Safe Sleeping For Baby – Reducing The Risk Factors For SIDS

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Nearly two decades after public health campaigns began promoting sleep safety for babies, many parents and caretakers are still unaware of the habits that may lead to sudden infant death syndrome, or SIDS. Although the incidence of SIDS has dropped dramatically over the last ten years, it still remains the leading cause of death among infants aged 28 days to 12 months.

Two main factors associated with SIDS are bed sharing (co-sleeping) and putting your baby to sleep on her tummy, and there continues to be heated debate from advocates of both approaches. However, ongoing research clearly indicates there are a number of factors to be aware of. SIDS is not necessarily related to just one or two factors, but more likely to be the result of multiple factors, not all of which are within a parent’s control. 

But first, let’s consider perhaps the most controversial factor associated with SIDS... bed sharing. This is when mum and/or dad sleep in the same bed as their baby.  Sometimes done deliberately and sometimes done out of sheer exhaustion, it has become a hot topic among child sleep experts and parents alike. 

There is no doubt that it's best for babies to be within sensory distance from their mum. Bed sharing advocates argue that bed-sharing makes night time breast-feeding easier, and ultimately both mum and baby thrive with less sleep disruption.  The physical closeness they enjoy whilst sleeping together is also beneficial to the baby’s development, since the baby's stress hormones are shown to reduce, and her oxygen intake stablises when she enjoys physical contact with her mother.  Researchers at the University of Notre Dame have even speculated that through a bed-sharing situation a mum has increased sensitivity to her baby, and may instinctively awaken if her baby's breathing changes.

However, repeated scientific studies continue to provide irrefutable evidence that bed-sharing increases the risk for SIDS, as well as the child's risk of suffocation. A baby can become suffocated by a sleeping parent, become trapped between the mattress and pillow, or suffocated by adult-sized bedding.  There is even evidence that a baby placed alone in an adult bed may be suffocated, as adult bedding is often much softer than a crib mattress and can compress inwards restricting air flow around the baby.  Babies have very compressible chests when they're little, as well as tiny little heads and tiny noses and tiny mouths. If these get covered, it's very dangerous.

Tummy sleeping has also been shown to be a significant contributing factor in some SIDS cases. This is when a baby is placed to sleep on their tummy rather than on their side or back.  In some studies, nearly a third of babies who died of SIDS had been placed on their tummies.

But new research is indicating that there are also other contributing factors associated with SIDS.  Over 75% of SIDS cases are shown to have at least one, and nearly 60% at least two, of the risk factors mentioned in this article, including emerging significant risk factors such as:

  • Age of the baby - the risk of SIDS is greatest in the first year of life, and infants are most vulnerable during the second and third months of life
  • Sex of the baby - boys are more likely to die of SIDS than girls
  • Premature babies and babies with a sibling or cousin who died of SIDS face a higher risk
  • Pre and post natal exposure to cigarette smoke and/or alcohol
  • Over wrapping a baby or covering its face with blankets
  • Serotonin deficiency - recent studies suggest some infants may be vulnerable to SIDS due to a serotonin deficiency.  Serotonin is a brain chemical that helps regulate breathing, temperature, sleeping, waking and other functions. Serotonin normally helps babies respond to high carbon-dioxide levels in sleep by helping them wake and shift head position. When face down, exhaled carbon dioxide may pool in bedding and be breathed back in.

What is absolutely clear is that parents who are under the influence of drugs or alcohol should never sleep in the same bed as their babies, nor should obese parents or parents who smoke.  Parents should never sleep with their infants on a couch, beanbag or water bed - only a safe, firm mattress with light natural fibre bedding and no excess pillows, soft toys or throws. 

We recommend room sharing, rather than bed sharing.  Children are safest sleeping alone in a safety-approved bassinette or cot that has a firm mattress and tight-fitting sheets, without blankets, pillows and other soft materials.  We suggest using a sleeping bag rather than a cot duvet ,which can easily slip over a baby’s head!  Choosing natural fibre bedding for your infant is preferable since air flows more freely, and body temperature can be better regulated by fibres such as merino and wool – creating a drier, safer, healthier environment for your baby to sleep and grow in.