Next Steps

Prevention

There is currently no way to predict which infants are at risk for SIDS. SIDS has been linked to certain risk factors. Therefore, eliminating or preventing these factors has reduced the risk of SIDS for many infants.

• Sleep position and the local sleep environment: Educate babysitters, day-care providers, grandparents, and everyone who cares for your baby about SIDS risk and the importance of observing the advice offered in the "Back to Sleep" Campaign.
  
  
  • Back to sleep: You should place your baby on his or her back to sleep at night and nap time.
    
    
    • You should avoid fluffy, loose bedding in your baby's sleep area.
      
      
    • Keep your baby's face clear of coverings.
      
      
    • Be careful not to overheat your baby by overdressing or adding unnecessary covers.
      
      
    • Don't allow anyone to smoke around your baby.
      
      
    • Use a firm mattress in a safety-approved crib.
      
      
    • Do not allow your baby to sleep alongside another person. The risk of unintentional smothering is too great.
      
      
    • Keep all "well-child" appointments, including immunizations.
  
  
• Home monitoring: The use of home monitoring for infants perceived to be at risk of SIDS is still controversial. Doctor-prescribed monitors are available that sound an alarm if the baby's breathing or heartbeat stops. The transthoracic electrical impedance monitors are by far the most frequently used and have the widest availability in the United States. These documenting event monitors detect the respiration and heart activity by using three electrodes. In case of breathing irregularities or decreased heart activity, the device gives off an acoustic or optical alarm. The choice of electronic monitor may measure heart rate, respiratory rate, and pulse oximetry (blood oxygen saturation), or any combination of these three parameters. The information recorded should be downloaded periodically and examined by a doctor.
  
  
  • Current studies still echo the National Institutes of Health Consensus Report on SIDS. To date, no reports scientifically demonstrate the effectiveness of home monitoring for siblings of SIDS victims (babies born after a family has had a child die of SIDS).
    
    
  • Currently, certain guidelines exist for use of home cardiorespiratory monitoring:
    
    
    • Infants with one or more life-threatening episodes in which the baby turned blue or became limp requiring mouth-to-mouth resuscitation or vigorous stimulation
      
      
    • Symptomatic preterm infants with apnea of prematurity
      
      
    • Infants with certain diseases or conditions that include central breathing irregularities
      
      
    • If families have questions related to the use of home monitors, they should seek assistance from their child's primary medical care provider
  
  
• Motor development: Recent studies have evaluated the effect of back sleeping on an infant's motor development. Babies younger than 1 year who slept on their backs showed slightly decreased upper trunk strength as reflected in mild delays in their ability to crawl, sit upright unassisted, or pull to stand.
  
  
  • However, it is important to emphasize that face-up sleepers still attained these milestones within the accepted time range for normal development. No significant difference was seen in the age when either infant group started to walk.
    
    
  • Parents should incorporate a certain amount of tummy time while the infant is awake and observed. This type of play while baby is on his or her tummy is recommended for developmental reasons and may also help to prevent flat spots on the back of the head.