It’s scary to think that you could do something as normal and safe as putting your baby down for a nap, and he might not wake up. But it happens more often than it should, unfortunately. About 3,500 infants die suddenly and unexpectedly each year in the United States. The cause of death for many of these babies can’t be determined, but there are things you can do to make sure your baby has a safe sleep environment.

So what are those things we can do to help babies sleep safely?

First and foremost, place your baby on his or her back for all sleep times, including naps. They should sleep on a firm, flat sleep surface (such as a mattress) in a safety-approved crib with no soft bedding or soft toys. Avoid using a couch, soft chair, car seat, swing, bouncy seat, stroller, infant carrier, or infant sling for routine sleep. Instead of soft bedding, keep babies comfortable with clothing or put them in a sleep sack or a wearable blanket. Health officials also recommend keeping your baby’s sleep area in the same room (but not in the same bed) where you sleep until your baby is at least 6 months to 12 months old.

What do we know about sudden unexplained infant deaths?

Sudden Unexpected Infant Death (SUID) is defined as a death that occurs suddenly and unexpectedly for an infant of less than 1 year old. It includes deaths without a clear cause, such as Sudden Infant Death Syndrome (SIDS), and those from a known cause, such as accidental suffocation and strangulation. Sudden Unexpected Infant Death is the fourth leading cause of death for Idaho children younger than 1 year old. There are many things we don’t know about Sudden Unexpected Infant Death, but there are some things we have learned, including:

• Infants are more vulnerable between the second and fourth months of their lives.
• Breastfeeding for the first six months seems to lower the risk.
• Sucking on a pacifier at bedtime may reduce the risk. However, do not hang the pacifier around a baby’s neck.

One of the hallmarks of sudden and unexpected infant deaths is the “sudden” part. Is there any way to know if your baby’s risk is higher than normal?

No, there really isn’t. It is unpredictable and strikes seemingly healthy babies without warning. Putting your baby to bed in a safe sleep environment is critical. A mother’s behavior during pregnancy also can have an impact, including whether or not she smoked, took drugs or drank alcohol, and had proper prenatal care. The risk also seems to increase for premature babies or those with a low birth weight, and for mothers who were younger than 20 when they gave birth.

So we know that putting babies to sleep on their backs is safer than their bellies or their sides. But couldn’t they choke on their spit-up or vomit?

That is a common concern for parents, and if you have that concern, you should discuss it with your medical provider. However, the American Academy of Pediatrics has reported no increased risk of choking for babies who sleep on their backs. In fact, since the organization recommended in 1992 that babies sleep on their backs, the rate of Sudden Unexpected Infant Death has dropped by more than 50 percent.

Resources

• Safesleep.dhw.idaho.gov
• Centers for Disease Control and Prevention: http://www.cdc.gov/sids/aboutsuidandsids.htm
• Helping Babies Sleep Safely
• What does a safe sleep environment look like?