaths prompt CPSC, FDA warning on infant sleep positioners.
What if my baby doesn’t like sleeping on their back?
Given a little time to adjust, your baby will probably grow used to sleeping on their back. Read what one expert has to say about the question of babies who don’t seem to like it on their backs. The fact is: your baby’s risk of SIDS is much greater on their tummy than on their back.
Is it safe to sleep in a family bed (co-sleep) with my baby? 
Doctors do not all agree on whether co-sleeping is safe. Their concern is based on statistics that show that half of all child suffocation deaths occur in adult beds due to overlaying or suffocation in bedding. Therefore, many experts recommend not sleeping with your baby at all. Other doctors, however, believe co-sleeping can be safe if the necessary safety precautions are taken.
If you choose to sleep with your baby, here are the safety precautions to follow:
- Healthy babies under six months should sleep on their backs.
- Do not sleep with your baby if you have had drugs or alcohol, are extremely tired, or for any other reason may have reduced awareness of your baby [3] [4] [6]. Even some prescription or over-the-counter medication, such as pain-killers, antihistamines or sleep-aids can reduce your awareness of the baby.
- Breastfeeding moms tend to be more aware of baby than the co-parent, so put baby between mom and the wall or side rail, until the other parent develops a good nighttime awareness of the baby. Be sure there are no crevices in which your baby could become trapped.
- Don’t sleep on soft surfaces with your baby—like waterbeds, pillows, comforters, soft mattresses, beanbags, or couches. Sleeping on a couch with a parent is associated with a higher risk of infant death. [6]
- Do not use soft, loose bedding [2], such as comforters or quilts [6]. Dress your baby in sleep clothing of similar warmth to what you are comfortable wearing. Remember that sleeping with other warm bodies will keep your baby warmer.
- Make sure your bed is baby-safe. It should not have spaces between the mattress and wall, side rail, headboard or footboard, bed frame sides, or other furniture. Do not use side rails, headboards, or footboards that have slats or cutouts that could entrap the baby’s head. Mesh insert side rails are safest.
- Obese parents should be extra cautious.
- If you smoke, do not co-sleep with your baby, [7] [8] [9] [10] [11] and never smoke around your baby, or allow anyone else to do so.
- Keep curtains, blinds, and dangling strings well away from the bed and out of baby’s reach.
- Only one baby or child at a time should share the bed with parents.
- Don’t allow other children [2] —not even siblings—or adults other than parents to sleep with the baby.
- Room-sharing with parents was found to lower the risk of SIDS [6] in a British study. If bed-sharing is not for you, but you want to keep your baby close, consider a crib or co-sleeper in your room or up next to your bed for easy breastfeeding at night.
How can I find out more about babies, SIDS and sleep safety?
- American Academy of Pediatrics Policy Statement on Changing Concepts of Sudden Infant Death Syndrome: Implications for Infant Sleeping Environment and Sleep Position.
- SIDS: "Back to Sleep" Campaign Spanish brochures from the National Institute of Child Health and Human Development:
- Ponga al bebé a dormir sin peligros: Reduza el riesgo del sindrome de muerte súbita del bebé
- Ponga al bebé a dormir boca arriba
- MEDLINEplus: Sudden Infant Death Syndrome has many links to more information.
- Here is a discussion of co-sleeping safety and research interpretation from William Sears, M.D.
- Alan Greene, M.D. discusses SIDS, The Family Bed, & The U.S. Consumer Products Safety Commission.
- Reduce the Risk of Sudden Infant Death Syndrome is a 5-page brochure that addresses myths and facts, steps to reduce risk, and common questions.
- The CPSC has many resources in both English and Spanish on crib safety and SIDS prevention.
What are some organizations that work on the issues of SIDS and infant death?
These groups may be able to provide counseling and support if you have lost a baby to SIDS.
- In Michigan: Tomorrow's Child (formerly Michigan SIDS Alliance). Call 800-331-7437.
- The American SIDS Institute
- The National SIDS Resource Center
- The Association of SIDS and Infant Mortality Programs
- First Candle/SIDS Alliance
Reviewed by faculty and staff at the University of Michigan
Updated October 2005
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U-M Health System Related Sites:
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